NewMEDICAL RECORDS CODER 2 Methodist Health SystemMEDICAL RECORDS CODER 2Dallas, TXYour Job Requirements: • High school graduate or its equivalent • Minimum of 2 years of DRG based coding experience in an acute care hospital with experience using an encoder • Proficient in detailed work • Maintain a professional image in handling confidential patient information • Excellent written and oral communication skills to interact with physicians, other health care workers, the general public, administration, and health information management staff • Team oriented Your Job Responsibilities: • Communicate clearly and openly • Build relationships to promote a collaborative environment • Be accountable for your performance • Always look for ways to improve the patient experience • Take initiative for your professional growth • Be engaged and eager to build a winning team Methodist Dallas Medical Center is one of North Texas’ best places to work. The Coder 2 classifies and abstracts inpatient and outpatient diagnoses and procedures, which are assigned appropriate ICD10-CM, ICD10 PCS and/or CPT codes for optimal reimbursement.
NewMEDICAL RECORDS CODER 2- PRN Methodist Health SystemMEDICAL RECORDS CODER 2- PRNDallas, 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. The Coder II classifies and abstracts inpatient/outpatient diagnoses and procedures which are assigned appropriate ICD-10-CM, ICD-10-PCS, and/or CPT codes for optimal reimbursement.
Associate Director, Medical Review Lead, MSRM - Remote Agios PharmaceuticalsAssociate Director, Medical Review Lead, MSRM - RemoteDallas, TXRemote$185,369–$308,948 / yearThe current base salary range for this position is expected to be between $185,369 and $308,948 annualized; final salary will be determined based on various factors including, but not limited to, years of relevant experience, job knowledge, skills and proficiency, degree/education, and internal comparators. This role provides oversight of medical review for Individual Case Safety Reports (ICSRs) across investigational and marketed products, ensuring medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance and risk management activities.
NewRegistered Nurse Navigator Home Health Review-Health Admin CHRISTUS HealthRegistered Nurse Navigator Home Health Review-Health AdminIrving, TXOutreach to TOC patients should focus on medication reconciliation/adherence, self-management, use of personal health records, follow-up with PCPs/Specialists, and review of indicators that a patient’s condition is worsening and how to respond. Promotes a positive work environment by displaying a caring, sensitive approach to others, as evidenced by listening, understanding, and responding to the needs of patients, colleagues, and supervisors.
NewProgram Administration Records Coordinator SevitaProgram Administration Records CoordinatorSan Angelo, TXWith our dedicated team and experienced staff, we provide person-centered services that help people build skills, overcome challenges, and reach their full potential. Maintain files and individual records by updating and filing data upon receipt of information Initiate records for new individuals served and create a computer index .
NewRegistered Nurse Navigator Home Health Review - Population Health Christus HealthRegistered Nurse Navigator Home Health Review - Population HealthIrving, TXAs a key member of the patient’s care team, the RN Navigator acts as a patient advocate, providing proactive outreach to post-acute facilities to review patient needs. The RN Navigator Home Health Review plays a crucial role in monitoring post-acute patients to ensure they continue to meet the CMS criteria for services.
MMM Discharge Planner BC ForwardMMM Discharge PlannerSan Juan, PRFor associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position. Experience supporting quality improvement initiatives, including HEDIS measures, reduction of emergency room utilization, and overall healthcare utilization management.
NewHIM/MEDICAL RECORDS ANALYST/CODING SPECIALIST-FT University Health Services IncHIM/MEDICAL RECORDS ANALYST/CODING SPECIALIST-FTHOUSTON, TXOperating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. Job Duties/Responsibilities: Chart Abstraction and Review Coding Chart Analysis (as needed) Outpatient discharge charts Chart Audits Administrative duties to include answering incoming calls and provide assistance to customers.
Medical Records Clinical Supervisor Nursing Solutions IncMedical Records Clinical SupervisorSherman, TXThis role supervises Medical Records staff, partners with internal teams to resolve deficiencies, and helps ensure consistent quality, strong service, and efficient workflow across the department. The Medical Records Clinical Supervisor is responsible for overseeing medical records review and audit activities to support documentation accuracy, regulatory compliance, and timely response to records requests.
