Trabajos remote utilization review nurse en San Antonio, TexasCrear alertas

\n\n Now Hiring – Coding Educator & Auditor Revenue Integrity \n\n \n\n University Health is one of the largest employers in San Antonio. We are a nationally recognized teaching hospital and consistently recognized as a leader in advanced treatment options, new technologies and clinical research. Our mission is to improve the good health of the community through high quality compassionate patient care, innovation, education and discovery. We are currently looking for a talented health professional to join our team as a Coding Educator & Auditor for our Revenue Integrity department. This is an exciting opportunity to join a company with a reputation for exceptional service and patient care. \n\n \n\n The Position: \n\n Works under the direct supervision of the Coding Education & Audit Manager. Will perform any or a combination of the following types of coding education and audit: Basic ancillary services, Emergency Room services, Hospital Observation, Ambulatory surgery, Inpatient Admission. Utilizes the ICD-10-CM and CPT coding classification systems and ensures proper assignment and completion of Diagnosis and Procedure Coding on all cases. Trains new Coding Specialist(s), Technician(s), and Associate(s). Promotes the Health System’s guest relations’ policy. Complies with all Federal, State, local and accrediting bodies’ regulations and protocols. Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), National Committee for Quality Assurance (NCQA) that promotes Healthcare Effectiveness Data and Information Set (HEDIS) metrics, Utilization Review Accreditation Commission (URAC), and the Joint Commission (TJC). \n\n \n\n Duties: \n\n\n\t • Communicates and interacts positively and professionally throughout all levels of the organization, and with external customers. Consistently demonstrates the ability to communicate with strong analytical, problem solving and critical thinking skills. \n\t, • Provides onsite and remote quality assurance reviews/audits with appropriate compliance with governmental and payer regulations.\n\t, • Provides and monitors instructions/education provided to Providers, Coding, Risk, CDI, and Quality team members involved with the coding processes. \n\t, • Implements Coding Education programs for professional and facility Service lines, including ongoing assessment, metrics and dashboards. \n\t, • Prepares departmental coding and denial progress reports. \n\t, • Performs other related duties as assigned.\n\n\n \n\n Qualifications: \n\n Associate’s degree in Health Information Management and/or Bachelor’s degree is preferred. Completion of a coding program is required. [Note: Completion of a coding program from the American Health Information Management Association (AHIMA) and/or American Association of Professional Coders (AAPCS) will be accepted. Completion of a coding program from other licensing bodies shall be accepted on a case by case basis and upon managerial discretion, with the approval of the Director of Revenue Integrity-Coding.] At least five (5) years of coding experience in professional services, hospital services, or a combination of both is required for external applicants. At least four (4) years of pro-fee, outpatient/ambulatory, and inpatient coding experience is required for internal applicants. Experience and working knowledge of 3M Encoding and Grouping software is required. Preference will be given to applicants with experience and knowledge of regulatory requirements, Microsoft Office products, and Epic EMR. \n\n \n\n LICENSURE/CERTIFICATION: \n\n The Coding Educator & Auditor must maintain a valid credential offered by the accrediting bodies mentioned above (AHIMA and AAPC). [Note: Valid credential(s) from the American Health Information Management Association (AHIMA) and/or American Association of Professional Coders (AAPC) will be accepted. Credential(s) from other licensing bodies shall be accepted on a case by case basis and upon managerial discretion, with the approval of the Director of Revenue Integrity-Coding]. Licensure as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), and/or Registered Nurse(s) (RN) are highly preferred. \n\n \n\n Why Should You Apply? \n\n\n\t • We offer exceptional pay and opportunities for advancement.\n\t, • Continuing Education\n\t, • Gym membership discounts \n\t \n\n \n\n \n\n

At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. The Medica

The Registered Nurse Patient Navigator Lead is a Registered Nurse or licensed Nurse Practitioner who provides health and wellness coaching, case management services, analysis and expertise regarding CHRISTUS services. Incumbent oversees integrated data warehouse including program utilization, diseas

Emergency Room Physician – San Antonio VA Hospital.Board-Certified Emergency Room Physician.Join a mission-driven team focused on delivering exceptional care to those who served.Overnight and weekend shifts available – we’ll work with your availability.Serve those who served our co

POSITION SUMMARY/RESPONSIBILITIES.Provides comprehensive specialty health care to a population that has multiple health care needs in the University Healthnetwork of community-based ambulatory care centers.Must have completed training in an ACGME approved and accredited residency program.Completion

If you aspire to grow in a supportive environment that values your contributions, consider applying today for our Registered Nurse opportunity in the Clinical Decision Unit. We are excited to review your application and look forward to discussing your future with us. Are you seeking an exciting oppo

Physician Assistant - Medical Review Dept.

