- Elevance Health (Houston, TX)
- …or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR** is responsible for auditing… more
- Elevance Health (Grand Prairie, TX)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- …service rendered to patients. * Conducts complex reviews of physician/provider billing compliance activities in accordance with applicable laws, regulations, rules ... retrospective audits of documentation to confirm compliance with documentation and billing rules and government regulations. Provides feedback and education related… more
- CVS Health (Austin, TX)
- …Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding ... practices through comprehensive record reviews for medical , behavioral, transportation, and other healthcare providers. The CPC Manager will be responsible for… more
- Humana (Austin, TX)
- …field. + Healthcare insurance industry knowledge. + Experience validating and interpreting medical record documentation to ensure billing for services is ... Manager, you will spearhead audit and validation processes to ensure medical documentation and coding are precise, compliant, and support optimal reimbursement.… more
- The Hartford (San Antonio, TX)
- …MedBill Team Leader is responsible for overseeing a small team within the Medical Billing department, ensuring efficient operations and timely completion of ... communication, and organizational skills, along with a solid understanding of medical terminology, insurance policies, billing procedures, and reimbursement… more
- BAYADA Home Health Care (Austin, TX)
- …the following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with company match, direct ... it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each… more
- BAYADA Home Health Care (Austin, TX)
- …the following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with company match, direct ... it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each… more
- Houston Methodist (Houston, TX)
- …denials, denial reason and trending, interpretation of payer manuals, medical policies, and local/national coverage determinations. **SERVICE ESSENTIAL FUNCTIONS** + ... are needed. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Analyzes data from various sources ( medical records, claims data, payer medical policies, etc.), determines… more
- Houston Methodist (Houston, TX)
- …Methodist facilities. The Director manages personnel performing inpatient and outpatient medical record coding, DRG and APC assignment, abstracting, and data entry ... functions; ensures accuracy and quality of coded and abstracted medical record data. This position coordinates coding and abstracting activities; provides data… more