- BAYADA Home Health Care (Austin, TX)
- …while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each clinician to promote OASIS accuracy. ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...review . + Knowledge of OASIS, Home Care and Medicare regulations + Excellent organizational, interpersonal and communication skills… more
- BAYADA Home Health Care (Austin, TX)
- …while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each clinician to promote OASIS accuracy. ... Utilization Review , Quality Assurance, Remote, Home Health Coding, Coder, Medicare **As an accredited, regulated, certified, and licensed home health care… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of care using...local and national coverage determinations + Comprehensive knowledge of Medicare , Medicaid, and Managed Care requirements + Comprehensive knowledge… more
- Houston Methodist (Houston, TX)
- …+ Recent work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid, and Managed Care ... At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered...Non-Coverage (HINN), Ambulatory Benefit Notice (ABN), Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON),… more
- Evolent (Austin, TX)
- …for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact ... reviews for cardiovascular cases, serving as a specialty-matched expert reviewer for invasive/interventional cardiology cases (eg, cardiac catheterizations, coronary… more
- HCA Healthcare (Houston, TX)
- …**Introduction** Do you have the career opportunities as a Revenue Integrity Charge Review Analyst you want with your current employer? We have an exciting ... group of colleagues. Do you want to work as a Revenue Integrity Charge Review Analyst where your passion for creating positive patient interactions is valued? If you… more
- HCA Healthcare (Round Rock, TX)
- …to join an organization that invests in you as a Pro Fee Coding Quality Review Educator? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... are looking for a dedicated Pro Fee Coding Quality Review Educator like you to be a part of...of unique coding requirements for major payers such as Medicare , Medicaid, HMO's, PPO's, IPA's, employers, etc. + Demonstrate… more
- Evolent (Austin, TX)
- …Reviewers. **What You Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet the applicable medical necessity ... the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Austin, TX)
- …or required. **What You Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity ... rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Austin, TX)
- …or required. **What You Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially meet the applicable medical ... rationale for standard and expedited appeals. . Utilizes medical/clinical review guidelines and parameters to assure consistency in the...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more