Do you have the career opportunities as a Registered Nurse in the CDU you want with your current employer? We have an exciting opportunity for you to join Methodist Hospital Metropolitan which is part of the nation's leading provider of healthcare services, HCA Healthcare. Do you want to work as a(a

Clinical Coding Nurse Consultant will drive Risk Adjustment improvement initiatives, develop recommendations for Risk Adjustment remediation plans and create tools and databases to capture relevant data for assigned markets to achieve corporate and market specific Risk Adjustment goals and initiativ

At Methodist Hospital Metropolitan, our nurses play a vital part. Do you want to create your own personal career path in nursing? HCA Healthcare is your career destination! Our scale makes it possible for nurses to create the career path that fits their life - for life - and empowers their passion f

We are seeking Medical Claims Reviewers to assist the Air Force Security Assistance and Training (AFSAT) Squadron in monitoring the welfare of U. Selected individuals will perform medical claims review activities, receive and process treatment requests, and provide guidance to treatment facilities.

Medical Informatics OpportunitySan Antonio, TX more information on this Medical Informatics opening and others like it through Metropolis, a Provider Engagement Platform that connects you with organizations in the top 100 Metropolitan areas.Metropolis sources physicians according to each organizatio

Specialized care includes orthopedic and surgical services, ICU, women’s services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more.

Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Work experience in case management, utilization review or hospital quality is preferred. The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/

This position utilizes knowledge of Medicare and state HMO guidelines in order to facilitate and comply with the Utilization Management plan in data entry and to prepare letters utilizing standard templates. Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DO

Our 330-bed facility is one of the largest freestanding psychiatric hospitals in the United States.Set on a therapeutic 29-acre campus in north central San Antonio, Laurel Ridges serves as the setting for the treatment for children, adolescents, young adults, adults, veterans and military personnel.

Collaboration: Work closely with specialists, nurses, and other healthcare professionals.

Do you have the career opportunities as a Registered Nurse in the CDU you want with your current employer? We have an exciting opportunity for you to join Methodist Hospital Metropolitan which is part of the nation's leading provider of healthcare services, HCA Healthcare. Do you want to work as a(a

Primary Responsibilities: * Develop and implement market business plans to motivate providers to engage in improving Risk Adjustment metrics * Provide analytical interpretation of Risk Adjustment reporting including, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporti

Our Registered Nurses have access to a variety of resources to help you reach your goals including:. Minimum of six (6) months of clinical experience as a licensed Registered Nurse. Current Registered Nurse License in the State of Texas or Multi-State Compact License (Employees with RN Compact Licen

We’ve built a best-in-class remote work platform for our freelance contributors to provide valuable, specialized skills, and we in turn strive to provide them with a positive experience based on our core pillars of reliability, transparency, and flexibility. Evaluate AI outputs by reviewing and

FCE Benefit Administrators, Inc.The ideal candidate will be responsible for the accurate and timely processing of a wide range of claims while ensuring compliance with company standards and regulatory requirements.This role requires strong attention to detail, effective communication skills, and the

POSITION SUMMARY/RESPONSIBILITIES.Works under the direct supervision of the Coding and Reimbursement Manager, Health Information Management.Codes inpatient, outpatient surgery and observation visits utilizing the ICD-9-CM and CPT coding classification systems.Assists in the training of new coding te

About the job Registered Nurse - Remote.

Collaborate with physicians and nurse practitioners, experienced nurses, and a dedicated support staff to ensure comprehensive patient care. Provide exceptional virtual care, including patient assessments, medical history reviews, and appropriate medical treatment.

We are seeking a(an) Registered Nurse Resource Float Pool to join our healthcare family. It is the first hospital in San Antonio to achieve Pathway to Excellence designation by the American Nurses Credentialing Center. At Methodist Hospital Metropolitan, our nurses play a vital part.

Do you have the career opportunities as a Registered Nurse that you want in your current role? We invest in what matters most to nurses like you – at home, at work, and at every stage in your career. Our Registered Nurses have access to a variety of resources to help you reach your goals including

University Health is Bexar County and South Texas' first health system to earn Magnet status from the American Nurses Credentialing Center (ANCC).