Medical Records Specialist Erico Technologies LLCMedical Records SpecialistHouston, TexasRemote$18–$24 / hourThe Medical Records Specialist will play an important role in maintaining accurate data integrity, supporting internal teams, and ensuring all records are properly processed and stored. This role is fully remote and best suited for individuals who are organized, reliable, and able to work independently while managing multiple documentation tasks.
Medical Records Development Clerk - Remote TX Heard & Smith, LLPMedical Records Development Clerk - Remote TXSan Antonio, TexasRemoteAs the Medical Development Clerk you work closely with the attorneys, legal assistants and other staff to assist in developing client cases by requesting and obtaining updated medical records from. Heard and Smith, LLP was founded on the principles of compassion, humility and the relentless desire to pursue financial assistance for our clients.
Medical Records Clerk Gentiva HospiceMedical Records ClerkStafford, TexasFull timeOur nationwide reach is powered by a family of trusted brands that include: Hospice care: Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon. Our place is by the side of those who need us – from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis.
Medical Records Clerk Team1MedicalMedical Records ClerkHouston, TXA healthcare organization is seeking a Medical Records Clerk to support department needs by gathering medical records, managing medical records requests, and following up on medical records. In the spirit of pay transparency, we want to share the base salary range for this position is $18.00 per hour, not including benefits, potential bonuses, or additional compensation.
Medical Records Technician II Team1MedicalMedical Records Technician IIHouston, TX$15–$16 / hourJoin one of Houston’s top healthcare systems as a Medical Records Technician II and play a vital role in ensuring the accuracy and availability of patient documentation. Located in the Texas Medical Center, this department values teamwork, reliability, and a detail-oriented approach to healthcare support services.
Medical Records Clerk Gentiva Health Services Inc (Inactive)Medical Records ClerkHouston, TXIn this vital administrative role, you will manage and maintain accurate patient records, ensure compliance with healthcare regulations, and provide essential office support to help our team deliver exceptional care. Provide general administrative support, including answering phones, ordering supplies, and data collection/entry.
Medical Records Clerk GentivaMedical Records ClerkHouston, TXIn this vital administrative role, you will manage and maintain accurate patient records, ensure compliance with healthcare regulations, and provide essential office support to help our team deliver exceptional care. + Provide general administrative support, including answering phones, ordering supplies, and data collection/entry.
Medical Record Technician Loyal Source Government Services LLCMedical Record TechnicianTemple, TXShall have at least one of the following credentials from the American Health Information Management Association (AHIMA): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS or CCS-P), or Registered Health Information Administrator (RHIA) or American Academy of Professional Coders (AAPC) Certified Professional Coder (CPC). About Loyal Source Loyal Source is an Orlando-based workforce solutions provider dedicated to delivering elite services worldwide, with a focus in government healthcare, technical and support services, engineering, and travel healthcare.
Hand Surgeon Medical Review Stream Physician Concentra Inc.Hand Surgeon Medical Review Stream PhysicianDallas, TXMust be in active medical practice to perform appeals JOB-RELATED EXPERIENCE:Post-graduate experience in direct patient careJOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills-Demonstrated ability to perform review services.-Ability to work with various professionals including members of regulatory agencies, carriers, employers, nurses and health care professionals. -Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer.
Spine Telecommute Medical Review Stream Physician Concentra Inc.Spine Telecommute Medical Review Stream PhysicianDallas, TXMust be in active medical practice to perform appeals JOB-RELATED EXPERIENCE:Post-graduate experience in direct patient careJOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills-Demonstrated ability to perform review services.-Ability to work with various professionals including members of regulatory agencies, carriers, employers, nurses and health care professionals. -Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer.
NewEmergency Medicine Telecommute Medical Review Stream Physician ConcentraEmergency Medicine Telecommute Medical Review Stream PhysicianHouston, TexasCurrent, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer reviewed literature that support sound and objective decision making and rationales in reviews.
Medical Records Specialist II (31642) GI AllianceMedical Records Specialist II (31642)Leander, TXResponsibilities/Duties/Functions/Tasks: Assembles patients health information including patient symptoms and medical history, exam results, X-ray reports, lab tests, diagnoses, and treatment plans. Uses practice management software to store, tabulate, analyze and retrieve data to improve patient care, control costs, respond to surveys, or use in research studies.
