Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)TX$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
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).
Trauma Surgical Profee Coder HCA Healthcare IncTrauma Surgical Profee CoderAustin, TXYou will be a key promoter of Central Coding and responsible for setting the tone of the Coding Physician Service Center as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs. Submit your application for the opportunity below: Trauma Surgical Profee Coder Job Summary and Qualifications As a Profee Coder, you will be responsible for reviewing and coding clinical notes and operative reports for a minimum of one specialty.
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 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.
Coding Specialist (31954) GI AllianceCoding Specialist (31954)Austin, TXInterprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services. Responsibilities/Duties/Functions/Tasks: Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
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.
Supervisor, Revenue Cycle and Coding Specialist TRAVIS COUNTY HEALTHCARE DISTRICTSupervisor, Revenue Cycle and Coding SpecialistAustin, TXThis role functions as the primary liaison between Revenue Cycle, clinical providers, and coding teams, supporting documentation and coding improvement through education and collaboration This role leads initiatives to improve documentation integrity, coding accuracy, compliant charge capture, and revenue performance through targeted provider education, coding audits, workflow evaluation, and continuous improvement strategies. Through prospective and retrospective audits, the role identifies documentation gaps, coding inaccuracies, denial drivers, and compliance risks, and partners with clinical, operational, coding, and compliance leadership to drive measurable improvement in provider documentation quality and reimbursement outcomes.
Supervisor, Revenue Cycle and Coding Specialist Central HealthSupervisor, Revenue Cycle and Coding SpecialistAustin, TexasFull timeThis role functions as the primary liaison between Revenue Cycle, clinical providers, and coding teams, supporting documentation and coding improvement through education and collaboration This role leads initiatives to improve documentation integrity, coding accuracy, compliant charge capture, and revenue performance through targeted provider education, coding audits, workflow evaluation, and continuous improvement strategies. Through prospective and retrospective audits, the role identifies documentation gaps, coding inaccuracies, denial drivers, and compliance risks, and partners with clinical, operational, coding, and compliance leadership to drive measurable improvement in provider documentation quality and reimbursement outcomes.
IPA Consultative Coding Manager Humana IncIPA Consultative Coding ManagerTXRemote$86,300–$118,700 / yearWork at Home Requirements: To 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 required; wireless, wired cable or DSL connection is suggested. This includes monitoring coding staff workload and redistributing resources as needed to meet market operational demands, developing KPIs to monitor the performance of the consultative coding team, tracking and monitoring responses to provider questions for consistency, and analyzing trends to identify opportunities for improved documentation and coding.
Coding Quality Auditor Houston Methodist HospitalCoding Quality AuditorTXHouston 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.
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).
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.
NewCoding Auditor AscensionCoding AuditorAustin, TexasFull timeOur legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. What minimum qualifications you'll need: Licensure / Certification / Registration: Certified Professional Coder (CPC) credentialed from the American Academy of Professional Coders (AAPC) preferred.
Senior Clinical Coding Analyst TriWest Healthcare AllianceSenior Clinical Coding AnalystAustin, TXRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment.
Program Integrity Investigator (Healthcare Fraud Waste & Abuse) TriWest Healthcare AllianceProgram Integrity Investigator (Healthcare Fraud Waste & Abuse)Austin, TXRemoteFull timeComplies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).
NewClinical Documentation Specialist RN Houston Methodist HospitalClinical Documentation Specialist RNTXThis Clinical Documentation Specialist RN position also facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient care givers, and medical records coding staff to ensure that appropriate reimbursement is received for the level of service rendered to all patients. 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.
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.
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.