Medical Management - Medical Review Examiner Nurse 135-1009 CommunityCareMedical Management - Medical Review Examiner Nurse 135-1009Tulsa, OKIdentifying issues related to and/or participates in various projects aimed at identifying areas of non-compliance and/or potential fraud, waste and abuse, as it relates to provider billing practices. EDUCATION/EXPERIENCE: Current, active, unrestrictive license to practice as Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the State of Oklahoma.
Medical Records Clerk Family Health Center of Southern OklahomaMedical Records ClerkOK10) Administers specified medication, orally or by subcutaneous, intravenous, or inter-muscular injection, and notes time and amount on patients' charts. Providing care for all patients whether they have insurance or not, we offer comprehensive services like medical, dental, prescription and mental health services, striving to treat the whole body.
Medical Records Specialist FAMILY & CHILDRENS SERVICES, INC.Medical Records SpecialistTulsa, OKPrimary responsibilities include; prepping, scanning, indexing and reviewing of records and loose documentation for incompleteness; processing requests for protected health information and various medical records support functions; destruction of medical records that have reached the appropriate date of maturity. Review all clinical documentation for completeness before it is prepped, scanned and indexed into the client record; Scan, and Index client records and loose documentation generated from inside and outside the agency per document imaging protocols.
Medical Review Officer (MRO) - Bid MaximusMedical Review Officer (MRO) - BidTulsa, OKFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - After completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)OK$50,460–$72,644 / yearRequired as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Medical Records Technician (Third Party Billing) US Department of Health and Human ServicesMedical Records Technician (Third Party Billing)Pawnee, OK$45,409–$59,031 / yearRequired as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Career Transition Assistance Program (CTAP)/Interagency Career Transition Assistance Program (ICTAP): If you are claiming CTAP/ICTAP, follow the instructions below: http://www.opm.gov/policy-data-oversight/workforce-restructuring/employee-guide-to-career-transition/ctap_guideline.pdf.
Medical Records Technician US Department of Health and Human ServicesMedical Records TechnicianLawton, OKMENU Sign in My jobs Profile Resumes & documents Search preferences Notifications Sign out My jobs Profile Resumes & documents Notifications Search preferences Sign out Events Help Center Search Back to results Apply Medical Records Technician Department of Health and Human Services Indian Health Service Various locations across the Agency Apply Print Share Save. Perform a variety of medical records technician duties which include the complete and accurate process and maintenance of hybrid paper-electronic environment of analyzing filing compiling scanning releasing information retrieving and dispatching charts and documents file managing archiving Third Party and entering data of treatment provided to patients within a complex health care facility.
Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadOklahoma City, OKRemoteFull timeThe team lead supports clinical and non-clinical staff supporting CQM programs by providing training and onboarding of new staff; determining work assignments; performing audits for clinical records and/or work accuracy; and ensuring effective, consistent and accurate workflow. Technical Skills: Comprehensive knowledge of research methodology; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria; proficient with Microsoft Word, Excel, and PowerPoint.
Utilization Review and Preauthorization Nurse Alliance Coal LLCUtilization Review and Preauthorization NurseTulsa, OKRoute complex inpatient, outpatient, specialty, or high-cost service requests to the appropriate clinical reviewer (Medical Director, Nurse Manager, or Care Manager). As a leading provider of baseload energy for both domestic and international markets, ARLP boasts a diverse portfolio of coal assets and mineral and royalty interests.
Utilization Review and Preauthorization Nurse Alliance Resource Partners LPUtilization Review and Preauthorization NurseTulsa, OKRoute complex inpatient, outpatient, specialty, or high-cost service requests to the appropriate clinical reviewer (Medical Director, Nurse Manager, or Care Manager). As a leading provider of baseload energy for both domestic and international markets, ARLP boasts a diverse portfolio of coal assets and mineral and royalty interests.
Lead Reviewing Physician Consultant (Bid) MaximusLead Reviewing Physician Consultant (Bid)Oklahoma City, OKFull timeAfter completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.
Mental Health Reviewing Consultant (Bid) MaximusMental Health Reviewing Consultant (Bid)Oklahoma City, OKFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - After completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service.
Alternate Vision Reviewing Physician Consultant (BID) MaximusAlternate Vision Reviewing Physician Consultant (BID)Oklahoma City, OKFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Maintain working knowledge of Office of Personnel Management (OPM) medical and suitability policies and ensure all consultations reflect current clinical best practices, regulatory requirements, and program objectives.
NewMedical Assistant VIPcareMedical AssistantYukon, Oklahoma$18–$23 / hourFull timeGreet and prepare patients for provider examination by obtaining patient history, chief complaint, current medications, medical history, allergies, surgical history, family history, social history, and other preventative medicine reviews, take patients' vitals, and record information in the patient electronic medical record . The Medical Assistant is a clinical role and is responsible for administrative and clinical tasks, such as maintaining patient records, preparing patients and rooms for examination, assisting physicians with exams, and performing front-desk tasks.
Medical Billing Coder I (69287) Variety Care LLCMedical Billing Coder I (69287)Oklahoma City, OKTop performers consistently demonstrate high coding accuracy, low rejection rates, timely claim processing, strong problem-solving skills, and proactive communication with providers and team members. The Medical Billing Coder I plays a critical role in reducing claim denials, supporting revenue cycle performance, and ensuring patients are billed appropriately according to payer and government guidelines.