Medical Records Assistant Cardiology AscensionMedical Records Assistant CardiologyCedar Creek, 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. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.
Medical Records Specialist HCA Healthcare IncMedical Records SpecialistAustin, TXWhat you will do in this role: You will perform collection, processing, filing and maintenance of medical recordsYou will arrange all chart forms and correspondence reports (e.g., operative, lab, electrocardiogram, x-ray, pathology, etc.) in appropriate order You are responsible for adhering to medico-legal requirements when answering correspondence and inquiriesYou will obtain all missing chart contents needed to complete medical recordsYou will uphold a checkout and return system for medical records while maintaining confidentiality and security of the documentsYou are responsible for the arrangement of a safe off-site for the storage of microfilming You will serve as a liaison between your surgery center and the transcription companyQualifications you will need: Minimum (1) year of experience in a medical office setting highly preferred (i.e. ambulatory surgery center, hospital, doctor's office) Benefits North Austin Surgery Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses."Bricks and mortar do not make a hospital.
NewROI Medical Records Specialist MRO CorporationROI Medical Records SpecialistVictoria, Texas$16–$22 / hourFull timeResponsibilities: Determines records to be released by reviewing requestor information in accordance with HIPAA guidelines and obtaining pertinent patient data from various sources, including electronic, off-site, or physical records that match patient request. Overview: The ROI Specialist is responsible for providing support at a specified client site for the Release of Information (ROI) requests for patient medical record requests*.
ROI Medical Records Specialist - Local Travel MRO CorporationROI Medical Records Specialist - Local TravelAustin, Texas$16–$22 / hourFull timeResponsibilities: Determines records to be released by reviewing requestor information in accordance with HIPAA guidelines and obtaining pertinent patient data from various sources, including electronic, off-site, or physical records that match patient request. Overview: The ROI Specialist – Local Travel is responsible for providing support at various client sites for the Release of Information (ROI) requests for patient medical record requests*.
Medical Records Specialist - San Antonio Thompson Law Injury LawyersMedical Records Specialist - San AntonioSan Antonio, TXFull timeThompson Law’s vision is to be the law firm of choice for every person injured or killed due to preventable tragedy while providing our clients world-class service and record-setting results. If you're ready to contribute your talents as part of one of Texas's fastest-growing personal injury firms while enhancing your skills within a dynamic environment—apply today!
Site Supervisor, Medical Records, Release of Information MRO CorporationSite Supervisor, Medical Records, Release of InformationOdessa, Texas$52,000–$70,000 / hourFull timeThe Site Supervisor will act as the liaison between MRO and Client Management staff to ensure that all ROI activities are compliant with established client policies, federal and state regulations and are completed in a timely manner. Promotes a positive self-image of MRO with emphasis on customer service by treating patients, co-workers, and medical center personnel with courtesy and respect.
Medical Records Reviewer Bienvivir All Inclusive HealthMedical Records ReviewerEl Paso$13.42–$20.13Full timeRetrieves records from the EMR, prepares and audits medical record packets for participants placement admissions, respite stays, and monthly medical records updates to be sent to nursing home facilities and maintains records of the packets sent as a backup documentation. Bienvivir All-Inclusive Senior Health (“Bienvivir”) is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors.
Medical Review Officer (MRO) - Bid MaximusMedical Review Officer (MRO) - BidSan Antonio, TXFull 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.
Supervisory Medical Records Administration Specialist U.S. Department of DefenseSupervisory Medical Records Administration SpecialistFort Sam Houston, TX$75,776–$98,514 / yearFOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For each relevant work experience, make sure you include the employers name, job title, start and end dates (include month and year), for qualifications purposes, the number of hours worked per week, and a brief description that show you can perform the tasks at the required level listed in the job announcement.
Medical Records Specialist Witherite Law Group PLLCMedical Records SpecialistRichardson, TXPosition Summary: Medical Records Specialist at Witherite Law Group is responsible for managing and organizing all medical records and related documents for ongoing personal injury cases, particularly those involving motor vehicle accidents. Detect, Determine, Perceive, Identify, Recognize, Judge, Observe, Inspect, Estimate, Assess - The ability to observe details at close range (within a few feet of the observer).
