• Coding Data Quality Auditor

    CVS Health (Austin, TX)
    …and Federal regulations and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + ... and internal policies and procedures. + Utilize medical records to ensure support is documented for etiology and manifestations of disease processes. + Adhere… more
    CVS Health (08/09/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers. **Job Duties** ... Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. + Provides training and support to clinical peers. + Identifies and refers members with special… more
    Molina Healthcare (08/08/25)
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  • Clinical Quality Consultant NP 100% Virtual,…

    Elevance Health (TX)
    …accountability for the HCC/Risk Adjustment of goals and workflows to support value capture initiatives and high-quality clinical documentation. + Chart reviews ... in charts. + Provide feedback to the provider for improved documentation to support specific codes. **Minimum Requirements:** + Requires an MS in Nursing and… more
    Elevance Health (08/08/25)
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  • Special Investigation Unit (SIU) Coding Review…

    CVS Health (Austin, TX)
    …we do it all with heart, each and every day. The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations ... mentor a team of CPCs, providing training, guidance, and support in coding practices and medical record reviews. +...absence of the director, ensuring continuity of operations and support . + Develop and implement training and onboarding programs… more
    CVS Health (08/08/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Fort Worth, TX)
    …must be licensed for the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer candidates ... plan such as Utilization Review, Medical Claims Review, Long Term Service and Support , or other specific program experience as needed or equivalent experience (such… more
    Molina Healthcare (08/02/25)
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  • Manager Revenue Cycle - Self-pay Collections

    Houston Methodist (Katy, TX)
    …N/A **LICENSES AND CERTIFICATIONS - PREFERRED** + CPC - Certified Professional Coder (AAPC) -- or equivalent if overseeing revenue integrity related functions ... a subject matter expert in assigned area to provide support for staff + Knowledge of full revenue cycle...adjusts processes and procedures based on the changes with support from the Director **SUPPLEMENTAL REQUIREMENTS** **WORK ATTIRE** +… more
    Houston Methodist (07/31/25)
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  • Palantir Foundry Developer

    Jacobs (Houston, TX)
    We're looking for a Palantir Foundry Developer to work on innovative solutions that support Jacobs' diverse range of projects and programs around the globe. In your ... * Lead developer on Foundry and AIP solutions and projects. * Support other developers, some learning Palantir, on project teams. * Architect solutions… more
    Jacobs (07/29/25)
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  • Physician

    CenterWell (El Paso, TX)
    …care supported by analytics and tools, and deep community relationships. This robust support allows our PCPs to see fewer patients and spend more time with ... medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined by Clinical… more
    CenterWell (07/25/25)
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  • Coding Educator FT-Katy CC

    Houston Methodist (Houston, TX)
    …is captured accurately. + Performs/Leads performance improvement activities that support operational efficiencies, data integrity and service quality including ... for best practices. + Strives to improve and enhance support to the Hospital and System and seeks opportunities...AND CERTIFICATIONS - PREFERRED** + CPC-I - Certified Professional Coder Instructor (AAPC) -- (CBO Coders only) **OR** +… more
    Houston Methodist (07/23/25)
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  • Non-Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Austin, TX)
    …OASIS Review and Coding Manager. The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome ... coding on the plan of care and accurate OASIS documentation. + Provide support and communication to all disciplines within the service. + Provide customer… more
    BAYADA Home Health Care (07/01/25)
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