• DRG Coding Auditor

    Elevance Health (Houston, TX)
    …Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR** is responsible for auditing… more
    Elevance Health (08/13/25)
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  • Diagnosis Related Group Clinical Validation…

    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
    Elevance Health (08/09/25)
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  • Manager DRG Coding Validation

    Elevance Health (Grand Prairie, TX)
    …Broad knowledge of medical claims billing /payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The Manager of DRG Coding Audit & Clinical Validation… more
    Elevance Health (09/09/25)
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  • Cash Applications Representative - (Museum…

    Houston Methodist (Houston, TX)
    …include hospital and physician charges + Knowledge of hospital and PO billing , collections, reimbursement , contractual agreements and the appeals process, and ... are accurately reflected in the daily activity. + Coordinates with Single Billing Office (SBO) and/or AR representatives to resolve cash application discrepancies,… more
    Houston Methodist (08/15/25)
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  • RCMI Senior Solution Technical Expert - Order…

    Guidehouse (San Antonio, TX)
    …and collaborating with colleagues, providing feedback and guidance on work performance. + Medical billing experience + PMP or CAPM Certification. + Certified ... patient orders within the Oracle Health (Cerner) system, ensuring accurate billing and compliance. + Designing, developing, and maintaining rules, including Discern… more
    Guidehouse (07/17/25)
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  • Sr. Medicaid Regulatory Pricer Analyst

    Zelis (Plano, TX)
    …administration, or a related field + Five+ years of experience in Medicaid billing , reimbursement , claim payment or cost reporting. + Experience with Medicare ... /Medicare Advantage or commercial billing and reimbursement a plus + Ability...good understanding of public and private healthcare payment systems, medical claims, standard claim coding, claim editing, contracting, preferred-provider… more
    Zelis (08/27/25)
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  • Insurance Verification Specialist

    Prime Healthcare (Dallas, TX)
    …Days Employment Type: Full-Time Hours: 8-hour - 8:00am to 4 : 3 0pm Location: Dallas Medical Center - Farmers Branch, TX Here are some of the benefits of working at ... leave , FMLA and other leave options + Employer 401K options + Tuition reimbursement options + Life, disability, and other insurance options + Many other amazing… more
    Prime Healthcare (08/27/25)
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  • Revenue Cycle Management Specialist - Collections

    KPH Healthcare Services, Inc. (Longview, TX)
    …practice. **Qualifications** **Job Skill Requirements:** + Ability to read and interpret medical records for billing purposes. + Competent in mathematic ... Submit appeals/claim corrections as needed within timely filing limits. + Utilize billing software to maintain accurate and detailed records of all collection… more
    KPH Healthcare Services, Inc. (08/16/25)
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  • Director Revenue Integrity

    Baylor Scott & White Health (Dallas, TX)
    …Codes and CPT/HCPCS coding methodologies and has a comprehensive knowledge of healthcare billing , finance, and reimbursement . + Epic Hospital Billing , ... program for all wholly owned and operated hospitals, clinics, and employed medical groups. + Provides oversight of the development of charge capture methodologies… more
    Baylor Scott & White Health (08/03/25)
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  • Insurance Verification Rep

    Catholic Health Initiatives (The Woodlands, TX)
    …support the need and documentation for each service. 7. Coordinate copies of medical documentation with physician charges to support billing to third-party ... payers. 8. Identify physician services provided, but not accurately documented in the medical record. 9. Resolve routine patient billing inquiries and problems.… more
    Catholic Health Initiatives (07/30/25)
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