Medical Assistant II (68877) Variety Care LLCMedical Assistant II (68877)Norman, OKSummary of Duties and Responsibilities: The Medical Assistant assists their assigned Providers with patient examinations, pre-visit questions, treatments and procedures as directed by the Provider, while maintaining an efficient flow of patients through the clinic. Ability to demonstrate, to the satisfaction of the licensed Provider, an ability to perform tasks, administer medications and injections, has knowledge of instrumentation used in lab point of care testing, as directed within 90 days.
Medical Assistant, II Bilingual (69213) Variety Care LLCMedical Assistant, II Bilingual (69213)Oklahoma City, OKSummary of Duties and Responsibilities: The Medical Assistant assists their assigned Providers with patient examinations, pre-visit questions, treatments and procedures as directed by the Provider, while maintaining an efficient flow of patients through the clinic. Ability to demonstrate, to the satisfaction of the licensed Provider, an ability to perform tasks, administer medications and injections, has knowledge of instrumentation used in lab point of care testing, as directed within 90 days.
Medical Assistant, Bilingual (69205) Variety Care LLCMedical Assistant, Bilingual (69205)Oklahoma City, OKSummary of Duties and Responsibilities: The Medical Assistant assists their assigned Providers with patient examinations, pre-visit questions, treatments and procedures as directed by the Provider, while maintaining an efficient flow of patients through the clinic. Ability to demonstrate, to the satisfaction of the licensed Provider, an ability to perform tasks, administer medications and injections, has knowledge of instrumentation used in lab point of care testing, as directed within 90 days.
Medical Assistant, Bilingual (69008) Variety Care LLCMedical Assistant, Bilingual (69008)Oklahoma City, OKSummary of Duties and Responsibilities: The Medical Assistant assists their assigned Providers with patient examinations, pre-visit questions, treatments and procedures as directed by the Provider, while maintaining an efficient flow of patients through the clinic. Ability to demonstrate, to the satisfaction of the licensed Provider, an ability to perform tasks, administer medications and injections, has knowledge of instrumentation used in lab point of care testing, as directed within 90 days.
Medical Assistant, Bilingual (68620) Variety Care LLCMedical Assistant, Bilingual (68620)Oklahoma City, OKSummary of Duties and Responsibilities: The Medical Assistant assists their assigned Providers with patient examinations, pre-visit questions, treatments and procedures as directed by the Provider, while maintaining an efficient flow of patients through the clinic. Ability to demonstrate, to the satisfaction of the licensed Provider, an ability to perform tasks, administer medications and injections, has knowledge of instrumentation used in lab point of care testing, as directed within 90 days.
Medical Assistant I, Bilingual (68596) Variety Care LLCMedical Assistant I, Bilingual (68596)Oklahoma City, OKSummary of Duties and Responsibilities: The Medical Assistant assists their assigned Providers with patient examinations, pre-visit questions, treatments and procedures as directed by the Provider, while maintaining an efficient flow of patients through the clinic. Supports Variety Cares accreditation as a Patient Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable.
Quality Compliance Professional HumanaQuality Compliance ProfessionalOklahoma City, OklahomaRemoteTo ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.
RN Care Manager ArchWell Health LLCRN Care ManagerOklahoma City, OKJob Summary: The Nurse Care Manager is responsible for helping coordinate and evaluate the management of patients with acute and chronic conditions, across the care continuum, to achieve high quality care measured by positive patient outcomes. In our medical clinics, we provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, better patient experience and lower total cost of care.
Clinical Program Manager TruHealth LLCClinical Program ManagerOklahoma City, OKFull timeThe Program Manager is responsible for conducting clinical audits of the providers to ensure excellent service deliver, and that care is administered in accordance with Medicare, Medicare Advantage, and all other compliance programs, state laws and regulatory compliance, privacy and security, detecting, preventing, and correcting fraud, waste, and abuse. The Clinical Program Manager is responsible for supporting cost-effective, high-quality health care for patients enrolled in long-term care facilities within a designated region by managing the activities performed by a team of Providers and to support national clinical strategy and leadership.
Clinical Program Manager American Health Companies IncClinical Program ManagerOklahoma City, OKThe Program Manager is responsible for conducting clinical audits of the providers to ensure excellent service deliver, and that care is administered in accordance with Medicare, Medicare Advantage, and all other compliance programs, state laws and regulatory compliance, privacy and security, detecting, preventing, and correcting fraud, waste, and abuse. JOB SUMMARY: The Clinical Program Manager is responsible for supporting cost-effective, high-quality health care for patients enrolled in long-term care facilities within a designated region by managing the activities performed by a team of Providers and to support national clinical strategy and leadership.
Risk Adjustment - Risk Adjustment Coding Analyst 135-2014 CommunityCareRisk Adjustment - Risk Adjustment Coding Analyst 135-2014Tulsa, OK$95–$98 / hourKEY RESPONSIBILITIES: Ensure ICD codes submitted to CMS for the Risk Adjustment Payment System are accurate, appropriate, and supported by written clinical documentation in accordance with all federal and state regulations. JOB SUMMARY: This role will report directly to the Supervisor of Clinical and Risk Coding and is responsible for clinical and risk adjustment audits for both Medicare Advantage and ACA Programs.