- CenterWell (Houston, TX)
- …a part of our caring community and help us put health first** The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value ... Clinical Leadership. + Meet with medical directors to discuss quality of care, review outcome data, and address policy, procedure, and records issues. + Participate… more
- CenterWell (Beaumont, TX)
- …a part of our caring community and help us put health first** The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value ... defined by Clinical Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues. . Participates in potential… more
- CenterWell (Humble, TX)
- …on teamwork and providing a positive and welcoming environment for all. The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a ... Clinical Leadership. + Meet with medical directors to discuss quality of care, review outcome data, and address policy, procedure, and records issues. + Participate… more
- Houston Methodist (Houston, TX)
- …to the Physician Advisor (or services) for appropriate second level review , peer-peer discussions, and payer denial- appeal needs. Consults with physician ... + Recent work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid, and Managed 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...process improvements). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care… 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
- Intermountain Health (Austin, TX)
- …(GED) required + One (1) years of experience in hospital or physician back-end revenue cycle (Payment Posting, Billing, Follow-Up, Collections) required + Knowledge ... of Medicaid and Medicare billing regulations required **Physical Requirements** + Operate computers and other office equipment requiring the ability to move fingers… more
- Humana (Austin, TX)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will...daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, … more
- Humana (Austin, TX)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more