- 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
- Oracle (Austin, TX)
- …your career in this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical inputs to engineering for ... Denial Prevention and Appeals features of Oracle Health Clinical AI Agent (CAA). This role leverages expert ...clinical validation) to lead the appeals initiative to review denied claims, create write-ups for appeals packets, identify… 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
- 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
- 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 (Dallas, TX)
- …review , long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with… more
- HCA Healthcare (Dallas, TX)
- …**What you will do in this role:** + Conduct reviews of charging, coding , and clinical documentation, collaborating with Corporate Revenue Integrity Leadership ... recognized. Submit your application for the opportunity below:Revenue Integrity Charge Review Analyst Parallon **Benefits** Parallon offers a total rewards package… more
- Prime Therapeutics (Austin, TX)
- …staff and/or pharmacists. + Escalates requests to Pharmacist when request requires extensive clinical review or denial . + Monitors telephone system to ... Come build the future of pharmacy with us. **Job Posting Title** Clinical Pharmacy Technician Sr - Remote **Job Description** Evaluates and authorizes approval… more
- MD Anderson Cancer Center (Houston, TX)
- …future denials and delays in payment. * Pursue appeals when available, collaborating with coding teams and clinical staff for coding -related and medical ... Expertise*: Skilled in managing work queues, following up on claims, denial management experience, experience using UB-04 (CMS-1450) forms, and engaging payor… more
- Public Consulting Group (Austin, TX)
- …other contractual deliverables when needed. Ensures accurate system support through review and updating reference data, contractual metrics, and compliance metrics. ... other contractual deliverables when needed. Ensures accurate system support through review and updating reference data, contractual metrics, and compliance metrics.… 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
- Cardinal Health (Austin, TX)
- …Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and ... revenue cycle process. This includes, billing follow up, collections, payment posting, denial resolution, and responding to patient inquiries in a professional and… more