- Houston Methodist (Houston, TX)
- …changes are needed. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Analyzes data from various sources ( medical records , claims data, payer medical policies, etc.), ... documentation, and claims information into a concise appeal letter, including appropriate medical records submission. + Performs timely review of medical … more
- Elevance Health (Grand Prairie, TX)
- …may be considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the ... its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate...Certified Coding Specialist and/or CIC as a Certified Inpatient Coder . + Requires 5 years of experience working with… more
- CenterWell (Arlington, TX)
- …on outpatient medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records . Refers the patient to ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
- Cardinal Health (Austin, TX)
- …insufficiencies. + Facilitates assigning of ICD-9 and ICD-10 codes by analyzing patient medical records . + Maintains a functional knowledge of enterprise EMRs, ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- CenterWell (Houston, TX)
- …on outpatient medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records . Refers the patient to ... 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… more
- CenterWell (El Paso, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… more
- CenterWell (San Antonio, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. + Follows level of medical care and quality for patients and monitors care...in a timely manner working with a quality- based coder to optimize coding specificity. + Follows policy and… 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...in a timely manner working with a quality- based coder to optimize coding specificity. . Follows policy and… more
- Molina Healthcare (Houston, TX)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... more of the following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional… more
- Centene Corporation (Houston, TX)
- …High school diploma or equivalent. 2+ years of pharmacy technician or medical office (ie biller, coder , office assistance, or prior authorization/certification) ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
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