• Inpatient Audit Specialist

    Datavant (Austin, TX)
    …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... Academic/Trauma Level 1 facility. **What You Will Do:** + Performs Inpatient Facility coding audits according to scope of work, for the purpose of Onboarding,… more
    Datavant (07/29/25)
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  • Early Careers - Audit Specialist Intern

    Health Care Service Corporation (Richardson, TX)
    …of or experience with BlueChip claims processing is a strong plus. + Knowledge of quality review processes is a strong plus. + Ability to analyze problem claims ... internship is in Richardson, TX **What Are Your Responsibilities?** The Audit Specialist Intern responsibilities may include assisting with claim accuracy audits… more
    Health Care Service Corporation (09/27/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding . **Job Summary** Utilizing clinical knowledge and experience, ... decision making pertinent to clinical experience + Documents clinical review summaries, bill audit findings and ...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience + Familiar with… more
    Molina Healthcare (09/06/25)
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  • Director of Revenue Integrity

    UTMB Health (Galveston, TX)
    …Health Care Administration. + Experience in billing/ coding , collections, claims, and quality and integrity audit review . **Equal Employment Opportunity** ... in payer requirements in a timely manner. + Ensures quality measurements, such as charge audits and compliance driven...of CDM, regulatory compliance, ICD-10, and CPT-4 medical record coding and UB04 billing. + Knowledge and understanding of… more
    UTMB Health (09/19/25)
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  • Director, Prospective + Concurrent Risk Adjustment…

    Datavant (Austin, TX)
    …and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review ). You will manage ... regulations and best practices related to prospective risk capture and concurrent review . **Compliance & Quality :** + Partner with Legal, Compliance, and… more
    Datavant (08/08/25)
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  • Vendor Resource Management Team Lead

    HCA Healthcare (Arlington, TX)
    …the monthly random, focus, prebill review , and Ad Hoc quality review process + Submits and reviews coding appeals as appropriate **What qualifications ... with vendor management including monitoring processes and services for improvement, coding quality , trending/analyzing data, creating and presenting education,… more
    HCA Healthcare (09/27/25)
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  • Home Health Quality Assurance Auditor

    Humana (Corpus Christi, TX)
    …a part of our caring community and help us put health first** The Quality Assurance, Clinical Professional 1 consults and collaborates with clinicians to ensure high ... accountability of compliance and quality . The Quality Assurance, Clinical Professional 1...all records meet federal, state, and payer-specific standards, reducing audit risk and financial exposure. The QA Auditor will… more
    Humana (10/01/25)
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  • Inpatient Medical Coder - PRN - Up to $1,000 Sign…

    Datavant (Austin, TX)
    …preferably within an academic medical facility. + Experience with significant level of coding quality review feedback + Experience in computerized encoding ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
    Datavant (09/24/25)
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  • Claims Auditor (Remote)

    WTW (Dallas, TX)
    …of project + Clearly communicate and professionally interact with vendor and audit team + Review documentation of potential discrepancies for thoroughness ... **Description** As a Lead Auditor you will apply your audit , project management and client management skills to lead client audits. You will serve as the team leader… more
    WTW (09/26/25)
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  • Director of Payment Integrity Consulting

    CGI Technologies and Solutions, Inc. (Dallas, TX)
    …on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity, ... on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity,… more
    CGI Technologies and Solutions, Inc. (09/25/25)
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