- Elevance Health (Houston, TX)
- ** Clinical Provider Auditor II** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration and ... an accommodation is granted as required by law. The ** Clinical Provider Auditor II** is responsible for...you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies… more
- Elevance Health (Grand Prairie, TX)
- ** Clinical Provider Auditor II** **Supports the Payment Integrity line of business** **Hybrid 1** : This role requires associates to be in-office **1-2** days ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II** is responsible for identifying issues… more
- HCA Healthcare (Houston, TX)
- …recognized. Submit your application for the opportunity below: Inpatient Coding Quality Auditor Parallon. **This is a fully work from home position.** **This ... by location._** We are seeking an Inpatient Coding Quality Auditor for our team to ensure that we continue...Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr. Internal Auditor is responsible for independently planning, coordinating, and executing reviews of processes or activities of Houston ... in achieving organizational objectives including the adequacy of internal controls, compliance with laws and regulations, adherence to policy and procedures,… more
- Humana (Austin, TX)
- …with business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance , ... requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional, you will develop and/or evaluate compliance policies… more
- Highmark Health (Austin, TX)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim… more
- Insight Global (Houston, TX)
- …A large healthcare employer in Houston, TX is seeking a Physician Educator & Auditor to join their growing team. This team will consist of provider auditors and ... to ensure the documentation is correct and effective from a coding and clinical perspective. The ideal candidate needs to be comfortable building rapport with… more
- Houston Methodist (Houston, TX)
- …TX, LA, FL, TN, WA or GA** At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and ... based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory body guidelines. This position… more
- CVS Health (Austin, TX)
- …part in ensuring coding accuracy and data integrity, directly impacting compliance and financial performance. Ideal candidates will bring a strong understanding ... purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and… more
- Humana (Austin, TX)
- …us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical records and assigns appropriate ... medical coding, analytics, health record security and privacy, HIPAA compliance , and data governance. + Hold at least one...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
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