Current jobs related to Senior Compliance Specialist - Bellaire - Texas Children's Hospital
-
Senior Call Center Representative
4 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Senior Call Center RepresentativeWe are seeking a highly skilled and experienced Senior Call Center Representative to join our team at Texas Children's Health Plan. As a Senior Call Center Representative, you will be the first point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals, and any...
-
Sr. Credentialing Specialist
4 weeks ago
Bellaire, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
-
Senior Technical Writer for IT Policies
1 week ago
Bellaire, Texas, United States Harris Health Full timeJob SummaryThe Senior Technical Writer for IT Policies provides advanced writing and editing skills in the preparation and publication of Harris Health System policies and procedures (P&P) and other key documents as assigned. The Technical Writer works closely with the Director, Information Technology (IT) Process Improvement and IT service/units to assure...
-
Senior Business Development Liaison
1 week ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Senior Business Development Liaison to join our team at Texas Children's Hospital. As a key member of our business development team, you will be responsible for developing and executing strategic plans to acquire, grow, and nurture strong relationships with physicians and their staff. Your goal will be to drive...
-
Pharmacy Clinical Specialist
4 weeks ago
Bellaire, Texas, United States Houston Methodist Cypress Hospital Full timeJob Title: Senior Pharmacy Clinical SpecialistHouston Methodist Cypress Hospital is seeking a highly skilled and experienced Senior Pharmacy Clinical Specialist to join our team. As a key member of our pharmacy department, you will play a vital role in providing expert clinical pharmacy services to our patients and healthcare teams.Key...
-
Senior Property Accountant
2 weeks ago
Bellaire, Texas, United States Artemis Professionals, LLC Full timeJob OverviewArtemis Professionals, LLC seeks a highly skilled Senior Property Accountant to join our team. The ideal candidate will possess a strong background in real estate accounting, with expertise in financial reporting, reconciliation, and tax compliance.Key Responsibilities:Prepare and manage financial statements for multiple properties, ensuring...
-
Senior Call Center Representative
4 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Senior Call Center RepresentativeWe are seeking a highly skilled and experienced Senior Call Center Representative to join our team at Texas Children's Health Plan. As a Senior Call Center Representative, you will serve as a member and/or provider advocate, understanding our organization's processes, policies, and procedures to investigate,...
-
Senior Associate
1 week ago
Bellaire, United States W3Global Inc Full timeJob DescriptionJob DescriptionOverviewWe are seeking a dedicated and experienced Senior Associate to join our dynamic legal team. The ideal candidate will possess a strong background in Family law, particularly in areas such as child custody and high asset divorces. This role requires exceptional research and writing skills, as well as the ability to...
-
Senior Fraud Investigator
1 week ago
Bellaire, Texas, United States Texas Children's Hospital Full timeWe are seeking a highly skilled Senior Fraud Investigator to oversee the Special Investigations Unit (SIU) and Fraud, Waste & Abuse (FWA) Program at Texas Children's Health Plan.The ideal candidate will have 8 years of experience in fraud, waste & abuse investigations or special investigations unit, including 1 year of experience working with...
-
Senior Associate
16 hours ago
Bellaire, United States W3Global Inc Full timeJob DescriptionJob DescriptionOverviewWe are seeking a dedicated and experienced Senior Associate (Family law)ResponsibilitiesConduct comprehensive legal research and analysis on various issues, including divorce and child custody.Draft legal documents, including contracts, pleadings, and motions, ensuring clarity and compliance with relevant laws.Negotiate...
-
Business Process Specialist
2 weeks ago
Bellaire, Texas, United States Texas Children's Health Plan Full timeJob Title: Business Process SpecialistJob Summary:We are seeking a highly skilled Business Process Specialist to join our team at Texas Children's Health Plan. The successful candidate will be responsible for supporting and developing programs aligned with strategic health plan goals, conducting effective and timely assessments, and implementing processes...
-
Business Process Specialist
1 week ago
Bellaire, Texas, United States Deans Professional Services Full timeJob DescriptionWe are seeking a highly skilled Business Process Specialist to join our team at Dean's Professional Services. As a Business Process Specialist, you will play a critical role in supporting and developing programs aligned with health plan strategic goals.Key Responsibilities:Support the facilitation of process and/or system changes through...
-
Administration Specialist
2 weeks ago
Bellaire, Texas, United States PRIDE Health Full timeJob Summary:We are seeking an experienced Administration Specialist to join our team at PRIDE Health. As a key member of our Quality Management department, you will be responsible for ensuring the highest standards of quality in our administrative processes.Key Responsibilities:* Provide administrative support to the Quality Management team* Develop and...
-
Medical Billing Specialist
1 month ago
Bellaire, Texas, United States Bellaire ER Full timeJob SummaryWe are seeking a skilled Medical Billing/Collections Specialist to join our team at Bellaire ER. As a key member of our revenue cycle team, you will be responsible for managing the billing and payment process for healthcare services. Your expertise will ensure accurate and timely billing of medical procedures and services provided to patients.Key...
-
Technical Writer IT Policies Specialist
1 month ago
Bellaire, Texas, United States Harris Health Full timeJob SummaryThe Harris Health System seeks a skilled Technical Writer to provide advanced writing and editing services for the preparation and publication of policies and procedures. The ideal candidate will work closely with the Director of IT Process Improvement and IT service/units to ensure high-quality documentation of organizational expectations.Key...
