- HCA Healthcare (Plano, TX)
- **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? ... are a committed, caring group of colleagues. Do you want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive… more
- Texas Health Resources (Arlington, TX)
- …coding education, training, and best practices for areas vulnerable to compliance errors. Denial Support & Case Review - Conduct additional reviews to assist ... organizational policies. Evaluate the effectiveness of internal controls and compliance procedures. Coding & Documentation Review - Assist the audit team with… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …coding inventories. Coordinates with vendor quires and questions related to assigned multi-specialty coding inventories. + Review ETM coding denials for ... coding training programs, educational handouts/materials, FAQs, etc. for physicians/providers, coding staff and clinical department administrators. + Assist… more
- US Physical Therapy (Houston, TX)
- …Pricing rationale + Maintain and update pricing annually for new CPT Codes + Review denial trends + Financial Class determination + Update Medicare Expected ... nationwide, across 44 states, offering them the resources, operational support, and clinical expertise needed to thrive in today's healthcare landscape. By aligning… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are ... regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services, length of stay and… more
- Datavant (Austin, TX)
- …to realize our bold vision for healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, ... review of admissions for medical necessity and necessity of...medical necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be… more
- Ascension Health (Austin, TX)
- …utilization management and denial mitigation, including but not limited to: + Review medical records of identified patients to assist with the level of care ... appropriate utilization of alternate levels of care, community resources, clinical documentation improvement, coding , quality and/or compliance processes.… more