Sr Outpatient Coder Houston Methodist HospitalSr Outpatient CoderTXMust have one of the following: • RHIT - Certified Health Information Technician (AHIMA) • RHIA - Registered Health Information Administrator (AHIMA) • CCS - Certified Coding Specialist (AHIMA) • CCA - Certified Coding Associate (AHIMA) • CCS-P - Certified Coding Specialist Physician-Based (AHIMA) • CPC - Certified Professional Coder (AAPC). Must have one of the following: •RHIT - Certified Health Information Technician (AHIMA) •RHIA - Registered Health Information Administrator (AHIMA) •CCS - Certified Coding Specialist (AHIMA) •CCA - Certified Coding Associate (AHIMA) •CCS-P - Certified Coding Specialist Physician-Based (AHIMA) •CPC - Certified Professional Coder (AAPC).
Inpatient Coder Houston Methodist HospitalInpatient CoderTXHouston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.
Medical Coding Specialist (Flexible schedule options) Aspire Allergy & SinusMedical Coding Specialist (Flexible schedule options)austin, texasThe Certified Medical Coder or Charge Entry Specialist is responsible for reviewing a patient’s medical records after a visit and translating into codes that insurers use to process claims. This includes confirming treatment with providers and medical staff, identifying missing information and submitting claims to insurers for reimbursement.
Medical Account Receivable Specialist (Level 3) Aspire Allergy & SinusMedical Account Receivable Specialist (Level 3)Austin, TexasThe Level 3 AR Specialist also identifies root causes of reimbursement challenges, supports Accounts Receivable operations across all financial classes as needed, and ensures compliance with industry regulations, practice protocols, and company policies while driving overall revenue cycle performance. Aspire Allergy & Sinus is seeking a full-time Medical Accounts Receivable Specialist (Level 3) to serve as a subject matter expert (SME) responsible for resolving complex, high-dollar, and systemic reimbursement issues.
Certified Professional Medical Auditor Kinwell HealthCertified Professional Medical AuditorTXRemote$58,600–$93,800 / yearIn addition to auditing, the auditor is responsible for correcting coding errors, submitting clarifying queries to clinicians, coding outpatient encounters, and delivering targeted coding education. This role supports both revenue cycle optimization and clinical documentation excellence by partnering closely with coding teams, compliance, and primary care providers.
Coding Quality Assur Spec III Texas Children's HospitalCoding Quality Assur Spec IIITXIn this position you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. Ascertains the accuracy of the physicians'' E/M and procedure coding to their documentation and completes the auditing reporting tool and provides this feedback to the education team and/or provider.
Provider Coding Education Specialist The University of Texas at AustinProvider Coding Education SpecialistAustin, TexasCertification in at least ONE of the following: Certified Coding Specialist (CCS) from AHIMA or Certified Professional Coder Instructor (CPC-I), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Physician Practice Manager (CPPM), Certified Documentation Expert Outpatient (CDEO), or Certified Professional Compliance Officer (CPCO) from AAPC. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.
Senior Compliance Coding Auditor (REMOTE) TRAVIS COUNTY HEALTHCARE DISTRICTSenior Compliance Coding Auditor (REMOTE)Austin, TXRemoteEssential Functions: Conduct prospective and retrospective chart reviews (i.e. baseline, routine periodic, monitoring, and focused) comparing medical record notes to reported CPT/HCPCS and ICD codes with consideration of applicable payer coding requirements. Work closely with all departments, including but not limited to, Clinical Services, Nursing, Practice Leadership, Finance, IT, Training, Rev Cycle, and Billing to assist in accuracy of reported services and with chart reviews, as requested.
Revenue Cycle and Coding Specialist (Remote, based in Austin, Tx) TRAVIS COUNTY HEALTHCARE DISTRICTRevenue Cycle and Coding Specialist (Remote, based in Austin, Tx)Austin, TXRemoteAdheres to internal coding policies and expectations set forth by management and acts as a trainer and resource: Reviewing clinical documentation to assign appropriate ICD-10, CPT, HCPCS, and other relevant codes; Ensuring that all codes assigned align with the services rendered, diagnoses, and treatments documented in the patient''s medical records; Making necessary adjustments to codes in cases where discrepancies or errors are identified; Collaborating with healthcare providers to clarify documentation and coding as needed; Adhering to all applicable coding guidelines, including those provided by the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Under the supervision of the Revenue Cycle Supervisor, responsible for revenue cycle functions including and not limited to coding/edit charge review, accurate timely submission of insurance claims, failed claims/follow‐up resolutions, training, education, research, denial appeals, resolving unpaid medical claims, cash posting, processing billing calls and inquiries and may serve as an intermediary between healthcare providers, clients, patients, and health insurance companies.
Revenue Cycle and Coding Specialist (Remote, based in Austin, Tx) Central HealthRevenue Cycle and Coding Specialist (Remote, based in Austin, Tx)Austin, TexasRemoteFull timeAdheres to internal coding policies and expectations set forth by management and acts as a trainer and resource: Reviewing clinical documentation to assign appropriate ICD-10, CPT, HCPCS, and other relevant codes; Ensuring that all codes assigned align with the services rendered, diagnoses, and treatments documented in the patient's medical records; Making necessary adjustments to codes in cases where discrepancies or errors are identified; Collaborating with healthcare providers to clarify documentation and coding as needed; Adhering to all applicable coding guidelines, including those provided by the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Overview: Under the supervision of the Revenue Cycle Supervisor, responsible for revenue cycle functions including and not limited to coding/edit charge review, accurate timely submission of insurance claims, failed claims/follow‐up resolutions, training, education, research, denial appeals, resolving unpaid medical claims, cash posting, processing billing calls and inquiries and may serve as an intermediary between healthcare providers, clients, patients, and health insurance companies.
