• DRG Coding Auditor

    Elevance Health (Grand Prairie, TX)
    …Skills, Capabilities and Experiences** : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital ... ** DRG CODING AUDITOR** **_Virtual_** **_: _**...billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred. +… more
    Elevance Health (10/25/25)
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  • Healthcare Clinical Documentation Specialist

    Deloitte (Dallas, TX)
    …case manager , clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health IT preferred + Knowledge of Medicare ... improvement, and value-based payment models + Proven applicable CPT and ICD-10 coding experience; APR- DRG , MS- DRG and HCC assignment + Other revenue cycle… more
    Deloitte (11/08/25)
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  • Medical Review Nurse (RN)

    Molina Healthcare (TX)
    …care issues. + Assists with complex claim review including diagnosis-related group ( DRG ) validation , itemized bill review, appropriate level of care, inpatient ... Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Provides support for medical claim and internal appeals review… more
    Molina Healthcare (09/06/25)
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