- Evolent (Austin, TX)
- …+ Offer **clinical rationale for standard and expedited appeals,** ensuring compliance with UM policies and regulatory requirements. + Collaborate with ... organizational skills.** + Passion for **value-based care and improving healthcare quality.** + **Computer proficiency** and ability to navigate...we'd love to hear from you! **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)),… more
- Highmark Health (Austin, TX)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim… more
- STG International (Temple, TX)
- …community team members and others 19. Does not disclose resident information, maintains HIPAA compliance per regulation 20. Observe and comply with all Community ... monitoring pharmacy delivery and distribution of medication is timely and in compliance with all state/federal/VA regulations and STGi policies & procedures, while… more
- Houston Methodist (Houston, TX)
- …personal information. Adheres to all Health Insurance Portability and Accountability Act ( HIPAA ) and Payment Card Industry (PCI) compliance regulations **FINANCE ... and supervises staff while maintaining adequate staffing levels and budget compliance . The supervisor position contributes to staffing decisions such as hiring,… more
- WM (Conroe, TX)
- …a US based business-to-business services company and leading provider of compliance -based solutions that protects people and brands, promotes health and well-being, ... range of increasingly complex and highly regulated arenas, serving healthcare organizations and commercial businesses of every size. Every...with new hire orientation o Complete location audits * Compliance : o Track and input DOT hours/JJ Keller o… more
- Humana (Austin, TX)
- …performance, data integrity, and security through rigorous governance and proactive compliance practices. + Build a best-in-class Finance data and analytics function ... build stakeholder alignment, and drive innovation. + Familiarity with compliance standards, Finance data governance, and system audit-readiness. **Preferred… more
- Humana (Austin, TX)
- …time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work ... computer applications. Due to the auto dialer process and compliance needs of the business there is limited day...space lacking ongoing interruptions to protect member PHI / HIPAA information **Additional Information - How we Value You**… more
- Humana (Austin, TX)
- …encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance ... Medicaid/Medicare + Ensure encounter submissions meet or exceed all compliance standards via analysis of data + Develop tools...space lacking ongoing interruptions to protect member PHI / HIPAA information** **Our Hiring Process** **As part of our… more
- Humana (Austin, TX)
- …pillars, including continuous integration (CI), continuous delivery (CD), quality, security, compliance , metrics, and reporting. + Ensure compliance with ... space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position,...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Prime Therapeutics (Austin, TX)
- …risk mitigation, and regulatory interpretation + Demonstrated experience in federal healthcare laws and regulations such as HIPAA , Anti-Kickback Statute, ... **Additional Qualifications** + Advanced knowledge of PBM regulatory frameworks and healthcare law, with demonstrated ability to proactively identify and address… more