• DRG Revenue Integrity Auditor

    Insight Global (Plano, TX)
    …chart reviews to accurately reflect the patient's condition. Stay current with medical coding guidelines and industry developments. Assist in developing training ... Group (DRG) validation and quality audits on inpatient charts to ensure accurate coding and compliance with federal regulations. This is a remote opportunity and the… more
    Insight Global (10/30/25)
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  • Senior Compliance Coding Analyst - Business…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and ... identifying potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide feedback regarding… more
    Houston Methodist (10/23/25)
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  • Health Services Manager (IC) - Payment Policy…

    CVS Health (Austin, TX)
    …key member of the Medical Policy & Program Solutions Team. The Medicaid Medical Coding Policy Writer is an individual contributor and will research and ... and corporate leaders to develop deliverables on policy priorities + Provide medical coding and payment policies deliverables for Medicaid and Duals and other… more
    CVS Health (11/19/25)
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  • Manager, Medical Economics (New York Health…

    Molina Healthcare (Austin, TX)
    …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... **Job Summary** The Manager, Medical Economics provides support and consultation to the...health plan performance and identify the root causes of medical cost trends. With those root causes identified, drives… more
    Molina Healthcare (11/21/25)
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  • Senior Analyst, Medical Economics (Vbc)…

    Molina Healthcare (TX)
    …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation to the...health plan performance and identify the root causes of medical cost trends. With those root causes identified, drives… more
    Molina Healthcare (08/31/25)
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  • VP, Medical Economics

    Molina Healthcare (Austin, TX)
    …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form). * Advanced understanding of key managed ... executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data… more
    Molina Healthcare (11/21/25)
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  • Sr Business Analyst ( Medical Claims Audit)

    Molina Healthcare (San Antonio, TX)
    …Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). + Medical Coding certification. + Strong Medical Claims Audit knowledge To ... processing functions to support systems solutions development and maintenance for Medical Claim Audit. This role includes coordination with stakeholders and subject… more
    Molina Healthcare (11/08/25)
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  • Revenue Cycle Specialist - Plastics…

    Houston Methodist (Houston, TX)
    …Resolves denials as they appear with actionable items that result in resolution. Engages the coding follow up team for any medical necessity or coding ... **FINANCE ESSENTIAL FUNCTIONS** + Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients. This includes… more
    Houston Methodist (10/08/25)
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  • Emergency Room Medical Coder - Level 1…

    Cognizant (Austin, TX)
    …+ Familiarity with **federal, state, and payer regulations** + Ability to interpret medical records and apply coding guidelines accurately + Proficiency in MS ... **Job Title: Emergency Room Medical Coder - Level 1 Trauma Center (Remote)**...Role** Cognizant Technology Solutions is seeking an experienced **ICD-10 Coding Consultant - Outpatient** to join our team and… more
    Cognizant (10/30/25)
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  • Clinical Provider Auditor II

    Elevance Health (Grand Prairie, TX)
    …related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + ... **Minimum Requirements** + Requires a AA/AS and minimum of 4 years medical coding /auditing experience, including minimum of 1 year in fraud, waste abuse… more
    Elevance Health (11/14/25)
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