• Manager Healthcare Analytics - Medical

    Highmark Health (Austin, TX)
    …with claims data **LICENSES AND CERTIFICATIONS** **Required** + None **Preferred** + Medical Coding **SKILLS** + Agile Application Development + Business ... operations of the healthcare management analytics function with the Medical Policy department. The incumbent retains responsibility for development, implementation… more
    Highmark Health (12/24/25)
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  • DRG Clinical (RN) Validation Auditor

    Elevance Health (Grand Prairie, TX)
    …but are not limited to: + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance ... of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions. +… more
    Elevance Health (01/15/26)
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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 (01/16/26)
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  • Administrative Associate - Medical Records

    Texas A&M University System (College Station, TX)
    …or sensitive records management. + Medical Office Administration Certificate, Medical Records Certification, Medical Records/ Coding Certification. + ... Job Title Administrative Associate - Medical Records Agency Texas A&M University Department Vet...Are you a detail-oriented individual with experience with electronic medical records, exceptional communication skills, and a passion for… more
    Texas A&M University System (01/15/26)
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  • Account Representative - (Museum District)

    Houston Methodist (Houston, TX)
    …claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity or coding related ... of Diseases Tenth Revision (ICD-10), and Healthcare Common procedure Coding System (HCPCS) coding + In depth...ESSENTIAL FUNCTIONS** + Expedites and maximizes payment of insurance medical claims by contacting third party payors and patients.… more
    Houston Methodist (01/16/26)
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  • Sr. Data Analyst/Risk Adjustment - US Remote

    Datavant (Austin, TX)
    …interpret, and aggregate data from multiple data sources for supporting risk adjustment medical record coding and quality processes + Design, develop, test, and ... and interpret raw data from databases to support risk adjustment coding and medical record + Experience in using business intelligence, data visualization,… more
    Datavant (12/25/25)
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  • Coder - Inpatient

    Highmark Health (Austin, TX)
    …School / GED + 1 year in Hospital coding + Successful completion of coding courses in anatomy, physiology and medical terminology + Certified Coding ... Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret… more
    Highmark Health (12/13/25)
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  • Medical Review Nurse (RN)- Itemized Bill…

    Molina Healthcare (TX)
    …of stay, level of care, and inpatient readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement ... medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination… more
    Molina Healthcare (01/09/26)
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  • Clinical Documentation Specialist - RN Residents…

    Houston Methodist (Houston, TX)
    …extensive interaction with physicians, nursing staff, other patient care givers, and medical records coding staff to ensure that appropriate reimbursement is ... quality and completeness of clinical documentation. This position analyzes medical records for DRG's, complications, and comorbidities; identifies trends; and… more
    Houston Methodist (01/16/26)
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  • Medical Billing/ Customer Care

    Robert Half Accountemps (Spring, TX)
    …eligibility information and request prior authorizations from insurance providers + Support medical billing and coding activities as needed + Maintain strict ... and care coordination functions for pediatric patients receiving critical medical equipment and supplies. This role requires strong communication skills,… more
    Robert Half Accountemps (01/15/26)
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