- Baylor Scott & White Health (Dallas, TX)
- …correspondence to collect inaccurate insurance payments and penalties according to BSWH Managed Care contracts. Maintains collection files on the accounts ... to resolve payment difficulties and penalties owed to BSWH in accordance with Managed Care contracts. Contacts insurance company representatives by telephone or… more
- US Physical Therapy (Houston, TX)
- …company as a **Contract Manager/Analyst.** This is a dual role that will support the ** Managed Care Operations Team** . The person in this role should have ... experience in Managed Care , WC, Replacements & Auto lines of business. They will work directly with payors to negotiate key payor contracts for the organization… more
- Humana (Austin, TX)
- …adapt and the courage to innovate. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage and Managed Medicaid. ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Humana (Austin, TX)
- …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
- Molina Healthcare (Austin, TX)
- …health care vendor, commercial health insurance, large physician practice, managed care organization, etc.) * Advanced proficiency with retrieving specified ... utilized in medical coding/billing (UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk… more
- UTMB Health (Rosharon, TX)
- …Managerial & Finance UTMB Health Requisition # 2506597 The mission of Correctional Managed Care is to address the healthcare needs to underserved patient ... practice to fulfill the mission and vision of UTMB Correctional Managed Care . **_ESSENTIAL JOB FUNCTIONS_** **:** + Personnel Management: + Defines non-clinical… more
- Houston Methodist (The Woodlands, TX)
- …services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and state and ... tasks and role components + Knowledge of Medicare, Medicaid and Managed Care requirements + Comprehensive knowledge of community resources, health care… more
- Houston Methodist (Houston, TX)
- …by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state, and federal ... national coverage determinations + Comprehensive knowledge of Medicare, Medicaid, and Managed Care requirements + Comprehensive knowledge of community resources,… more
- Houston Methodist (Sugar Land, TX)
- …determinations and, denial reason and trending as appropriate, Monitors CMS, managed care and payor communications for updates/alerts/releases and functions ... knowledge of Federal, State, and local billing regulations and partners with managed care contracting as needed. + Maintains knowledge of contracts, payor plans… more
- Humana (Austin, TX)
- …services (such as inpatient rehabilitation). **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more