- Humana (Austin, TX)
- …manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an appeal or further request is ... warranted. The Appeals Representative 4 IRT (Internal Review Team) + Review documents + Building cases + Inventory Management + Data Entry **Use your skills to make an impact** **Required Qualifications** + 2 or more years of Appeals experience + 1 or more… more
- Gentiva (Woodville, TX)
- …diagnostic tests as permitted by state law. + Maintain timely, accurate clinical documentation in compliance with professional standards. + Communicate ... effectively with physicians, caregivers, and other healthcare professionals. + Participate in evening/weekend call rotation as needed. + Facilitate referrals for additional care services when appropriate. **About You** **Specialized Knowledge/Skills:** +… more
- Caris Life Sciences (Irving, TX)
- …guidelines and general laws related to all payers. + Basic knowledge of clinical documentation review for alignment with insurance authorization requirements + ... Basic knowledge of CPT, ICD-10 + Meets productivity/performance standards as set forth by management. **Preferred Qualifications** + Prior experience working with Insurance providers in a payor setting. + Must possess professionalism, superior organizational… more
- Datavant (Austin, TX)
- …adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and ... severity of a patient's health status. **You will:** + Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for the project. + The coder will ensure compliance with established ICD-10 CM, third… more
- Gentiva (Bellaire, TX)
- …team, ensuring timely and appropriate interventions. + Maintain accurate, up-to-date clinical documentation and follow infection control and compliance ... standards. + Support the organization's quality improvement and scheduling initiatives to ensure care is consistent, compassionate, and efficient. + Help patients and families understand and navigate topics such as: * Medication administration * Hospice… more
- Baylor Scott & White Health (Marble Falls, TX)
- …payor forms related to notification and authorization. Coordinates the submission of clinical documentation from physicians to payers for authorization needs. ... Calculates accurate patient financial responsibility. Communicates timely with Utilization Review, and collaborates effectively with physician and facility staff to ensure financial clearance of the patient?s account prior to scheduled or unscheduled service… more
- Baylor Scott & White Health (Plano, TX)
- …forms related to notification and authorization. + Coordinates the submission of clinical documentation from physicians to payers for authorization needs. + ... Calculates accurate patient financial responsibility. + Communicates promptly with Utilization Review. Collaborates effectively with the physician and facility staff. Ensures financial clearance of the patient's account before any service during the hospital… more
- BrightSpring Health Services (Temple, TX)
- …counseling, crisis intervention, and emotional support + Maintain accurate and timely clinical documentation + Educate and assist with advance directives + ... Provide referrals and practical support for patients and families + Serve as liaison with community resources and agencies + Collaborate with team members to support holistic patient care + Support funeral, financial, and legal planning with families Benefits… more
- WelbeHealth (Austin, TX)
- …Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our ... teams on best practices to promote compliance. **Essential Job Duties:** + Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants + Conduct pre-visit chart preparations and post-visit chart reviews +… more
- Caris Life Sciences (Irving, TX)
- …guidelines and general laws related to all payers. + Basic knowledge of clinical documentation review for alignment with insurance authorization requirements + ... Basic knowledge of CPT, ICD-10 + Meets productivity/performance standards as set forth by management. **Preferred Qualifications** + Previous experience with Business-to-Business (B2B) communications. + Must possess professionalism, superior organizational… more
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