- Elevance Health (Irving, TX)
- …and billing department to address issues. + Ability to review and interpret clinical records to ensure patient meets medical policy guidelines for coverage, for ... ability beyond intake calls that include verifying eligibility and benefits for medical and pharmacy payers through multiple methods for specialty chronic and acute… more
- Elevance Health (Grand Prairie, TX)
- …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners ... non-routine reviews. Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing… more
- CenterWell (Beaumont, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care...manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by… more
- CenterWell (San Antonio, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...manner working with a quality- based coder to optimize coding specificity. + Follows policy and protocol defined by… more
- CenterWell (Beaumont, TX)
- …treats center patients in accordance with standards of care. . Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. . Acts as...manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by… more
- Elevance Health (Houston, TX)
- …and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches new healthcare related questions as ... provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:** + Coding Certificate or Registered Nurse strongly preferred + Law Enforcement… more
- MD Anderson Cancer Center (Houston, TX)
- …in both direct and indirect patient care situations using information from clinical history, medical records , and imaging to ensure the clinical needs of the ... malfunctions to the DI Engineering Team, Physics team, supervisor and manager with appropriate information readily available. 6. Performs general x-ray procedures… more
- CenterWell (Weatherford, TX)
- …for normality, fax a copy of lab to doctor, make a copy for the Case Manager , and route to Medical Records Department. Initiate Employee / Patient Infection ... + Prior packet review / QI experience preferred. + Coding certification is preferred. + Must possess a valid...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Citigroup (Irving, TX)
- …relational database. In-depth knowledge in Documentum client application D2, Documentum Administrator, Records Manager , DFC and WDK based application. + In-depth ... + Utilize advanced knowledge of system flow and develop standards for coding , testing, debugging, and implementation + Develop comprehensive knowledge of how areas… more
- CenterWell (Humble, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... quality of patient care using available data and chart reviews. + Complete all medical record documentation in a timely manner, working with a quality-based coder to… more