- Elevance Health (Grand Prairie, TX)
- …Nurse license. + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement , and a minimum of ... DRG Clinical (RN) Validation Auditor **Virtual** :...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement… more
- Humana (Austin, TX)
- …entry regarding claim/encounter information + Support and participate in process and quality improvement initiatives **What Humana Offers** We are fortunate to ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct… more
- Houston Methodist (TX)
- At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or ... coding accuracy, and revenue preservation. Additional duties include participating in quality review and performance improvement projects throughout the… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with ... **42910BR** **Extended Job Title:** Medical Coding Auditor **Org Level 1:** Texas Tech Unv Hlth...refining audit tools, policies, and procedures to support continuous improvement + Monitor and track corrective actions post-audit, ensuring… more
- Elevance Health (Houston, TX)
- …Preventable Adverse Events (PAEs) or Never Events. + Suggests and develops high quality , high value concept and or process improvement and efficiency ... **DRG Coding Auditor Principal** **_Virtual: _** _ _ This role...Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad, deep and niche… more
- Elevance Health (Grand Prairie, TX)
- …as re-admissions, Inpatient to Outpatient, and HACs. + Suggests and develops high quality , high value concept and or process improvement and efficiency ... (DRG) Coding/ Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment… more
- Insight Global (Plano, TX)
- …policy bulletins, CMS guidelines, NCDs, and LCDs. Adhere to coding guidelines and Clinical Documentation Improvement (CDI) best practices as endorsed by ACDIS ... will perform Diagnostic Related Group (DRG) validation and quality audits on inpatient charts to ensure accurate coding...care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). -CCS… more
- Molina Healthcare (TX)
- … Quality Program Management and Performance implements new and existing healthcare quality improvement activities to maintain compliance with quality ... + Oversees quality program management activities, which include preparation for quality improvement audits, surveys, and other federal and state-required … more
- Grifols Shared Services North America, Inc (Nacogdoches, TX)
- …Works toward certification from American Society for Quality to be a Certified Quality Auditor . Certification as a Designated Trainer for quality area is ... and calibration of equipment and documentation of procedures. * Ensures that Clinical Lab Improvement Amendments (CLIA) proficiency test surveys, complaint… more
- Datavant (Austin, TX)
- …in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding education, interim coding ... you to help shape the future of healthcare from your own workspace! Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART software… more