• CDQI Nurse Specialist - Part Time - Remote

    Datavant (Austin, TX)
    …to realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist , you will play a pivotal ... Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients. + Demonstrate understanding of… more
    Datavant (11/11/25)
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  • Prior Authorization Specialist

    Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
    **43332BR** **Extended Job Title:** Prior Authorization Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for ... workflow for the pre-authorization process. + Provide instruction and guidelines on coding and pre-authorization processes to faculty, residents and staff. + Assist… more
    Texas Tech University Health Sciences Center - El Paso (12/20/25)
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  • Patient Therapy Access Specialist

    Abbott (Plano, TX)
    …location in **Plano, TX** currently has an opportunity for a **Patient Therapy Access Specialist ** (PTA). This is an in office 5 days a week position. Preferred ... hours 8am to 5pm. As a PTA Specialist you are responsible for facilitating and assisting Abbott...for requested authorizations. + For each procedure, audit required clinical documents for completeness and accuracy. + Obtain authorization… more
    Abbott (11/18/25)
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  • Medical Collections Specialist

    HCA Healthcare (Houston, TX)
    …We care like family! Jump-start your career as a Medical Collections Specialist today with HCA Healthcare. **Benefits** HCA Healthcare offers a total rewards ... location._** Come join our team as a Medical Collections Specialist . We care for our community! Just last year,...on accounts to ensure prompt payment You will identify coding or billing errors from EOBs and work to… more
    HCA Healthcare (12/07/25)
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  • Insurance Collections Specialist - CBO

    HCA Healthcare (Austin, TX)
    …is recognized. Submit your application for the opportunity below:Insurance Collections Specialist - CBOSurgery Ventures **Benefits** Surgery Ventures offers a total ... vary by location._** We are seeking an Insurance Collections Specialist - CBO for our team to ensure that...accounts to ensure prompt payment + You will identify coding or billing errors from EOBs and work to… more
    HCA Healthcare (10/30/25)
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  • Referral Specialist II - Paragon Healthcare

    Elevance Health (Plano, TX)
    …our specialty pharmacies, our infusion centers, and the home setting. **Referral Specialist II - Paragon Healthcare** **Location: TX-PLANO, 3033 W PRESIDENT GEORGE ... accommodation is granted as required by law.** The **Referral Specialist II** is responsible for providing support to a... II** is responsible for providing support to a clinical team in order to facilitate the administrative components… more
    Elevance Health (12/18/25)
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  • Patient Account Specialist - RCO PB…

    UTMB Health (Galveston, TX)
    Patient Account Specialist - RCO PB Follow-Up **Galveston, Texas, United States** **New** Business, Managerial & Finance UTMB Health Requisition # 2507282 ... or one year of patient accounts experience. **JOB SUMMARY:** The Patient Account Specialist will be responsible for billing all third-party payers through a claims… more
    UTMB Health (12/31/25)
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  • Insurance Authorization Specialist

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Insurance Authorization Specialist position is responsible for obtaining and managing insurance authorizations for medical services and ... interactions with patient's, co-workers, insurance companies, physicians, and other clinical and administrative partners. **PEOPLE ESSENTIAL FUNCTIONS** + Promotes a… more
    Houston Methodist (11/06/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Houston, TX)
    …make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical ... audit activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions. + Utilizes… more
    Elevance Health (12/09/25)
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  • RN Clinical Appeals Nurse Remote

    Molina Healthcare (San Antonio, TX)
    …Office suite/applicable software program(s) proficiency. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals...Utilization Review and/or Medical Claims Review experience. Knowledge in coding : DRG, ICD-10, HCPCS codes is highly preferred. Additional… more
    Molina Healthcare (01/02/26)
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