- Baylor Scott & White Health (Temple, TX)
- **Job Description :** We are seeking a detail-oriented and experienced ** System Analyst 2** to join our team. The ideal candidate will be responsible for testing, ... ensure that claims data meets internal standards and regulatory compliance (HIPAA, CMS , etc.). **Key Responsibilities:** + Analyze, test, and validate healthcare EDI… more
- Prime Healthcare (Weslaco, TX)
- …in the United States in the various areas we serve: + Centers For Medicare & Medicaid Services ( CMS ) Five-Star Quality Rated + LeapFrog Hospital Safety ... EXPERIENCE, TRAINING + Must be knowledgeable regarding the Health Information Management Department process and its application and evaluation of qualitative issues.… more
- Humana (Austin, TX)
- …inventory monitoring and assignment of escalated inventory + Research on guidelines - CMS , AMA, etc. + Training new coders/auditors + Responsible for updating and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (TX)
- …contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability ... staff to determine; for example, non-compliance with Molina policies/procedures or CMS guidelines/regulations, or to assess the non-clinical quality of customer… more
- Cognizant (Austin, TX)
- …+ Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims. + Knowledge of Medicare /Medicaid payment and coverage ... and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA paper...and external SLAs. + Other duties as assigned by management . **Qualifications:** + A minimum of 2 years' claims… more
- Banner Health (TX)
- …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services ( CMS ), Office of the Inspector General (OIG) and the ... (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification… more
- Molina Healthcare (San Antonio, TX)
- …and procedures to ensure accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services ( CMS ) regulations and guidelines of risk ... CPC credential **Preferred Education** Bachelor's Degree in Business Administration, Health Care Management o To all current Molina employees: If you are interested… more
- Molina Healthcare (TX)
- …inquiries. + Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. + Create and ... quarterly Key Performance Indicator (KPI) reports. + Support the management of the regulatory memo distribution process Ability to...notices of proposed rulemaking. + Manages user access to CMS . + Analyze data use critical thinking + Ability… more
- UTMB Health (Friendswood, TX)
- …experience in the management of population health-related programs such as health system management , health plans, or public health or Project or program ... quality metrics as identified. + Organize Quality and Risk Management meetings. + Make recommendations to the CBC administrative...academic health system or integrated healthcare delivery system + Experience with Medicare , Medicaid, or… more
- Wolters Kluwer (Coppell, TX)
- …market insights into actionable product requirements, collaborates closely with Engineering, Content , and go-to-market teams, and ensures that our solutions meet the ... long-term advocacy. **Cross-Functional Collaboration** * Coordinate with Engineering and Content teams to ensure product requirements are well understood,… more