- University Health (San Antonio, TX)
- …accuracy and compliance in coding practices. A strong understanding of reimbursement methodologies, including DRG , APC, and ASC payment structures, is preferred. ... Plan. This position is responsible for conducting complex audits of medical coding , billing, and documentation practices to ensure adherence to federal and state… more
- Elevance Health (Grand Prairie, TX)
- Manager of DRG Coding Audit -Program/Project Locations: _The selected candidate must reside within a reasonable commuting distance of the designated ... eliminate and prevent unnecessary medical-expense spending. The ** Manager of DRG Coding Audit ** leads a high-performing team responsible for auditing… more
- Elevance Health (Houston, TX)
- …be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). **How you will make an ... : + BA/BS preferred. + Experience with vendor based DRG Coding / Clinical Validation Audit...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Elevance Health (Grand Prairie, TX)
- …Experiences** : + BA/BS preferred. + Experience with vendor based Diagnosis-Related Group ( DRG ) Coding /Clinical Validation Audit setting or hospital ... **Build the Possibilities. Make an Extraordinary Impact.** **Title** : DRG Coding Auditor **Virtual: ** _ _...clinical guidelines and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Elevance Health (Houston, TX)
- … Credential such as CCS or CIC. + Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement ... **Title:** Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding… more
- Texas Health Resources (Arlington, TX)
- Manager Compliance Coding _Are you looking for...guidance based on Federal, State, Local, and THR policies. Coding Audit Team Management - Lead the ... work hours: Monday - Friday; 8:00a-5:00p; Position Summary The Coding Compliance Manager oversees and manages auditing...coding audit team, including training and performance evaluation, to maintain… more
- Cardinal Health (Austin, TX)
- …and conducts investigations to resolve ethics and compliance issues. **Compliance Audit Manager ** Reporting to the Compliance Director, this position ... well as the development and completion of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all… more
- Datavant (Austin, TX)
- … changes with the appropriate manager . + Prepare the final reports for the coding audit and actively participates in the resolution of audit findings. + ... headset, and keyboard + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in… more
- Datavant (Austin, TX)
- …headset, and keyboard + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in ... Types of reviews, using appropriate assignment of codes and other coding -related elements using MS DRG or APR DRGs. + Provides rich and concise rationale… more
- Humana (Austin, TX)
- …certification (AHIMA or AAPC - ex: RHIA, RHIT, CCS, CIS, CIC) + Inpatient coding claim experience + Prospective payment methodologies, DRG auditing experience + ... and help us put health first** The Nurse Auditor 2 performs clinical audit /validation processes to ensure that medical record documentation and diagnosis coding … more
- Datavant (Austin, TX)
- …headset, and keyboard + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in ... codes from patient records, ensuring precision and adherence to documentation + Oversee and audit the work of Level 1 & 2 Coders, where applicable + Champion… more
- Molina Healthcare (Dallas, TX)
- …proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated… more
