Top 29 Clinical auditor Jobs in Houston Tx

Clinical Pre-Service Nurse Auditor
Premier Medical Resources —Houston, TX
- Background check
- Pass drug screening
- Mid-level
- AD&D insurance
- Disability insurance
Quick Apply
Inpatient Coding Compliance Auditor (Remote)
Memorial Hermann Health System —Houston, TX
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- 4 years
Senior Corporate Compliance Auditor (Hybrid)
Memorial Hermann Health System —Houston, TX
- Full-time
- Hybrid work
- Nursing
- 7 years
- Customer service
Coding Auditor/Educator
The Menninger Clinic —Houston, TX
- Full-time
- HIPAA
- Mid-level
- Business Administration
Quick Apply
Program Manager, Accreditation & Regulatory Affairs
Harris Health —Bellaire, TX
- $108,721.60 - $141,377.60 a year
- Extended hours
- Microsoft Word
- Nursing
- Microsoft Outlook
1d
Coding/Education Liaison
Memorial Hermann Health System —Houston, TX
- Full-time
- Research
- Clinic
- Computer skills
1d
Research Coordinator
IQVIA —Houston, TX
- $43,400 - $108,200 a year
- Full-time
- Nursing
- RN License
- 5 years
PRN Research Assistant - overnight, weekend, and holidays
Tranquil Clinical and Research Consulting Services LLC —Webster, TX
- Part-time
- Microsoft Excel
- Hospital
- Customer service
Quick Apply
Clinical Study Coordinator
Tranquil Clinical and Research Consulting Services LLC —Webster, TX
- $50,000 - $65,000 a year
- Full-time
- Microsoft Excel
- Computer literacy
- Writing skills
Quick Apply
VRCC Director, Business Office
SUN Behavioral Health —Houston, TX
- Full-time
- HIPAA
- Office
- High school diploma or GED
Senior Information Security Analyst in Information Technology
UTHealth Houston —Houston, TX
- System design
- HIPAA
- Windows
- Health insurance
- Employee discount
7d
Clinical Research Manager
Tricoastal Narcolepsy and Sleep Disorders Center —Sugar Land, TX
- Weekends as needed
- Background check
- Management
- Patient monitoring
Quick Apply
5d
PRN EMT-P - overnight, weekend, and holiday staff
Tranquil Clinical and Research Consulting Services LLC —Webster, TX
- $25 - $30 an hour
- Overnight shift
- Microsoft Excel
- Computer literacy
- Mid-level
Quick Apply
PRN Research Nurse - overnight, weekend, and holiday staff
Tranquil Clinical and Research Consulting Services LLC —Webster, TX
- Overnight shift
- Nursing
- Microsoft Excel
- Computer literacy
Quick Apply
PRN Research Nurse Practitioner - Overnight, weekends, holidays
Tranquil Clinical and Research Consulting Services LLC —Webster, TX
- Part-time
- Nursing
- Microsoft Excel
- Computer literacy
Quick Apply
Finance Controller
HOUSTON RECOVERY CENTER LGC —Houston, TX
- Full-time
- Background check
- Ability to walk for extended periods
- Office
9d
Finance Controller
Houston Recovery Center —Houston, TX
- $75,751.09 - $91,227.13 a year
- Full-time
- Background check
- Ability to walk for extended periods
- Writing skills
- Disability insurance
- Health insurance
Quick Apply
8d
Certified Pharmacy Technician (Bilingual Spanish, Vietnamese, or Chinese preferred)
HOPE Clinic —Houston, TX
- $16 - $23 an hour
- Full-time
- Background check
- 18 years or older
- Computer literacy
Quick Apply
HCS/TxHmL Program Manager (Pre-Certified / Texas HCS Experience Required)
Bridgeden Living LLC —Katy, TX
- $42,000 - $56,000 a year
- Temporary
- Background check
- Clean driving record
- Management
Quick Apply
9d
Director of Accounting - Corporate and Consolidations
US Physical Therapy —Houston, TX
- $130,000 - $150,000 a year
- Full-time
- 7 years
- CPA
- Office
- Health insurance
- Dental insurance
Quick Apply

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clinical auditor jobs near houston tx

Clinical Pre-Service Nurse Auditor

Premier Medical Resources -
Houston, TX

Quick Apply

Job Details

Benefits

AD&D insurance
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Hospital experience

Full Job Description

Revenue Cycle Management is looking for a Clinical Pre-Service Nurse Auditor to join our team!

SUMMARY: The Clinical Pre-Service Auditor will provide/confirm precertification of and all authorization requests. The Clinical Pre-Service Auditor will assist with minimizing denials by way of ensuring medical criteria / medical necessity is met prior to services are scheduled. This process includes clinical judgement, utilization management, application, understanding of payor protocols requirements, and verification of medical necessity utilizing nationally recognized criteria.

ESSENTIAL FUNCTIONS:

Works as part of integrated team and is involved in reviews of authorization requests and communicates with the physicians and clinic when additional information is needed.
Performs activities that include obtaining payer authorization for outpatient services that require notification/authorization based on payer specific guidelines.
Maintains a thorough understanding of the plan's provider contracts, authorization requirements and ongoing follow-up and re-evaluation of clinical departments/areas as requested or needed for authorization review.
Compiles and maintains established payer protocols to determine the medical appropriateness of ordered pre and post scheduled services.

KNOWLEDGE, SKILLS, AND ABILITIES:

Familiar with hospital coding and billing processes.
Knowledge of InterQual/Milliman guidelines, Medicare guidelines
Above average verbal and written communication skills
Other Skills: Analytical, Mathematics, Medical Terms
Must be able to interact successfully in a culturally diverse environment

EDUCATION AND EXPERIENCE:

Nurse in good standing, currently licensed in the State of Texas without stipulations in practice as a Licensed Vocational Nurse
Three (3) years of hospital experience in various clinical areas.
One (1) year utilization review, authorization, or case management experience

BENEFITS:

3 Medical Plans
2 Dental Plans
2 Vision Plans
Employee Assistant Program
Short- and Long-Term Disability Insurance
Accidental Death & Dismemberment Plan
401(k) with a 2-year vesting
PTO + Holidays

Premier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career, and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Employment for this position is contingent upon the successful completion of a background check and drug screening.

Quick Apply

Refine Your Search

clinical auditor jobs in houston tx

Clinical Pre-Service Nurse Auditor

Inpatient Coding Compliance Auditor (Remote)

Senior Corporate Compliance Auditor (Hybrid)

Coding Auditor/Educator

Program Manager, Accreditation & Regulatory Affairs

Coding/Education Liaison

Research Coordinator

PRN Research Assistant - overnight, weekend, and holidays

Clinical Study Coordinator

VRCC Director, Business Office

Senior Information Security Analyst in Information Technology

Clinical Research Manager

PRN EMT-P - overnight, weekend, and holiday staff

PRN Research Nurse - overnight, weekend, and holiday staff

PRN Research Nurse Practitioner - Overnight, weekends, holidays

Finance Controller

Finance Controller

Certified Pharmacy Technician (Bilingual Spanish, Vietnamese, or Chinese preferred)

HCS/TxHmL Program Manager (Pre-Certified / Texas HCS Experience Required)

Director of Accounting - Corporate and Consolidations

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