- CVS Health (TX)
- …First Level Appeals / Special Projects and Committee participation when needed. The Medical Director will provide clinical, coding , and reimbursement ... License without encumbrances or willing to obtain a Texas License. In the Medical Director role you will provide oversight for medical policy implementation.… more
- Houston Methodist (Houston, TX)
- …Develops and reports performance metrics for assigned area under the direction of the Coding Operations Director . + Ensures that coding is performed ... areas; tracks, trends, and reports these issues to the Coding Operations Director . **FINANCE ESSENTIAL FUNCTIONS** +...assignment systems + Official coding guidelines and coding compliance + Working knowledge of medical … more
- HCA Healthcare (Dallas, TX)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... processes, and division relationship management as applicable. The RCOM assists the Regional Coding Operations Director with the oversight and implementation of … more
- Evolent (Austin, TX)
- …The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be ... coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and...or equivelent years of work experience. + **Certification in medical coding (CRC- Certified Risk Adjustment Coder)… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes,… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Datavant (Austin, TX)
- …requirements, medical record standards, and regulatory guidance impacting concurrent coding or risk adjustment. + Product experience integrating into EHRs or ... experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the… more
- CVS Health (Houston, TX)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...predetermination reviews ad reviews of claim determinations, providing clinical, coding , and reimbursement expertise, using multiple computer based applications.… more
- UTMB Health (Galveston, TX)
- …**K** **nowledge/Skills/Abilities:** + Knowledge of CDM, regulatory compliance, ICD-10, and CPT-4 medical record coding and UB04 billing. + Knowledge and ... Director of Revenue Integrity **Galveston, Texas, United States**...reimbursement procedures and methodologies + Adept at utilizing electronic medical record systems, preferably Epic, as well as the… more
- CVS Health (TX)
- …**This is a remote based (work at home) based anywhere in the US.** The Medical Director (Ortho/Total Joint) will be a Subject Matter Expert (SME) with a ... post-graduate direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs across the continuum of… more
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