- Elevance Health (Houston, TX)
- …systems and reference information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality standards as set ... Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or quality ...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare ... departmental leaders to provide education on medical coding and documentation based on audit findings and as required by current CMS regulations. Work directly with… more
- Textron (Fort Worth, TX)
- …This position serves as a subject matter expert on all Supply Chain audit and compliance matters or concerns including Small Business\. Coordination with internal ... audits, identify trends, provide training for gap correction, and offer advanced audit support for internal and external audits, including follow\-up on observations… more
- Highmark Health (Austin, TX)
- …retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external … more
- MUFG (Irving, TX)
- …for Audit and Exam purposes + **30%:** Supports EDD Manager with leadership responsibilities including performance metrics and reporting, trending analysis, and ... more details. Reporting to the Enhanced Due Diligence (EDD) Manager , the BSA Specialist III is responsible for performing...the BSA Specialist III is responsible for performing independent Quality Control review and analysis on others' EDD files… more
- Vaco (San Antonio, TX)
- …prepping for an upcoming audit . Or maybe she needs a seasoned project manager to lead a merger integration. As Client Services Director, you are a core revenue ... from CFOs and VPs of finance, tax, and internal audit as well as Controllers and Accounting Managers. They...by acting with respect, dignity, and integrity. + **Decision Quality -** ** ** Makes good and timely decisions… more
- Methodist Health System (Dallas, TX)
- …III denial actions and resolutions. **_Duty 3_** : At the direction of the Director/ Audit Manager , perform random risk audits for areas of concern to assure ... Assists in all other areas within the coding/auditing department as directed by Director/ Audit Manager . **_Duty 8_** : Adhere to patient and office… more
- Sunrise Senior Living (Dallas, TX)
- …and verify accuracy of payroll and census reconciliation and email to Regional Business Manager by deadline. ** Quality Assurance & Safety** + Focus on Resident ... Close and Management, Business Processes-Key Controls, Technical/Professional Knowledge, and Quality Assurance. **RESPONSIBILITIES & QUALIFICATIONS** **Essential Duties** As a… more
- Bank of America (Addison, TX)
- …ARM ticketing queue, and maintain program documentation. + Maintain QA documentation, audit documentation, and training materials. + Drive Quality Assurance ... (CST), Third Party management, Global Compliance and Operations Risk (CGOR), internal audit , and external regulatory agencies. Provide audit and regulatory… more
- Molina Healthcare (San Antonio, TX)
- …**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional ... appropriate/accurate billing and claims processing. + Identifies and reports quality of care issues. + Assists with Complex Claim...to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the… more
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