- Kelsey-Seybold Clinic (Houston, TX)
- …physician in the form of a written pathology report. + Maintains compliance with departmental key performic indicators such as turnaround time and peer ... and quality of care. + Participates in professional organizations, continuing medical educational conferences, and seminars to keep abreast of developments in… more
- Humana (Austin, TX)
- …analytics expertise, and a proven track record of leveraging data to meet compliance requirements and define and drive business value. The Senior Professional will ... analyze, synthesize, and present data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of… more
- Intermountain Health (Austin, TX)
- …of value-based care by Intermountain Healthcare to appropriate populations. It ensures compliance and accurate submission of publicly reported data for all payers. ... with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics (NCHS), US… more
- Humana (Austin, TX)
- …Business, Finance, Health Care/Administration, RN or a related field + Experience with Medicare Risk Adjustment and/or medical coding + Proven organizational and ... RN or a related field, or equivalent work experience + Experience with Medicare and/or managed care + Understanding of NCQA and CMS Stars Rating System… more
- Kelsey-Seybold Clinic (Webster, TX)
- …sonographers, and ensuring internal OB ultrasound quality. + Supervise and mentor medical staff, residents, and learners in MFM best practices and advanced imaging ... and therapeutic procedures + Maintain documentation, data quality, and regulatory compliance across all MFM services. **Experience:** Required: Completion of OB/GYN… more
- Kelsey-Seybold Clinic (Webster, TX)
- …and to improve the efficiency and effectiveness of resources + Ensure compliance with legal, regulatory, and clinical policies and procedures **Essential Duties and ... Prescribe medications including controlled substances + Order treatments and durable medical equipment as indicated + Perform other therapeutic or corrective… more
- Humana (Austin, TX)
- …to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, and Abuse in a ... a group of seasoned professionals. + Proven knowledge in Medicare regulations + Excellent PC skills MS Excel and...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Austin, TX)
- …industry in how digital can be used to drive customer acquisition in the Medicare Advantage space. Within this business area, we are aggressively driving new digital ... of working, and employing next-gen technology to revolutionize how Medicare Advantage is sold. This role is part of...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- BeneLynk (San Antonio, TX)
- …and proper disposition of cases. + Maintain current knowledge of state and federal regulatory requirements to adhere to strict compliance of all aspects ... vital aspects of the role will include making and fielding calls to help Medicare and Medicaid Managed Care Plan Members determine which benefit(s) best suit them… more
- Molina Healthcare (TX)
- …for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare , and Marketplace lines of business. This includes direct management of ... types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice, and mass tort-with the ability to manage… more