- Raytheon (Richardson, TX)
- …teams to design and implement development and mission solutionsIntegrate security and compliance into the platform with services such as encryption and access ... to Cloud based web services such as AWSKnowledge of secure coding practices such as OWASP, secrets management, and vulnerability remediationExperience with… more
- Raytheon (Richardson, TX)
- …teams to design and implement development and mission solutionsIntegrate security and compliance into the platform with services such as encryption and access ... frameworks such as Chef, Puppet, and Ansible.Knowledge of secure coding practices such as OWASP, secrets management, and vulnerability remediation.Experience… more
- 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
- CVS Health (Austin, TX)
- …and scope. + Assesses claims for accuracy and compliance with coding guidelines, medical necessity , and documentation requirements. + Documents ... and approves routine claims that cannot be auto adjudicated. Applies medical necessity guidelines, determines coverage, completes eligibility verification,… 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
- Catholic Health Initiatives (Houston, TX)
- …stay reviews, retrospective authorizations utilizing standardized criteria to determine medical necessity ; reviews and processes concurrent denials that ... require medical necessity determinations; processes appeals and reconsiderations. Act as a...efficient operations with all processes, policies, strategies and ensuring compliance with all regulatory and payer requirements. ESSENTIAL KEY… 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
- Adecco US, Inc. (Houston, TX)
- …Review Nurse:** . **Review Medical Records:** Thoroughly evaluate patient medical records to assess the necessity and appropriateness of treatments ... and services. . **Conduct Audits:** Regularly audit medical records and healthcare practices to ensure ...nurse/case management experience . 2 to 3 years of coding experience . Strong analytical, communication, and problem-solving abilities.… more
- Highmark Health (Austin, TX)
- …and in writing when the information provided is not adequate to make a medical necessity determination + Maintain or exceed department call center standards + ... based on the benefits for the line of business, and in compliance with the organization's policies, procedures and regulatory requirements. Document, process and… more
- HCA Healthcare (San Antonio, TX)
- …from the medical record. + Demonstrate understanding of use of all medical necessity software, including but not limited to InterQual. + Demonstrate the ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...root cause of each denial and apply company specific coding for trending and analysis. + Update the patient… 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
- 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 ... to Cloud based web services such as AWS + Knowledge of secure coding practices such as OWASP, secrets management, and vulnerability remediation + Experience with… more
