- Molina Healthcare (TX)
- …+ Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member ... Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and...NCQA, CMS, State and Federal requirements. May also perform non- clinical system and process audits, as needed. + Assesses… more
- HCA Healthcare (Houston, TX)
- …plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug ... and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options...3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more
- Baylor Scott & White Health (Austin, TX)
- **JOB SUMMARY** The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to ... coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS),...the coding and abstracting system. Works collaboratively with the Clinical Documentation Specialists and Coaches to communicate opportunities for… more
- Houston Methodist (San Antonio, TX)
- **Coding Quality Auditor - 100% Remote (Must Live in FL, TN, GA, LA, WA State, or TX)** **$5,000 Sign-On Bonus** At Houston Methodist, the Coding Quality Auditor ... and provides good feedback during coding section meetings, coding education in- services , and coder/CDMP meetings. Takes initiative to assist others and shares… more
- Omnicell (Grapevine, TX)
- **Job Description:** The Regulatory Auditor position plays a critical role in safeguarding the integrity and compliance of pharmacy operations. This position is ... to transforming pharmacy care through outcomes-centric innovation designed to optimize clinical and business outcomes across all settings of care. We strive… more
- Highmark Health (Austin, TX)
- …and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, ... Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or… more
- University of Texas Rio Grande Valley (Harlingen, TX)
- …Medicine/ Revenue Cycle FTE1.0 FLSAExempt Scope of Job To promote appropriate clinical documentation through collaboration with the School of Medicine clinical ... process is followed. Description of Duties * Obtains and promotes appropriate clinical documentation through interaction with clinical staff and physicians to… more
- The Arora Group (Abilene, TX)
- …+ Have practical knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and ... medical specialties must include: medical diagnostic and therapeutic procedures; ancillary services (which includes but is not limited to, Laboratory, Occupational… more
- Humana (Austin, TX)
- …the QSI Data Quality/Integrity Lead will leverage their expertise in clinical /healthcare data, data exploration, collaboration, and leadership to guide the daily ... the data procured digitally and manually. + Support STARs Clinical Team to gather data for pilots and Humana...and nonstandard supplemental data audit with NCQA and DTS auditor . **Use your skills to make an impact** **Required… more
- HCA Healthcare (Houston, TX)
- …plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug ... and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options...3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more