- Molina Healthcare (Fort Worth, TX)
- …Experience** 5+ years Clinical Nursing experience, including hospital acute care/ medical experience. **Preferred License, Certification , Association** Any one ... or more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified… more
- CenterWell (Arlington, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... of care, health maintenance, and disease prevention. Keeps a medical history and medical records. Refers the...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- CenterWell (El Paso, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- CenterWell (Beaumont, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and… 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
- CenterWell (San Antonio, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- Elevance Health (Grand Prairie, TX)
- …Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR** is responsible for auditing ... inpatient medical records and generating high quality recoverable claims for...Requires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator and/or RHIT… more
- CenterWell (Houston, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... quality of patient care using available data and chart reviews. + Complete all medical record documentation in a timely manner, working with a quality-based coder… more
- Humana (Austin, TX)
- …+ High school diploma or equivalent + Must hold AAPC CPC (Certified Professional Coder ) certification + 2 years or more experience with ICD-10 CM guidelines ... Coding Educator is responsible for reviewing and analyzing internal data and medical records, as well as coordinating educational sessions with providers to enhance… more
- CenterWell (Humble, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... quality of patient care using available data and chart reviews. + Complete all medical record documentation in a timely manner, working with a quality-based coder… more