NewRating/Claims System Analyst Elevance Health IncRating/Claims System AnalystGrand Prairie, TX$65,680–$94,415 / yearThree or more years of experience leading end-to-end User Acceptance Testing (UAT), including: (Test strategy and planning, Test scenario and test case development, Test execution, Defect management and validation, Production readiness activities, Code editing and claims knowledge) preferred. How you will make an impact: Responsible for collaborating with cross-functional stakeholders, including business partners, Product Owners, developers, Quality Engineering teams, and vendors, to ensure solutions meet business and technical requirements.
Benefit Verification Specialist - DFW Urology Partners of North TexasBenefit Verification Specialist - DFWArlington, TXIn this dynamic position, you’ll handle essential day-to-day administrative functions such as patient registration, insurance verification, prior authorizations, and managing key tasks like scanning, faxing, and financial reconciliation of deductibles, copayments, and coinsurance. Accurately utilizes cost estimate technology to create cost estimates for services and communicates estimated costs to patients and other affected parties.
Revenue Integrity Technician Parkland HospitalRevenue Integrity TechnicianTXStays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Maintains positive working relationships with other hospital departments such as Patient Financial Services, Medical Records, Compliance, and Clinical areas to ensure that the responsibilities of the department are performed in an expeditious and thorough manner.
Senior Manager, Corporate Compliance - Risk Adjustment CVS Health CorpSenior Manager, Corporate Compliance - Risk AdjustmentIrving, TX$75,400–$165,954 / yearThis position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements. As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements.
NewClaims Examiner Sr Sigma IncClaims Examiner SrIrving, TXThis is an excellent opportunity for professionals with experience processing medical claims, Medicare, managed care, and healthcare reimbursement . Collaborate with Business Configuration, Appeals, Provider Data, Network Management, and other operational teams.
NewAR Specialist I Methodist Health SystemAR Specialist IDallas, TXNamed one of the fastest-growing health systems in America by Modern Healthcare, Methodist has a network of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation, Level III Neonatal Intensive Care, neurosurgery, robotic surgical programs, oncology, gastroenterology, and orthopedics, among others. Work Shift: Job Description: Your Job: Working with one or more account receivables management system modules including but not limited to billing, claim corrections, reconciliation, payment posting, refunds/credit balances, customer service, and follow-up in accordance with the departmental protocol with an emphasis on maximizing customer satisfaction and profitability.
Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical CareDialysis Clinical Manager Registered Nurse - RNDallas, TexasOther: • Collaborates closely with, providing oversight as needed to, the Clinical Manager/Charge RN acting as nurse manager, the Medical Director, and the physicians regarding the direct patient care responsibilities within the facility to ensure the provision of outstanding quality of patient care, as defined by the FMS quality goals, and compliance with the pertinent company policies and procedures. • Demonstrated leadership competencies and management skills for the position, including excellent communication, customer service, continuous quality improvement, relationship development, results orientation, team building, motivating employees, performance management and decision making.
Principal Engineer-Software Development VerizonPrincipal Engineer-Software DevelopmentIrving, TexasYou will mentor technical teams and develop high-quality, robust applications that meet critical business needs within our evolving Customer Experience Platform (CXP) and FiOS Order management platform. In the role of Principal Engineer of Software Development, you will provide technical leadership for the design and implementation of complex, scalable software solutions primarily using Java Spring Boot and React.
NewInpatient Corporate Coder - Remote based in the US Tenet Healthcare CorpInpatient Corporate Coder - Remote based in the USDallas, TXRemote$26.40–$38 / hourThe CC is responsible for coding of Tenet facilities as assigned, assisting with productive coding to maintain DNFC, assisting with quality chart reviews, assisting with the training of new CC's and/or other projects where indicated. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need.
Refund Specialist (Credit Balance Reconciliation) RPC CompanyRefund Specialist (Credit Balance Reconciliation)Dallas, TX$20–$22 / hourAward-winning Radiology clinic hiring a full-time Refund Specialist at our Dallas, TX 75231 location off Walnut Hill Lane to handle the timely & thorough reconciliation of line-item credit balances. Maintain a high level of accuracy and efficiency regarding data input & account balance determinations while achieving minimum goal of 50 (fifty) account reviews daily.
