- Molina Healthcare (Houston, TX)
- …appropriateness of services provided, length of stay, level of care, and inpatient readmissions. + Validates member medical records and claims submitted/correct ... coding , to ensure appropriate reimbursement to providers. + Resolves...(DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment… more
- UTMB Health (Galveston, TX)
- …Management + Care Transitions and Hospital Follow-Up **Hospital Medicine and Inpatient Services:** + Academic Hospitalist Service + Direct Care Hospitalist Service ... with their appointment. **Clinical Responsibilities** **Hospital Medicine (for faculty with inpatient focus):** + Provide attending coverage or direct patient care… more
- Providence (TX)
- …Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding and billing regulations and accurately represents services provided. The Senior CDM ... for the training of Hospital ministry staff regarding the CDM Maintenance process, coding updates and charge capture improvement. The Senior CDM Specialist acts as a… more
- Humana (Austin, TX)
- …level of care, and/or requested site of service should be authorized at the Inpatient level. All work occurs within a context of regulatory compliance, and work is ... of decisions to internal associates. The clinical scenarios predominantly arise from inpatient or post-acute care environments. A remote possibility exists of doing… more
- MD Anderson Cancer Center (Houston, TX)
- …of charge capture experience to include two years of lead/supervisory experience. Coding experience is a plus.* *KEY FUNCTIONS* Conducts regularly scheduled employee ... assignments and issues, progress on projects, etc. Conducts regular meetings with Clinical Coding Ops to maintain review and resolve charge capture issues for all… more
- Datavant (Austin, TX)
- …+ Conduct timely, accurate, and complete documentation reviews for selected inpatient records, addressing inadequate or conflicting documentation. + Collaborate with ... secondary diagnoses, and procedure impact on DRG. + Improve coding specificity by educating physicians and caregivers on the...throughout a patient's stay. + Follow AHA guidelines and coding clinics for accurate coding and required… more
- Humana (Austin, TX)
- …participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians ... require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient… more
- Houston Methodist (Houston, TX)
- …accurate and timely documentation in medical records, including diagnosis and CPT coding . + Implements department strategies to achieve financial target and mentors ... accurate and timely documentation in medical records, including diagnosis and CPT coding . Finance + Implements department strategies to achieve financial target and… more
- ChenMed (Houston, TX)
- …physicians/clinicians needs or outstanding items regarding to patients. + Enters all Inpatient and Outpatient elective procedures in HITS tool. + Ensures patient's ... + Knowledge of medical terminology, CPT, HCPCS and ICD coding desired + Detail-oriented with the ability to multi-task....+ Knowledge of medical terminology, CPT, HCPCS and ICD coding desired + An understanding of the company's patient… more
- Houston Methodist (Katy, TX)
- …of Revenue Cycle, to include but not limited to: medical coding , insurance billing, collections, patient account resolution, appeals/denials, customer service, cash ... + Familiarity with managed care terminology and payor adjudication such as Inpatient / Outpatient Prospective Payment Systems, etc. + Stays informed of the latest… more