• DRG Coding Auditor

    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 (10/03/25)
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  • Clinical Documentation Specialist

    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
    University of Texas Rio Grande Valley (09/23/25)
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  • Inpatient Audit Specialist

    Datavant (Austin, TX)
    …for reviewing records via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. **What You Will Do:** + Performs Inpatient ... to ensure optimal workflow and turnaround time + Provides coder education via the auditing process + Function in...via client's auditing tool, updating coding and submitting for billing . Evaluator experience a plus. + 5+ years of… more
    Datavant (10/04/25)
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  • Coding Charges & Denials Specialist - (Telecommute…

    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 (09/12/25)
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  • Coding Educator FT-Katy CC (Hybrid)

    Houston Methodist (Houston, TX)
    …with pre-billed claim edits to ensure complaint coding, charting and billing . **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Designs, implements, and monitors effective ... AND CERTIFICATIONS - PREFERRED** + CPC-I - Certified Professional Coder Instructor (AAPC) -- (CBO Coders only) **OR** +...(CBO Coders only) **OR** + CPMA - Certified Professional Medical Auditor (AAPC) -- (CBO Coders only) **KNOWLEDGE, SKILLS,… more
    Houston Methodist (07/23/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Grand Prairie, TX)
    …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible for ... identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to identify opportunities for fraud and abuse… more
    Elevance Health (10/03/25)
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  • Education & Quality Coding Analyst- Remote Days

    Texas Health Resources (Arlington, TX)
    …- Certified Coding Specialist 12 months **REQUIRED** COC (Certified Outpatient Coder ) 12 months **REQUIRED** **Skills** Proficient in software applications (Excel, ... CPT-4. Expert in coding convention/automated encoder (knowledge management of NCCI/OCE billing edits). Knowledgeable in APC and DRG methodologies and all… more
    Texas Health Resources (09/20/25)
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