RN Senior Medical Reviewer - San Antonio

The RN Senior Medical Reviewer provides advanced medical review expertise and supports oversight of the medical review process focusing on complex services and quality assurance. · ...

The RN Senior Medical Reviewer provides advanced medical review expertise and supports oversight of the medical review process. · Bachelor of Science in Nursing (BSN) · Current, active, unencumbered Registered Nurse license in the United States · Certified Coder credentials requi ...

· Overview · Are you an accomplished Board Certified physician in one of the below specialties? Preferred candidates will have a TX license. · General Surgery · Neurologist · Orthopedic Surgery with hand or spine specialty · Physical Medicine & Rehabilitation · Plastic Surgery · ...

Overview · Are you an accomplished Board Certified physician in one of the below specialties? Preferred c andidates will have a TX license. · General Surgery · Neurologist · Orthopedic Surgery with hand or spine specialty · Physical Medicine & Rehabilitation · Plastic Surgery · P ...

The Specialty Medical Bill Reviewer/Coder position involves reviewing and auditing medical bills for multiple states and lines of business. Responsibilities include analysis of fee schedules, PPO interface, and contractual client requirements. · AAPC Coding Certification is requi ...

Dane Street is expanding our physician panel Dane Street is a national Independent Review Organization and we have a very robust legal clientele. As our business has expanded, we have need to add experts to our physician panel to support Texas Contra-Affidavit and exert witness r ...

Job Description · Under limited supervision, responsible for conducting the quality review of inpatient and outpatient coding, assures coding compliance with federal regulations, and maintains up-to-date coding guidelines and coding policy changes. · Responsibilities · Reviews, i ...

join a team of passionate and caring clinicians who make a difference in people's lives our nursing group focuses on compassion and meeting the needs of our clients in a variety of settings · assess health problems and needs of person(s) served develop and implement nursing care ...

Provides medical oversight and expertise in appropriateness and medical necessity of services provided to members. · Determines appropriateness and medical necessity of health care services provided to plan members. · Evaluates effectiveness of utilization management (UM) practic ...

General Summary · Responsible for maintaining GMG Electronic Medical Records (EMR) by importing and organizing documents correctly/timely manner. Receives documents from internal sources, external medical offices/facilities in paper and electronic formats. Reviews medical records ...

This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. · ...

Pediatric Otolaryngology Physician Opportunity in San Antonio · Position Summary: The Department of Otolaryngology is seeking a full-time Pediatric Otolaryngology Physician to join the team in San Antonio. This role involves collaboration with faculty, residents, and staff to del ...

· In need of a medical doctor to complete Life Care Plans and serve as expert witness when necessary. A Life Care Plan is the projection of the cost of injury over the course of the life of an injured party. As a medical life care planner, you will be responsible for reviewing m ...

Medical records coder responsible for conducting review of inpatient and outpatient coding under direct supervision. · Maintains up-to-date coding guidelines and policy changes. · Reviews charge documents for completeness. · ...

Under direct supervision responsible for conducting review of inpatient and outpatient coding assuring coding compliance with federal regulations and maintains up-to-date coding guidelines and coding policy changes. · ...

The HCC auditor will perform concurrent chart reviews to improve department's RAF score goals. The position requires reviewing electronic medical charts for accuracy of HCC codes captured in encounter data submission. · Conduct prospective and retrospective chart review audits on ...

**Recruiters please do NOT contact Advent Services** · Job Title: Aerospace Medical Technician (Flight & Operational Medical Technician) · Location: JBSA-Randolph, Texas · Duty Hours: Duty hours are from 7:00 a.m. to 5:00p.m., Monday through Friday, except for the scheduled feder ...

The company is seeking a Medical Quality Assurance Specialist on our Veteran Affairs Services team. · Review and audit exam reports sent over from medical providers · Ensure all medical coding is complete and accurate · ...

The Department of Otolaryngology at Baylor College of Medicine seeks to recruit a full-time Pediatric Otolaryngology Physician to work in collaboration with faculty, residents, and staff caring for a pediatric otolaryngology patient population. · Establish criteria and conducting ...

Behavioral Health Utilization Management Medical Case Manager · CalOptima · Join Us in this Amazing Opportunity · The Team You'll Join · We are a mission driven community‐based organization that serves member health with excellence and dignity, respecting the value and needs of e ...