Top 53 Document reviewer Jobs in Plano Tx

DRG Reviewer
Machinify —Dallas, TX
- $90,000 - $115,000 a year
- Remote
- Nursing
- HIPAA
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Contractor
Asurity Mortgage Group Inc —Dallas, TX
- Contract
- Remote
- Mid-level
Quick Apply
Spanish Language Document Review Attorney
Contact Discovery Services LLC —Dallas, TX
- $35 an hour
- Remote
- Mid-level
- 2 years
Quick Apply
Learning Innovation Designer
The University of St. Augustine for Health Sciences —Dallas, TX
- $68,100 - $95,760 a year
- Doctoral degree
- Customer service
- Writing skills
- Paid holidays
- Disability insurance
13d
Medical Staff Specialist 2- Grapevine
Baylor Scott & White Health —Grapevine, TX
- Mid-level
- High school diploma or GED
- Health insurance
- Tuition reimbursement
English Contract Attorney
Contact Government Services, LLC —Dallas, TX
- $27 - $40 an hour
- Contract
- Remote
- English
- Mid-level
- 2 years
Quick Apply
Aerospace Supplier Quality Engineer (FAI REVIEWER)
Trigo Group —Dallas, TX
- $70,000 - $100,000 a year
- Extended hours
- 5 years
- Pass drug screening
- Office
- Travel reimbursement
- Mileage reimbursement
PERMIT SPECIALIST
City of Balch Springs, TX —Balch Springs, TX
- $22.46 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Health insurance
- Dental insurance
2h
Aerospace Supplier Quality Engineer (FAI REVIEWER)
Trigo ADR Americas —Dallas, TX
- $70,000 - $100,000 a year
- Extended hours
- 5 years
- Pass drug screening
- Office
- Travel reimbursement
- Mileage reimbursement
Senior Project Manager, Clinical Risk Evaluation
Abbott Laboratories —Plano, TX
- $78,000 - $156,000 a year
- Full-time
- 6 years
- Office
- Master's degree
- Health insurance
- Tuition reimbursement
Associate Counsel – Real Estate, Corporate & Development
PopStroke —Plano, TX
- Full-time
- Hospitality
- 5 years
- Office
- Paid holidays
- Health insurance
Special Projects Coordinator - Midlothian
Bureau Veritas —Plano, TX
- Full-time
- Construction site
- Word processing
- Mid-level
Supply Chain Logistics Specialist
JPI Companies —Dallas, TX
- Full-time
- Mid-level
- Microsoft Office
- 3 years
- Paid parental leave
- Health savings account
Credit Review Officer
Texas Capital Bank —Dallas, TX
- Full-time
- 3 years
- Finance
- Bachelor's degree
- Wellness program
- Paid holidays
Sprinkler Inspector
Johnson Controls —Irving, TX
- $24 - $34 an hour
- Weekends as needed
- Customer service
- Mid-level
- Organizational skills
PreCon Field Procurement Manager
Johnson Controls —Irving, TX
- $100,000 - $150,000 a year
- Full-time
- 5 years
- Mid-level
- Analysis skills
High Level Eng - Controls - Central, GCOE
Johnson Controls —Dallas, TX
- $80,000 - $120,000 a year
- Full-time
- Computer literacy
- Mid-level
- 3 years
- Paid holidays
- Health insurance
Project Director
Foth —Dallas, TX
- $155,000 - $200,000 a year
- Full-time
- Remote
- Engineering
- 11+ years
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply
Project Manager V- Data Center
AECOM —Dallas, TX
- $115,000 - $200,000 a year
- Full-time
- Construction site
- Engineering
- 8 years
- AD&D insurance
- Employee stock purchase plan
9d
Senior Accountant- Financial Reporting
Central Insurance Company —Irving, TX
- Full-time
- Hybrid work
- Oracle
- Research
- Finance
- Health insurance

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document reviewer jobs near plano tx

DRG Reviewer

Machinify -
Dallas, TX

Quick Apply

Job Details

$90,000 - $115,000 a year

Benefits

Health savings account
Health insurance
Dental insurance
Flexible spending account
Tuition reimbursement
Paid time off
Vision insurance
401(k) matching

Qualifications

Root cause analysis
Clinical documentation standards
Healthcare coding investigations
DRG

Full Job Description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

About the Opportunity

As part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including clinical and coding assessments, of medical records and related documentation in accordance with contract-specific review criteria. This position requires an in-depth understanding of clinical guidelines, coding protocols, and regulatory requirements to ensure accurate payment determinations.