Medical Records Assistant Cardiology Ascension Health AllianceMedical Records Assistant CardiologyTXOur 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. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter.
Medical Records Coder 3 Methodist Health SystemMedical Records Coder 3Dallas, 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. Assist with resolution of OCE, medical necessity, discharge status, missing procedure charges, missing codes on claims and other billing issued provided through interaction with Central Business Office (CBO), medical STAFFnd other hospital departments.
Medical Records Coder 2- Prn Methodist Health SystemMedical Records Coder 2- PrnDallas, TexasNamed 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. The Coder II classifies and abstracts inpatient/outpatient diagnoses and procedures which are assigned appropriate ICD-10-CM, ICD-10-PCS, and/or CPT codes for optimal reimbursement.
Medical Records Coder 2 Methodist Health SystemMedical Records Coder 2Dallas, TexasYour Job Requirements: • High school graduate or its equivalent • Minimum of 2 years of DRG based coding experience in an acute care hospital with experience using an encoder • Proficient in detailed work • Maintain a professional image in handling confidential patient information • Excellent written and oral communication skills to interact with physicians, other health care workers, the general public, administration, and health information management staff • Team oriented Your Job Responsibilities: • Communicate clearly and openly • Build relationships to promote a collaborative environment • Be accountable for your performance • Always look for ways to improve the patient experience • Take initiative for your professional growth • Be engaged and eager to build a winning team Methodist Dallas Medical Center is one of North Texas’ best places to work. The Coder 2 classifies and abstracts inpatient and outpatient diagnoses and procedures, which are assigned appropriate ICD10-CM, ICD10 PCS and/or CPT codes for optimal reimbursement.
Medical Records Coder-Senior UT Health San Antonio School of DentistryMedical Records Coder-SeniorSan Antonio, TXAccreditation from a professional coding organization, such as American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) certification is required. Employees receive $50,000 of group term life insurance and $50,000 of basic accidental death and dismemberment insurance for free, with options to purchase additional employee and dependent coverage for both at group rates.
Medical Records Technician (Clinical Documentation Improvement Specialist (Out/Inpatient)) U.S. Department of Veterans AffairsMedical Records Technician (Clinical Documentation Improvement Specialist (Out/Inpatient))San Antonio, TX$62,729–$81,553 / yearGS-9 Experience Requirement: In addition to the basic requirements, you must possess the following: One year of creditable experience equivalent to the journey grade level (GS-8) of a MRT (Coder-Outpatient and Inpatient); OR, An associates degree or higher and three years of experience in clinical documentation improvement (candidates must also have successfully completed coursework in medical terminology, anatomy and physiology, medical coding, and introduction to health records); OR, Mastery level certification through AHIMA or AAPC and two years of experience in clinical documentation improvement; OR, Clinical experience, such as Registered Nurse (RN), Medical Doctor (M.D.), or Doctor of Osteopathy (DO), and one year of experience in clinical documentation improvement. The Medical Records Technician (Clinical Documentation Improvement Specialist) (CDIS) is located within the Health Information Management Section (HIMS) of the Business Operations Service (BOS) at the Kansas City VA Medical Center (KCVAMC).Incumbent provides quantitative and qualitative review and analysis of medical records and encounter forms of both inpatient and outpatient encounters to ensure all diagnoses and conditions for which care is being rendered are documented by the provider in the proper sequence, and procedures have been documented and/or evaluation and management services.
NewMEDICAL RECORDS SPECIALIST Methodist Health SystemMEDICAL RECORDS SPECIALISTDallas, 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. PRIMARY FUNCTION The HIM Specialist will be responsible for a variety of duties which may include the completion of birth certificates, chart preparation, scanning, form identification, analysis and other secretarial functions.
Medical Records Technician Planned Systems International, Inc.Medical Records TechnicianConroe, TexasThe United States Public Health Service (USPHS) Commissioned Corps Officers, civil service staff and contractors comprise the healthcare professionals working together to provide quality healthcare services. Physical Demands: The work requires some physical exertion, such as long periods of standing; walking or jogging unaided over rough, uneven, or rocky surfaces; recurring bending, crouching, stooping, stretching, reaching, or similar activities; or recurring lifting of moderately heavy patients or equipment.
