- CenterWell (Austin, TX)
- …continuity of care. The role is responsible for data collection and documentation, compliance , and consistent follow up on the initial referral process and decision. ... and departmental standards. + Comply with and adhere to all regulatory compliance areas, policies and procedures and the company's best practices. This position… more
- ChenMed (Houston, TX)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... work closely with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and quality management… more
- Molina Healthcare (Fort Worth, TX)
- …that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined ... staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and...with staff and identify opportunities for improved quality and compliance . + Acts as liaison to both internal and… more
- Molina Healthcare (TX)
- …**Highly Qualified Candidates Will Have the Following Experience-** Digital Tag Manager Programs Salesforce Marketing Cloud Google or Adobe analytics (or similar) ... Google AdWords, Tag Manager systems, (Adobe or Google) CMS (content management system)...utilizing best practices to increase lead conversion + Ensure compliance with consumer protection laws (CAN-SPAM, TCPA, etc.) and… more
- Houston Methodist (Houston, TX)
- …training, and provides support to other team members as advised by the Manager and/or Supervisor. + Identifies denial trends and notifies Supervisor and/or ... Manager to prevent future denials and further delay in...as the subject matter expert with all payers, including Medicare , Medicaid and commercial payers, and applicable department's revenue… more
- Banner Health (TX)
- …initial training by both the Banner Coding Education team and your hiring manager , with continued support throughout your career here! _*This position is for ... documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate code assignment. 3. Provides… more
- Houston Methodist (Houston, TX)
- …and provides support to other team members as advised by the manager and/or supervisor. Resolves routine insurance billing inquiries and problems within departmental ... Identifies claim processing issues and general billing trends. Notifies supervisor and/or manager regarding trends to avoid further delay in claims processing. +… more
- Elevance Health (Grand Prairie, TX)
- …analyzing and validating healthcare encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role involves ensuring the accuracy and ... identifying trends, and providing insights to support decision-making and regulatory compliance . **Location:** Norfolk, VA; Grand Prairie, TX; Tampa, FL; Mason, OH;… more
- CenterWell (Vernon, TX)
- …Adhere to and participate in Agency's mandatory HIPAA / Privacy Program and Employee Compliance Program. + Read and adhere to all Agency Policies and Procedures and ... and be able to problem solve effectively. + Must possess knowledge of Medicare guidelines governing home health and hospice agencies. + Must have exceptional… more
- Humana (Austin, TX)
- …comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root causes driving issues and developing solutions + ... researching and resolving provider reimbursement inquiries + Experience with Optum Rate Manager + Experience with Optum WebStrat or PSI applications + Experience… more