In this role, you will meticulously document findings, provide detailed clinical, policy, and regulatory support and collaborate with relevant stakeholders to ensure compliance with payment standards. Your expertise will be critical in ensuring that payment decisions are supported by accurate and complete documentation, ultimately contributing to the integrity and efficiency of the payment process.

What you'll do

Audit patient medical records using clinical, coding, and payer guidelines to ensure accurate reimbursement.
Provide clear, evidence-based rationale for code recommendations or reconsiderations to providers or payers.
Collaborate with team leaders to ensure thorough review of DRG denials.
Conduct audits in alignment with organizational quality and timeliness standards.
Use proprietary auditing systems proficiently to make consistent determinations and generate audit letters.
Recommend improvements to the audit system to enhance efficiency.
Ensure compliance with HIPAA regulations for protected health information.
Perform other duties as assigned.

What you bring (Role Requirements)

Education Requirements:

An associate or bachelor's degree in nursing (active/unrestricted license); or in health information management is required.
Work experience may be considered in lieu of formal education at leadership discretion.

Certification (at least one of the following is required):

RHIA - Registered Health Information Administrator
RHIT- Registered Health Information Technician
CCDS - Certified Clinical Documentation Specialist
CDIP - Clinical Documentation Improvement Practitioner
CCS - Certified Coding Specialist
CIC - Certified Inpatient Coder

Qualifications:

Inpatient claims auditing, quality assurance or recovery auditing experience of 2 years or more required, and/or Inpatient Clinical Documentation Integrity experience of 2 years or more required
Strong focus on quality and attention to detail.
Deep curiosity and analytical skills to understand root causes of events and behaviors.
Proven ability to apply critical judgment in clinical and coding determinations.
In-depth knowledge of clinical criteria and documentation requirements to support code assignments.
Expert in DRG methodologies (e.g., MS & APR).
Expertise in ICD-10-CM/PCS coding, UHDDS definitions, Official Coding Guidelines, and AHA's Coding Clinic Guidelines.
Ability to work independently and efficiently with minimal supervision.

What We Offer:

Work from anywhere in the US! Machinify is digital-first.
Top Medical/Dental/Vision offerings
FSA/HSA
Tuition reimbursement
Competitive salary, 401(k) with company match
PTO
Additional health and wellness benefits and perks
Flexible and trusting environment where you'll feel empowered to do your best work

The salary for this position is based on an array of factors unique to each candidate: Such as years and depth of experience, set skills, certifications, etc. We are hiring for different levels, and our Recruiting team will let you know if you qualify for a different role/range. Salary is one component of the total compensation package, which includes meaningful equity, excellent healthcare, flexible time off, and other benefits and perks.

Pay range: $90,000 - $115,000, plus quarterly bonus.

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/

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Refine Your Search

document reviewer jobs in plano tx

DRG Reviewer

Contractor

Spanish Language Document Review Attorney

Learning Innovation Designer

Medical Staff Specialist 2- Grapevine

English Contract Attorney

Aerospace Supplier Quality Engineer (FAI REVIEWER)

PERMIT SPECIALIST

Aerospace Supplier Quality Engineer (FAI REVIEWER)

Senior Project Manager, Clinical Risk Evaluation

Associate Counsel – Real Estate, Corporate & Development

Special Projects Coordinator - Midlothian

Supply Chain Logistics Specialist

Credit Review Officer

Sprinkler Inspector

PreCon Field Procurement Manager

High Level Eng - Controls - Central, GCOE

Project Director

Project Manager V- Data Center

Senior Accountant- Financial Reporting

I want to receive the latest job alert for document reviewer in plano tx

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