Clinical Quality Review Team Lead TriWest Healthcare AllianceClinical Quality Review Team LeadAustin, TXRemoteFull 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.
RN Utilization Review Coordinator, Full-time Methodist Hospital for SurgeryRN Utilization Review Coordinator, Full-timeAddison, TXFull timeMonitor, track, and analyze avoidable days and extended lengths of stay; identify contributing factors related to utilization, payer processes, discharge barriers, and system delays, and collaborate with Case Management, physicians, and interdisciplinary teams to support timely resolution. The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post‑discharge utilization reviews to ensure appropriate patient status, medical necessity, and compliance with hospital policy, payer requirements, and applicable local, state and federal regulations, including Centers for Medicare & Medicaid Services (CMS) guidelines.
Utilization Review RN Case Manager Houston Methodist HospitalUtilization Review RN Case ManagerTXAt Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators and criteria as approved by medical staff, payer guidelines, CMS, and other state agencies. This position collaborates with case management in the development and implementation of the plan of care and ensures prompt notification of any denials to the appropriate case manager, denials, and pre-bill team members, as well as management.
Registered Nurse II (RN) Utilization Review Nurse HMHRegistered Nurse II (RN) Utilization Review NurseTexasAt Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators and criteria as approved by medical staff, payer guidelines, CMS, and other state agencies. As a full-service, acute-care hospital located in the Texas Medical Center and the flagship hospital of Houston Methodist, it has evolved into one of the nation’s largest nonprofit teaching hospitals and a leader in innovative medical research with a comprehensive residency program.
Utilization Review Nurse PRN HMHUtilization Review Nurse PRNTexasAt Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators and criteria as approved by medical staff, payer guidelines, CMS, and other state agencies. As a full-service, acute-care hospital located in the Texas Medical Center and the flagship hospital of Houston Methodist, it has evolved into one of the nation’s largest nonprofit teaching hospitals and a leader in innovative medical research with a comprehensive residency program.
Clinical Review Auditor I CorVel Healthcare CorporationClinical Review Auditor IFort Worth, TXRemote$70,143–$107,253 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.
Behavioral Heath Social Worker, Utilization Review, Days Knight Health Holdings LLCBehavioral Heath Social Worker, Utilization Review, DaysPalestine, TXJoin Palestine Regional Medical Center in Palestine, TX, a 150-bed hospital that has recently earned the prestigious Leapfrog "A" Safety Grade, the Platinum Award for quality from parent-company ScionHealth, and certification as a Chest Pain Center and Level IV Trauma facility. The Social Worker-Utilization Review performs pre-certification, concurrent review, and discharge planning in accordance with applicable guidelines and acts as a liaison to support safe, timely, and medically necessary care.
Manager, Clinical Case Review Edwards LifesciencesManager, Clinical Case ReviewDallas, TXThe Case Review Manager leads the patient screening analysis and evaluation of baseline medical history and clinical imaging reports (e.g EDC screening records including clinic notes, lab results, cardiology assessments, CT and/or echocardiogram reports) to confirm protocol compliance and provide patient screening and case review support to clinical trial sites for Clinical Research Trials within THV Clinical Affairs. + Previous related experience working a clinical setting or equivalent work experience based on Edwards criteria Preferred and Experience working in the setting of a clinical trial or equivalent work experience based on Edwards criteria Preferred.
RN Case Manager/Utilization Review, Full-Time (Hybrid) Surgery Partners IncRN Case Manager/Utilization Review, Full-Time (Hybrid)TXJob Summary: The RN Case Manager/Utilization Review is responsible for performing prospective, concurrent, and post-discharge utilization reviews to ensure appropriate patient status, medical necessity, and compliance with hospital policy, payer requirements, and applicable local, state and federal regulations, including Centers for Medicare & Medicaid Services (CMS) guidelines. Monitor, track, and analyze avoidable days and extended lengths of stay; identify contributing factors related to utilization, payer processes, discharge barriers, and system delays, and collaborate with Case Management, physicians, and interdisciplinary teams to support timely resolution.
Clinical Review Auditor I CorVel CorpClinical Review Auditor IFort Worth, TXRemote$70,143–$107,253 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role.