- HCA Healthcare (Austin, TX)
- …general/focus education for facility leaders on (but not limited to) compliance , medical necessity , charge practices, coding requirement etc. + Tracks ... join an organization that invests in you as a Medical Necessity Compliance Coordinator? At...substitute education requirements. + Minimum 3 years of hospital coding experience preferred + Minimum 5 years healthcare experience… more
- HCA Healthcare (Conroe, TX)
- …specific responsibilities (examples may include but not limited to PEPP, medical necessity , lab compliance , billing and coding ). + If an ethics ... an organization that invests in you as a Lead Medical Technologist? At HCA Houston Healthcare Conroe, you come...to age-specific needs. + Supportive of the ethics and compliance programs forth by HCA Healthcare demonstrated by: a.… more
- Cardinal Health (Austin, TX)
- …detection and correction of documentation, coding , and billing errors and/or medical necessity of services billed. Particular areas of focus include: ... assigned. **_Qualifications_** + 4-8 years experience in physician and/or hospital technical coding /auditing, medical necessity reviews, or related work.… more
- Molina Healthcare (TX)
- …medical determinations as necessary, and applies clinical knowledge to assess the medical necessity , level of services, and/or appropriateness of care in ... to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews.… more
- Houston Methodist (Houston, TX)
- …appeals when necessary. Engages the coding follow-up team for any medical necessity or coding related appeals. **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** ... Portability and Accountability Act (HIPAA) and Payment Card Industry (PCI) compliance regulations. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Reviews third party payor… more
- CVS Health (Austin, TX)
- …approves routine claims that cannot be auto adjudicated. - Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify ... or referral submission to determine, review, or apply appropriate guidelines, coding , member identification processes, provider selection processes, claim coding… more
- Caris Life Sciences (Irving, TX)
- …for managing billing processes with a focus on resolving front-end rejections, submitting medical necessity appeals, and responding to medical records ... + Manage a team with focused responsibilities resolving front-end rejection, submitting medical necessity appeals, and responding to medical records… more
- Molina Healthcare (TX)
- …denied cases, in which an appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing. Identifies and ... for making appropriate and correct clinical decisions for appeals outcomes within compliance standards. This position will support our Claims business. The candidate… more
- Intermountain Health (Austin, TX)
- …Additionally, the Manager will support coordinating efforts on clinical denials for medical necessity when needed and collaborate with external stakeholders for ... or Above) in a hospital setting. + Demonstrated skills and experience in Medical Billing, Computer Coding , Business Office, Revenue Cycle, + Insurance… more
- RTX Corporation (Richardson, TX)
- …design and implement development and mission solutions + Integrate security and compliance into the platform with services such as encryption and access management. ... frameworks such as Chef, Puppet, and Ansible. + Knowledge of secure coding practices such as OWASP, secrets management, and vulnerability remediation. + Experience… more