Auditing & Education Consultant-Profee CorroHealth IncAuditing & Education Consultant-ProfeeTXRemoteEssential Functions: Perform complex, concurrent and/or retrospective analysis of medical record documentation to Validate coded data as recognized by the AHA, CMS, AMA, AHIMA, AAPC, Coding Clinic, and CPT Assistant. JOB SUMMARY: Serves in a consulting role by evaluating the work of client's coders in their assignment of ICD-10, CPT and/or HCPCS codes to hospital inpatient, outpatient and/or physician practice encounters.
Supervisor, DRG Revenue Integrity - REMOTE CorroHealthSupervisor, DRG Revenue Integrity - REMOTEPlano, TexasRemoteThis role ensures compliance with AHA, CMS, AMA, AHIMA, AAPC, Coding Clinic, CPT Assistant, and official coding guidelines, while supervising a team of auditors. The Supervisor, DRG Integrity Reviews/Audits, is responsible for overseeing the execution, quality, and delivery of complex, concurrent, and retrospective coding audits.
DRG Revenue Integrity Auditor - REMOTE CorroHealthDRG Revenue Integrity Auditor - REMOTEPlano, TexasRemoteThe DRG Revenue Integrity Auditor (DRG-A) performs comprehensive Diagnostic Related Group (DRG) validation and quality audits on inpatient medical records to ensure accurate representation of each patient's clinical story. As a global healthcare solutions company, we invest in our people through continued education, career advancement opportunities, mentorship from industry experts, and a flexible work environment that supports work-life balance.
Clinical Nurse Reviewer Zelis Healthcare, Inc.Clinical Nurse ReviewerPlano, TX$59,000–$75,050 / yearThe Nurse Reviewer is primarily responsible for conducting post-service, pre or post payment in-depth claim reviews based on accepted medical guidelines and clinical criteria, billing and coding rules, plan policy exclusions, and payment errors/overpayments. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Health Information Manager HIM ClearSky HealthHealth Information Manager HIMMansfield, TexasSafeguards the confidentiality of all medical records by ensuring the Release of Information policy is followed in accordance with HIPAA and other requirements; securing legal/risk management records; responding timely to subpoenas and/or court orders; and representing the hospital in court hearings and/or depositions as required. Oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization’s policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and the healthcare organization’s information privacy practices.
Health Information Management (HIM) Manager ClearSky HealthHealth Information Management (HIM) ManagerMansfield, TexasSafeguards the confidentiality of all medical records by ensuring the Release of Information policy is followed in accordance with HIPAA and other requirements; securing legal/risk management records; responding timely to subpoenas and/or court orders; and representing the hospital in court hearings and/or depositions as required. Oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization’s policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and the healthcare organization’s information privacy practices.
Medical Practice Assistant Parkland HospitalMedical Practice AssistantDallas, TXProactively outreaches to patients using motivational interviewing, demonstrating effective, caring communication to build patient trust and establish and maintain relationships to gather information, encourage patient self-interest in healthcare, and follow up on patient-established goals. Assists patients and families with health system navigation, making appointments, patient advocacy, determination of community resources to reduce barriers to care, and support set-up and initiation of electronic communication modes (email, MyChart, etc.).
Medical Practice Assistant- ENT/Oral Surg Clinic Parkland HospitalMedical Practice Assistant- ENT/Oral Surg ClinicTXProactively outreaches to patients using motivational interviewing, demonstrating effective, caring communication to build patient trust and establish and maintain relationships to gather information, encourage patient self-interest in healthcare, and follow up on patient-established goals. Assists patients and families with health system navigation, making appointments, patient advocacy, determination of community resources to reduce barriers to care, and support set-up and initiation of electronic communication modes (email, MyChart, etc.).
Medical Practice Assistant - Garland Pediatrics Parkland HospitalMedical Practice Assistant - Garland PediatricsGarland, TXVirtual Care Only: Proactively outreaches patient utilizing motivational interviewing, demonstrating effective and caring communication to develop patient trust and establish and maintain relationships to gather information, encourage patient self-interest in healthcare, and follow up on patient established goals. Assists patients and families with health system navigation, making appointments, patient advocacy, determination of community resources to reduce barriers to care, and support set-up and initiation of electronic communication modes (email, MyChart, etc.).
Medical Practice Assistant - PRN Parkland HospitalMedical Practice Assistant - PRNTXStays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Proficiently performs patient service activities in coordination with clinical team, including but not limited to: Ensures patient and family comfort, safety, privacy and confidentiality at all times.