- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California market **Job Description** Responsible ... in accordance with procedures or to present to management to recommend for audit or investigation. Serves as a corporate resource on fraud, waste and abuse… more
- Elevance Health (Grand Prairie, TX)
- …and reference information to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality standards as ... state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years… more
- Houston Methodist (Houston, TX)
- …uses problem-solving, troubleshooting skills and as appropriate, performs the final review and audit of all required documentation for the clearance of new hires and ... HR staff to ensure accuracy, as directed. Prepares reports when needed. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS** + Ensures the accuracy and compliance of data within… more
- MD Anderson Cancer Center (Houston, TX)
- …Cancer Institute. *Job Summary* We are seeking a highly motivated Regulatory Compliance Specialist to support clinical trial operations. This role is responsible ... EDUCATION PREFERRED - Master's Degree EXPERIENCE REQUIRED - 3 years experience in clinical research, regulatory compliance, or quality assurance OR 1 year… more
- Molina Healthcare (San Antonio, TX)
- …+ Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare ... **JOB DESCRIPTION** **Job Summary** Clinical Appeals is responsible for making appropriate and...Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases… more
- Ascension Health (Austin, TX)
- …**Additional Preferences** + 5 years RN or 3-5 CDI quality audit experience strongly preferred + Prior adult clinical documentation leadership experience ... the time of the offer._ **Responsibilities** Manage the daily operations of the clinical documentation area. + Manage and provide education regarding the clinical… more
- CVS Health (Austin, TX)
- …each and every day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This role plays a ... a passion for continuous improvement. This position will sit within our Coding Quality Operations team and offers the flexibility of working from home. **Position… more
- Elevance Health (Houston, TX)
- …preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + ... of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to...information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality… more
- Highmark Health (Austin, TX)
- …retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... terminology and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from… more
- Houston Methodist (Houston, TX)
- …Blood and Marrow Research (CIBMTR) reporting. This position evaluates productivity, quality , and education related to the CIBMTR registry, and responds to ... The Registry Coordinator RN position provides support for the CIBMTR Data Specialist team, including training, auditing, and providing feedback on staff performance… more