- Catholic Health Initiatives (Bryan, TX)
- …when required, obtaining pre‐certification reference number, approved length of stay, and utilization review company contact person and telephone number **Job ... regarding their third‐party coverage, financial responsibility, and billing procedures Review patient account summaries of unbilled charges, billing, payments, and… more
- Providence (Plainview, TX)
- …in a medical record. + 2 years - HEDIS, Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within ... and Data Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab and pharmacy records… more
- Elevance Health (Grand Prairie, TX)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- HCA Healthcare (Austin, TX)
- …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... agencies including government and non-governmental payers and quality assurance. Promotes a cooperative and supportive relationship as liaison with patient, family, facility staff, physician; funding representatives and community agencies. Ensure continuity… more
- YesCare Corp (Waxahachie, TX)
- …including sentinel event reviews and chart audits. + Engage actively in the Utilization Review process, ensuring appropriate use of healthcare resources. **Key ... + Provide and ensure on-call services to support patient care needs. + Review and approve clinical protocols, policies, procedures, and the medical disaster plan… more
- HCA Healthcare (Tomball, TX)
- …responsibility typically includes Accounting, Reimbursement, Managed Care, Health Information, and Utilization Review . Functions at an executive level in an ... administration, appropriate facility staff members and Division Office. + You will review denials issues and trends for maximizing net reimbursement for Facility.… more
- Ascendis Pharma (TX)
- …Institute for Clinical and Economic Review (ICER) and state Drug Utilization Review Boards (DURBs)). HCP Relationship Management + Through appropriate ... and initiates and manages collaborative external and/or internal projects upon alignment, review and approval + Participates on internal project teams as directed by… more
- HCA Healthcare (Austin, TX)
- …and retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... agencies including government and non-governmental payers and quality assurance. Promotes a cooperative and supportive relationship as liaison with patient, family, facility staff, physician; funding representatives and community agencies. Ensure continuity… more
- HCA Healthcare (Fort Worth, TX)
- …representatives, and other parties as appropriate regarding behavioral services Performs utilization review as assigned Participates in developing department ... you to apply for our Licensed Intake Therapist PRN opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member… more
- Elara Caring (San Antonio, TX)
- …Identifies and reports potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development ... of Key Accounts, including participation in weekly, monthly, and quarterly review meetings, as needed. + Ensures accuracy of all public information, materials, and… more