- Houston Methodist (Houston, TX)
- …denials, denial reason and trending, interpretation of payer manuals, medical policies, and local/national coverage determinations. **SERVICE ESSENTIAL FUNCTIONS** + ... impactful opportunities in denials and adjustments for the individual facilities and the system . + Works assigned claim edit and follow up work queues and meets… more
- Elevance Health (Grand Prairie, TX)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **DRG CODING AUDITOR** is responsible for auditing… more
- 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
- Jacobs (Houston, TX)
- …developer on various Foundry built solutions, making integrations into client systems , incorporating AI/LLMs into solutions, and managing solution deployments. You ... etc. * Strong problem-solving skills and ability to work independently * Strong coder with shown proficiency in programming languages such as Python, Java, C++,… more
- Surgery Care Affiliates (Arlington, TX)
- …a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without ... package to support your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company match, paid time… more
- USAA (San Antonio, TX)
- …interviews, searches of investigative databases, internal resources, internet resources, medical records, law enforcement records, and/or public records to support ... are conducted within regulatory requirements. + Applies proficient product and system knowledge to ensure appropriate investigation and/or claim settlement. +… more
- Ascension Health (Austin, TX)
- …obtained prior to hire date or job transfer date. + Certified Professional Coder (CPC) credentialed from the American Academy of Professional Coders (AAPC) obtained ... Central Texas and four teaching hospitals, including Dell Seton Medical Center at The University of Texas and Dell...love. Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600… more
- UTMB Health (Galveston, TX)
- …CDI to monitor key metrics and educational opportunities to ensure optimal coder / CDI performance. * Identifies process improvement opportunities for clinical ... of physician reimbursement and managed care contract issues. * Knowledge of Epic systems that support physicians billing services. * General knowledge of medical … more