Coding Quality Educator - Remote Providence Health & ServicesCoding Quality Educator - RemoteTXRemoteRequsition ID: 443735 Company: Providence Jobs Job Category: Coding Job Function: Revenue Cycle Job Schedule: Full time Job Shift: Multiple shifts available Career Track: Business Professional Department: 4010 SS PE OPTIM Address: WA Renton 1801 Lind Ave SW Work Location: Providence Valley Office Park-Renton Workplace Type: On-site Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Coding Quality Auditor Houston Methodist HospitalCoding Quality AuditorTXSKILLS AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles Knowledge of an electronic medical record and imaging systems Working knowledge of medical terminology, anatomy and physiology Proficiency with electronic encoder application AHIMA designated ICD-10 Approved Trainer preferred. Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities.
Coding Analyst Sr. Elevance Health IncCoding Analyst Sr.Austin, TXWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
Ambulatory Payment Classification Coordinator Houston Methodist HospitalAmbulatory Payment Classification CoordinatorTXMust have one of the following: • RHIT - Certified Health Information Technician (AHIMA) • RHIA - Registered Health Information Administrator (AHIMA) • CCS - Certified Coding Specialist (AHIMA) • CCA - Certified Coding Associate (AHIMA) • CCS-P - Certified Coding Specialist Physician-Based (AHIMA) • CPC - Certified Professional Coder (AAPC) • CPC-H - Certified Professional Coder - Hospital (AAPC) • CPC-I - Certified Professional Coder Instructor (AAPC) • CPC-A - Certified Professional Coder Associate (AAPC) • CCC - Certified Cardiology Coder (AAPC) • COC - Certified Outpatient Coder (AAPC). Must have one of the following: •RHIT - Certified Health Information Technician (AHIMA) •RHIA - Registered Health Information Administrator (AHIMA) •CCS - Certified Coding Specialist (AHIMA) •CCA - Certified Coding Associate (AHIMA) •CCS-P - Certified Coding Specialist Physician-Based (AHIMA) •CPC - Certified Professional Coder (AAPC) •CPC-H - Certified Professional Coder - Hospital (AAPC) •CPC-I - Certified Professional Coder Instructor (AAPC) •CPC-A - Certified Professional Coder Associate (AAPC) •CCC - Certified Cardiology Coder (AAPC) •COC - Certified Outpatient Coder (AAPC).
Coding Analyst Sr. Elevance HealthCoding Analyst Sr.Austin, FloridaWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
Auditor, Risk Adjustment Oscar Health IncAuditor, Risk AdjustmentTXRemote$82,717–$108,566 / yearResponsibilities: Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts. Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar''s unlimited vacation program and annual performance bonuses.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Austin, TXRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Health Information Management Clinical Documentation Integrity Specialist Parkland HospitalHealth Information Management Clinical Documentation Integrity SpecialistTXIdentifies need to clarify documentation in records and utilizes strong communication skills with physician, physician extender, nurse or other healthcare professionals, utilizing appropriate tools to capture needed documentation. Stays 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.
Managed Care Analyst University of Texas MD Anderson Cancer CenterManaged Care AnalystTXRemoteThe Analyst serves as a bridge between technical teams, finance, managed care administrators, and operational teams to translate complex contractual and technical information into actionable business insights, with a focus on advanced data analysis and accurate calculation automation. The Managed Care Analyst position is responsible for building, maintaining, optimizing, and analyzing managed care contracts within Epic's Contract Maintenance and Contract Modeling modules for both hospital (HB) and professional (PB) billing environments to ensure accurate reimbursement calculations.
Special Investigations Unit Investigator CareOregon IncSpecial Investigations Unit InvestigatorTX$72,765–$88,935 / yearStrong research, investigative and problem-solving skills Strong communication skills, including written, verbal and listening skills Effective computer skills, including MS Office Suite Strong interpersonal and motivational skills Ability to think logically and creatively without undue influence from personal biases Ability to operate with a high degree of professionalism and confidentially Ability to plan, organize, manage, and monitor work projects Ability to facilitate learning opportunities in a variety of informal and formal settings Ability to make presentations to small and large groups. Ability to bend and speak clearly for at least 3 hours/day Ability to learn, focus, understand, and evaluate information and determine appropriate actions Ability to accept direction and feedback, as well as tolerate and manage stress Ability to see, read and hear and for at least 6 hours/day Ability to perform repetitive finger and wrist movement for at least 3-6 hours/day Ability to work effectively with diverse individuals and groups.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Austin, TXRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Investigations Unit Investigator, Senior CareOregon IncInvestigations Unit Investigator, SeniorTX$90,225–$110,275 / yearCareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). Help identify potential areas of FWA vulnerability and risk; assist department leadership in developing and implementing corrective action plans for resolution of problematic issues and provide general guidance on how to avoid or deal with similar situations in the future.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)TX$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)TX$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)TX$43,888–$93,574 / yearExperience with Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research. Bachelor's Degree in Criminal Justice, Healthcare Management, Public Health, Biological Sciences, Data Analytics, or other related field preferred or equivalent experience.