• Clinical Compliance Medical Director

    Elevance Health (Grand Prairie, TX)
    …expertise representing MA plans in regulatory, compliance, and legal matters strongly preferred . + Certified Risk Adjustment Coder (CRC) or similar credential ... **Clinical Compliance Medical Director** _Please note that per our policy...education and experience, which would provide an equivalent background. ** Preferred Skills, Capabilities and Experiences:** + Deep understanding of… more
    Elevance Health (09/24/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …coding experience. ** PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder , Certified Medical Audit Specialists, Certified Case Manager , ... Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review… more
    Molina Healthcare (09/06/25)
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  • Medical Coding Auditor

    Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
    **42425BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for auditing ... medical records to ensure accurate coding and compliance with...individual selected **Pay Basis:** Monthly **Work Location:** El Paso ** Preferred Qualifications:** + Bachelor's degree preferred +… more
    Texas Tech University Health Sciences Center - El Paso (10/01/25)
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  • Medical Coding Appeals Analyst

    Elevance Health (Grand Prairie, TX)
    …based sponsorship. **Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective ... and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code. +… more
    Elevance Health (09/12/25)
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  • Consultative Coding Professional

    CenterWell (Austin, TX)
    …direction and receives guidance where needed. Follows established guidelines/procedures. **Consultative Coder ** The Consultative Coder provides medical ... a part of our caring community and help us put health first** The Medical Coding Professional extracts clinical information from a variety of medical records… more
    CenterWell (09/25/25)
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  • Supervisor, Medical Referrals

    CenterWell (San Antonio, TX)
    …6 years in a physician office, health care, or managed care environment + Certified Medical Coder with one of the following active certifications and with a high ... our caring community and help us put health first** The Supervisor, Medical Referrals schedules and pre-registers patients for exams and procedures with specialists… more
    CenterWell (09/25/25)
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  • Vendor Resource Management Manager

    HCA Healthcare (El Paso, TX)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
    HCA Healthcare (09/27/25)
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  • Coding Quality Auditor

    Houston Methodist (Houston, TX)
    …and/or inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory ... good feedback during coding section meetings, coding education in-services, and coder /CDMP meetings. Takes initiative to assist others and shares knowledge with… more
    Houston Methodist (09/30/25)
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  • Coding Data Quality Auditor

    CVS Health (Austin, TX)
    …every day. **Position Summary** Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that ... evidence and tools. + Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare… more
    CVS Health (09/27/25)
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  • Investigator

    Highmark Health (Austin, TX)
    …to prevent further improper payments.Forwards case to the Credentialing and/or Medical Review Committee, law enforcement and regulatory agencies. + Responsible for ... to internal and external law enforcement and regulatory agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment… more
    Highmark Health (09/10/25)
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