- Humana (Austin, TX)
- …audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support ... and interprets medical documentation to ensure capture of all relevant coding . Identifies members with high-risk CMS Hierarchical Condition Categories (HCC) and… more
- ManpowerGroup (Dallas, TX)
- …7-10 Years **Client Industry:** Banking / Financial Services Preferred Interview: CODING TEST FOLLOWED BY VIDEO/ON-SITE INTERVIEW **Job ID: Connect with RECRUITER ... solutions in a real-time transaction environment. If you're passionate about financial-grade coding , security, and system design and ready to own your impact; this… more
- System One (Frisco, TX)
- …key part in maintaining the clinic's financial health by managing billing, coding , and reimbursement processes. If you're passionate about accuracy, compliance , ... the billing system. + Maintain current knowledge of payer policies, coding guidelines, and neurology-specific procedures (EEG, EMG, Botox, Infusions, Ambulatory EEG,… more
- CGI Technologies and Solutions, Inc. (Dallas, TX)
- …key client stakeholders, including executive leadership, claims operations, finance, compliance , and clinical teams. * Lead client discovery sessions, workshops, ... including pre-payment review, post-payment audit, FWA detection and prevention, coding accuracy, clinical integrity, and provider data management. * Leverage… more
- Molina Healthcare (San Antonio, TX)
- …complex business challenges that impact cost containment and regulatory compliance . The position requires strong business judgment, cross-functional coordination, ... and solutions that drive measurable improvement. + Partners with finance and compliance to develop business cases and support reporting that ties operational… more
- HCA Healthcare (San Antonio, TX)
- …clinical documentation for evidence of co-morbid conditions. Verifies accuracy of coding under direction of attending Rehab physician. 2. Responsible for staff ... supervisors in areas needing improvement to support and validate rehab criteria compliance . Serves as an information source and educator to IRF-PAI users. Serves… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …workflow for the pre-authorization process. + Provide instruction and guidelines on coding and pre-authorization processes to faculty, residents and staff. + Assist ... with departmental expectations/requirements. + Stay current with changes in coding guidelines, regulations and insurance requirements. + Assess and monitor… more
- Sabre (Dallas, TX)
- …+ Ensure that security gates do not hinder velocity but maintain compliance . + Establish and maintain application security standards, baselines, and processes (eg, ... OWASP, SANS, CERT, NIST). + Provide subject matter expertise in secure coding , application architecture reviews, and threat modeling. + Maintain audit readiness and… more
- Qualtrics (Dallas, TX)
- …on and lead major projects, and dive into complex development via hands-to-keyboard coding that will scale the platform into the future. **How You'll Find Success** ... of the ServiceNow platform **Things You'll Do** + Technical Development: Apply technical/ coding expertise to complex development, code reviews, & technical designs +… more
- Elevance Health (Grand Prairie, TX)
- …and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud ... aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations....Requires a AA/AS and minimum of 4 years medical coding /auditing experience, including minimum of 1 year in fraud,… more