- Molina Healthcare (TX)
- …compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/ medical reviews of previously denied cases in which a formal ... likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge… more
- HCA Healthcare (Austin, TX)
- …This position is incentive eligible. **Job Summary and Qualifications** HCA Graduate Medical Education is one of the nation's largest providers of residency and ... HCA GME is building a leading network of innovative, patient-centered graduate medical education programs. We believe graduate medical education is much… more
- St. George Tanaq Corporation (Austin, TX)
- …be based anywhere in the United States. **Responsibilities** + Reviews medical records/case file, writes a reconsideration/dispute resolution decision that is clear, ... made, and documents review + Makes sound, independent decisions based on medical evidence in accordance with statutes, regulations, rulings, and policy + Responds… more
- CenterWell (Beaumont, TX)
- …treats center patients in accordance with standards of care. . Follows level of medical care and quality for patients and monitors care using available data and ... limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. . Acts as...manner working with a quality- based coder to optimize coding specificity. . Follows policy and protocol defined by… more
- CenterWell (Houston, TX)
- …medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records. Refers the patient to specialists ... 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 to… more
- MD Anderson Cancer Center (Houston, TX)
- …both direct and indirect patient care situations using information from clinical history, medical records, and imaging to ensure the clinical needs of the patients ... Whiteboards, CARE, and modality imaging systems. Exam Charges, Billable Medical Supplies, CPT/Procedure Codes, Patient Demographics, etc.) Maintain up to… more
- Fujifilm (Austin, TX)
- …with Key Accounts and Opinion Leaders within the Liver/Hepatology Medical Oncology community. Manage specific assigned geographic areas and successfully ... Liaise with office and laboratory staff to provide reimbursement support and test coding . + Development of business plans aligned to strategic accounts with resource… more
- Houston Methodist (Houston, TX)
- …population sciences, particularly with interest in disparities research for medical underserved and vulnerable populations. Experience in multivariable modeling ... and manages computerized databases in support of various educational applications for Medical Education and Research and for the design of various research studies.… more
- St. George Tanaq Corporation (Austin, TX)
- …that can be based anywhere in the United States. **Responsibilities** + Reviews medical records/case file, writes a decision that is clear, concise, and impartial ... made, and documents review + Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation, rulings, and policy + Responds… more
- Methodist Health System (Dallas, TX)
- …* Working knowledge of Hospital Medicare reimbursement areas of Wage Index, Medical Education, Organ Transplant, S-10, Medicare & Medicaid DSH, Charity Care and ... hospitals' Medicare cost reports to obtain payment from Champus for Capital and Medical education costs and file timely. * Prepare the required Medicaid UC/DSH… more