- HCA Healthcare (Pasadena, TX)
- **Description** **Introduction** Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. ... make a difference. We are looking for a dedicated Coding Quality Audit Reviewer...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
- Elevance Health (Houston, TX)
- …based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical claims ... medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review...information to make audit determinations and generate audit findings letters. + Maintains accuracy and quality… more
- HCA Healthcare (Arlington, TX)
- …the monthly random, focus, prebill review , and Ad Hoc quality review process + Submits and reviews coding appeals as appropriate **What qualifications ... with vendor management including monitoring processes and services for improvement, coding quality , trending/analyzing data, creating and presenting education,… more
- Houston Methodist (Houston, TX)
- …education sessions to coding staff based on needs identified due to coding audit results, regulatory changes, hospital policy changes or implementation of ... coding program and monitor the success of the coding program including assisting with student recruitment. ** QUALITY...or education **WORK EXPERIENCE** + Eight years of progressive coding and/or coding review (auditing)… more
- CenterWell (Austin, TX)
- …and internal business rules to respond to inquiries and issues. **Post-Visit/Offshore Coding Collaboration:** + Perform Quality Assurance on post-visit reviews. ... (Frequency and sampling methodology to be determined) + Review the encounter for potential missed opportunities. + Address...positive, collaborative mindset to foster partnership within and the Coding , Audit , and Education department, the PCO,… more
- Datavant (Austin, TX)
- …provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily operations pertaining to ... closely with Management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. **You will:** + Maintain a quality … more
- Datavant (Austin, TX)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... references for accurate DRG and APC assignment. + Review non-CC/MCC records to assess proper coding ...appropriate manager. + Prepare the final reports for the coding audit and actively participates in the… more
- Coinbase (Austin, TX)
- …and fully supported. *_* *Team / Role Paragraph:* Coinbase is looking for an Internal Audit IT Senior to join the Internal Audit team focusing primarily on ... US (Remote) and will be reporting to an Internal Audit IT Senior Manager. The individual will be responsible...to maximize meetings utility, testing efficiencies and internal controls review coverage across the organization. * Serve as a… more
- Datavant (Austin, TX)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... ED, Observation and I&I** **What You Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and… more
- Datavant (Austin, TX)
- …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... Academic/Trauma Level 1 facility. **What You Will Do:** + Performs Inpatient Facility coding audits according to scope of work, for the purpose of Onboarding,… more
- Health Care Service Corporation (Richardson, TX)
- …of or experience with BlueChip claims processing is a strong plus. + Knowledge of quality review processes is a strong plus. + Ability to analyze problem claims ... internship is in Richardson, TX **What Are Your Responsibilities?** The Audit Specialist Intern responsibilities may include assisting with claim accuracy audits… more
- Molina Healthcare (San Antonio, TX)
- …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding . **Job Summary** Utilizing clinical knowledge and experience, ... decision making pertinent to clinical experience + Documents clinical review summaries, bill audit findings and ...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience + Familiar with… more
- UTMB Health (Galveston, TX)
- …Health Care Administration. + Experience in billing/ coding , collections, claims, and quality and integrity audit review . **Equal Employment Opportunity** ... in payer requirements in a timely manner. + Ensures quality measurements, such as charge audits and compliance driven...of CDM, regulatory compliance, ICD-10, and CPT-4 medical record coding and UB04 billing. + Knowledge and understanding of… more
- Datavant (Austin, TX)
- …and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review ). You will manage ... regulations and best practices related to prospective risk capture and concurrent review . **Compliance & Quality :** + Partner with Legal, Compliance, and… more
- Methodist Health System (Dallas, TX)
- …for end of month. **_Duty 7_** : Assists in all other areas within the coding /auditing department as directed by Director/ Audit Manager. **_Duty 8_** : Adhere to ... Coder ( **CPC** ) certification from AAPC **or** Certified Coding Specialist - Physician-based ( **CCS-P** ) certification from...medical record. **Your Job Responsibilities** : **_Duty 1_** : Audit coder I & II assigned E&M levels and… more
- Humana (Corpus Christi, TX)
- …a part of our caring community and help us put health first** The Quality Assurance, Clinical Professional 1 consults and collaborates with clinicians to ensure high ... accountability of compliance and quality . The Quality Assurance, Clinical Professional 1...all records meet federal, state, and payer-specific standards, reducing audit risk and financial exposure. The QA Auditor will… more
- Houston Methodist (Katy, TX)
- …PERM, TPE, and commercial payer audits. + Oversee case intake, documentation collection, quality review , and timely submission. + Track and analyze audit ... and appeal outcomes to identify risks and recommend improvements. + **Compliance & Quality Assurance** + Ensure all audit activity complies with CMS, commercial… more
- WTW (Dallas, TX)
- …of project + Clearly communicate and professionally interact with vendor and audit team + Review documentation of potential discrepancies for thoroughness ... **Description** As a Lead Auditor you will apply your audit , project management and client management skills to lead client audits. You will serve as the team leader… more
- Datavant (Austin, TX)
- …preferably within an academic medical facility. + Experience with significant level of coding quality review feedback + Experience in computerized encoding ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
- CGI Technologies and Solutions, Inc. (Dallas, TX)
- …on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity, ... on various payment integrity domains, including pre-payment review , post-payment audit , FWA detection and prevention, coding accuracy, clinical integrity,… more