-
Pharmacy Technician Specialist
1 month ago
Bellaire, United States Houston Methodist Cypress Hospital Full timeAt Houston Methodist, the Pharmacy Technician Specialist position serves in an expanded role and is responsible for performing advanced level work including but not limited to medication reconciliation and medication histories, verification of orders, verification of doses dispensed by other technicians, support of medication acquisition programs to ensure...
-
Transportation Planning Specialist
4 weeks ago
Bellaire, Texas, United States Alliance Transportation Group, LLC Full timeJob SummaryWe are seeking a highly skilled Transportation Planning Specialist to join our team at Alliance Transportation Group, LLC. As a key member of our planning team, you will provide technical support and assistance to Senior Planners and/or Project Managers related to transportation planning analysis and technical reports.Key...
-
Technical Writer IT Policies Specialist
2 weeks ago
Bellaire, Texas, United States Harris Health Full timeJob SummaryThe Technical Writer (TW) provides advanced writing and editing skills in the preparation and publication of Harris Health System policies and procedures (P&P) and other key documents as assigned. The TW works closely with the Director, Information Technology (IT) Process Improvement and IT service/units to assure quality documentation of Harris...
-
Documentation Specialist IT Policy Team
2 months ago
Bellaire, Texas, United States Harris Health Full timeJob SummaryThe Technical Writer (TW) provides advanced writing and editing skills in the preparation and publication of Harris Health System policies and procedures (P&P) and other key documents as assigned. The TW works closely with the Director, Information Technology (IT) Process Improvement and IT service/units to assure quality documentation of Harris...
-
Tax Accountant
2 months ago
Bellaire, Texas, United States The Friedkin Group Full timeAbout the RoleWe are seeking a highly skilled Tax Accountant to join our team at The Friedkin Group. As a Tax Accountant, you will play a critical role in ensuring the accuracy and compliance of our financial reporting.Key ResponsibilitiesFinancial Statement Preparation: Prepare and review financial statements, including balance sheets, income statements,...
Senior Compliance Specialist
2 months ago
We are looking for a Senior Compliance Specialist, someone who's ready to grow with our company. In this position, you will independently and cooperatively plan and manage audits, reviews, investigations and projects to ensure compliance with Texas Children's policies/procedures and state and federal rules, regulations and statutes. To identify risks by conducting ongoing risk assessments for Texas Children's and document and report the risk(s) to Senior Management.
Skills & Requirements
- Required H.S. Diploma or GED - preferred Bachelor's Degree
- Preferred Licenses/Certifications: CPC - Cert-Cert Professional Coder, CCS-P - Cert-CCS-P Physician Based, RHIA - Cert-Reg Health Inform. Admins, CCS - Cert-Cert Coding Specialist, CHC - Certified in Healthcare Compliance
- Required 9 years in a healthcare regulatory environment including specific experience in project management and audit type work such as planning, supervising, executing, and reviewing audits, reviews, or investigations.
Job Duties & Responsibilities
•Strong in-depth knowledge of CPT, ICD-10 coding methodologies, and billing, as well an understanding of general business systems and their related control structure, knowledge of current issues affecting the healthcare industry, and in-depth knowledge of the healthcare regulatory environment. Strong knowledge of hospital medical record charting is preferred.
•Documents compliance issue(s) and prepares scope memorandum/project charter in accordance with agreed deadline. Confers with necessary parties in an effective and appropriate manner, including in-house legal counsel or external counsel when necessary, and communicates any issues or concerns to the Manager in an appropriate and timely manner.
•The ability to analyze data, people and situations, determine errors and problems, formulate workable and practical solutions, interact with all levels of Texas Children's employees, and be able to work in a team environment.
•Ability to prepare and deliver professional presentations to all levels of Texas Children's employees, management and physicians is required. Must have strong written and oral communication skills as well as strong project management skills.
•Prepares Audit or Review Work Program and obtains supervisory approval in accordance with agreed deadline.
•Conducts fieldwork and/or information gathering in effective, efficient, professional manner.
•Ensures that audit/review/project/investigation issues/findings are verified with sources for accuracy and appropriately supported by comprehensive, accurate, well-organized work papers.
•Prepares comprehensive, accurate documentation to support recommendations and/or proposed resolutions. Ensures that the audit/review/project/investigation is completed by the agreed upon deadline (or documents the exception), that workpapers are complete, and that staff and/or team-assigned work has been reviewed.
•Identifies significant issues within the scope of the audit/review/project/investigation ensuring compliance with appropriate statutes, rules and regulations. Obtains supervisory approval to seek external legal counsel when necessary.
•Prepares formal report to senior management documenting issues/findings identified during the audit/review/project/ investigation. Documents agreed upon resolution.
•Develops or assists in developing implementation plans.
•Leads, assists or monitors team assigned to implement recommended operational changes designed to mitigate risk and/or improve operational processes.
•Writes audit report and/or audit memoranda and/or project report in a timely manner as observed by the Assistant Director.
•Documents interviews, meetings, issues thoroughly and accurately in support of audit issues/findings.
•Schedules, prepares for and attends exit conference to discuss audit/project findings, area(s) of risk, identified issues and proposed recommendations for change.
•Exhibits the ability to communicate the issues to all levels of management, including senior management.
•Obtains written response to the audit/project report within agreed upon timeframe. Ensures follow up of findings/issues in an appropriate manner.
•Develops on-going Compliance training and awareness initiatives required for the IDS workforce.
•Develops and delivers educational training for clinics relative to professional coding, documentation, reimbursement and/or other compliance-related practices to reinforce and/or change processes or issues identified during audits/reviews/projects/investigations.
Please note: this is an onsite position, not remote nor hybrid
About Us
Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.
Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
