- Molina Healthcare (San Antonio, TX)
- …experience including diagnosis. Candidates with knowledge of CPT/HCPCS codes, record review, chart audit , provider disputes, appeals, and 1500 & UB04 claim ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities....clinical experience. * Facilitates document management, clinical reviews, bill audit findings and audit details in the… more
- CenterWell (Dallas, TX)
- …**Major Duties and Responsibilities** + Oversees day-to-day operations, quality chart audit reviews, recruiting/hiring, team management, and overall ... degree / license + 5 years or more prior nursing , case management, disease management and/or social work experience...or more years of management experience + Active Registered Nurse (RN) license or Social Work (SW) license +… more
- Providence (Plainview, TX)
- …+ Organize the data to identify and address opportunities for improvement + Perform chart audits electronically during the audit season + Complete HEDIS training ... Nurse (LPN). **Preferred Qualifications:** + Associate's Degree - Nursing or Healthcare related field, Health Information Management degree. + Experience… more
- Molina Healthcare (Austin, TX)
- …functions. These functions include, but may not be limited to: chart retrieval strategy, risk adjustment retrieval performance, process effectiveness, market ... performance, project build, chart retrieval maximization and risk adjustment compliance. Molina Risk...people management experience * Minimum 5 years Risk adjustment audit /RADV experience * Demonstrated knowledge of and experience with… more
- Molina Healthcare (Fort Worth, TX)
- …Adjustment, is responsible for the implementation, monitoring, and oversight of all chart collection for Risk Adjustment, RADV, or Risk Adjustment-like projects, and ... other state specific audit projects and deliverables related to accurate billing and...training, onboarding for CDA team members, vendor management for chart collection vendors, Supplemental data, and chart … more
- Fresenius Medical Center (Waco, TX)
- …and training for patients under the direct supervision of a licensed nurse under organization policies, procedures, and training and in compliance with regulations ... under the direct supervision of the Home Therapies registered nurse (HT RN), in compliance with, and as permissible...+ Participates in medical records, infection control, and other audit processes as directed. + Actively collaborates with others… more
- Fresenius Medical Center (San Antonio, TX)
- …and training for patients under the direct supervision of a licensed nurse under organization policies, procedures, and training and in compliance with regulations ... under the direct supervision of the Home Therapies registered nurse (HT RN), in compliance with and as permissible...+ Participates in medical records, infection control, and other audit processes as directed. + Actively collaborates with others… more