- Elevance Health (Houston, TX)
- …or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer ... **_: _** _ _ __ This role enables associates to work virtually full -time, with the exception of required in-person training sessions, providing maximum flexibility… more
- Elevance Health (Grand Prairie, TX)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... Validation Auditor-RN** **Virtual:** This role enables associates to work virtually full -time, with the exception of required inperson training sessions, providing… 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
- BAYADA Home Health Care (Austin, TX)
- …this requirement.** BAYADA Home Health Care has an immediate opening for a ** Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to ... Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with...and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate… more
- BAYADA Home Health Care (Austin, TX)
- …is no flexibility around this requirement.** BAYADA Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding Review Manager ... Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with...and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate… 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
- Humana (Austin, TX)
- …CM guidelines + Prior experience in provider education + Strong knowledge of medical record review + Understanding of billing , claims submission, and related ... is responsible for reviewing and analyzing internal data and medical records, as well as coordinating educational sessions with...or equivalent + Must hold AAPC CPC (Certified Professional Coder ) certification + 2 years or more experience with… more