Quality Improvement Registered Nurse (QI2606 - NIC). Review applicable employee immunization records and maintain OSHA exposure files. Is responsible for Pay for Performance and Accountable Care Organization-related functions to include clinical outcome metrics review, personal health assessment, co

Evaluate patients' medical conditions by reviewing their charts.

Evaluates the quality and completeness of clinical documentation processes by performing quality medical record reviews, assisting in the improvement of the clinical documentation process, maintaining accurate records of review activities, developing formal training and improvement programs and main

Review patient charts to ensure accurate coding of diagnoses and procedures.

San Antonio is a popular Texas city known for its scenic River Walk, which makes getting around downtown a breeze with shaded pathways that connect hundreds of shops, restaurants, hotels, historic landmarks, museums, and attractions.It is also the setting for many of the city's annual festivals and

Work collaboratively with a team of physicians, nurse practitioners, and experienced nurses to ensure comprehensive patient care. Deliver outstanding virtual care, including patient assessments, medical history reviews, and appropriate treatments.

Join a family that cares about every stage in your career! We are interviewing candidates for our Resource Float Registered Nurse opening. Methodist Hospital Northeast is committed to investing in the latest technology enabling nurses to work more efficiently. Submit your application for a Resource

Join a family that cares about every stage in your career! We are interviewing candidates for our Resource Float Registered Nurse opening. Methodist Hospital is committed to investing in the latest technology enabling nurses to work more efficiently. Submit your application for a Resource Float Regi

Full-time, permanent position for FNP or PA.At least 1 year of APP experience in Family Medicine.Competitive compensation and benefits package.FQHC Qualifies for Gov Loan Repayment.Board certified and licensed in Texas.Bilingual in Spanish is desired, but not required.Contact Cara Hermelyn at 954-83

Join our dedicated team as a Registered Nurse in the Clinical Decision Unit, where your commitment to delivering exceptional patient care is celebrated. Are you a passion-driven learner? With more than 94,000 nurses across HCA Healthcare, we prioritize education to ensure excellence in nursing pract

Under the supervision of the registered nurse (RN), the PCT assists the nursing staff in providing patient care in accordance with the PCTs skills/training and the needs of the Department, and consistently assists the patient care team with maintaining a clean, well-organized, and safe patient care

Do you want to create your own personal career path in nursing? HCA Healthcare is your career destination! Our scale makes it possible for nurses to create the career path that fits their life – for life – and empowers their passion for patient care. Apply today for our Registered Nurse

We promptly review all applications. Under the supervision of the registered nurse (RN), the PCT assists the nursing staff in providing patient care in accordance with the PCT's skills/training and the needs of the Department, and consistently assists the patient care team with maintaining a clean,

Are you a continuous learner? With more than 94,000 nurses throughout HCA Healthcare, we are one of the largest employers of nurses in the United States. Apply today for our Resource Float Registered Nurse opening and continue to learn!. Our Registered Nurses have access to a variety of resources to

Do you want to be appreciated daily? Our nurses are celebrated for being on the front line, empathetic for patients. At Methodist Hospital Specialty and Transplant our nurses set us apart from any other healthcare provider. At Methodist Hospital Specialty and Transplant, our nurses play a vital part

Works directly with Behavioral Health Network Liaison to oversee and monitor network utilization requirements to remain in compliance with DHA metrics and guidelines, this includes data verification and reports. Reviews, adjusts and manages new provider schedules to include resourcing within the ele

Large managed care company is looking for a Clinical Quality LPN to be responsible for onsite chart review and tracking, remote data mining in EHR systems, and direct provider outreach for year-round chart collection and abstraction. Must be able to review medical records and assess completeness. Re

RELOCATE TO VIRGINIA OPPORTUNITY.Join our esteemed team of healthcare professionals committed to advancing healthcare through cutting-edge research, comprehensive training, and compassionate care.UVA Health is an integrated health system with a world-class academic medical center that includes a lev

Provide individual, group and family psychotherapy; provides clinical supervision; conducts clinical evaluations and other clinical and case management functions as assigned.Writes appropriate clinical documents and effectively presents clinical information verbally.Appropriately support and impleme

Minimum of six (6) months of clinical experience as a licensed Registered Nurse Current Registered Nurse License in the State of Texas or Multi-State Compact License (Employees with RN Compact License are required to obtain Texas RN License within 60 days of hire date) Current American Heart Associa