- Public Consulting Group (Austin, TX)
- …+ Investigate complaints, initiatives and data packages against North Carolina (NC) Medicaid providers and conduct desk and routine reviews of assigned providers to ... letters, appeal summaries, etc. using standard templates. Communicate with NC Medicaid providers to obtain documentation, provide education as needed, and to… more
- Humana (Austin, TX)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Ascension Health (Austin, TX)
- …targeted audit of claims to ensure payment accuracy and adherence to state Medicaid guidelines. + Responsible for the comprehensive research and resolution of claim ... in the Facets platform preferred. + Experience working with Texas Medicaid claims and Medicaid regulatory requirements is preferred. + Knowledge of Texas … more
- Molina Healthcare (Dallas, TX)
- …relevant education and experience. + At least 3 years of Experience with Medicaid and/or Medicare. + Proven experience owning operational projects from concept to ... (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. + Skilled in Excel and SQL, with the ability… more
- HCA Healthcare (Tomball, TX)
- …guidelines in all interactions with the patient + In conjunction with the Medicaid Eligibility Staff visit all uninsured patients in-house + Provide estimates to ... + Assist patients with payment arrangements and in co-ordination with the Medicaid Eligibility Staff assists patient with financial applications + Contact patient… more
- Humana (Austin, TX)
- …of the managed care industry including Medicare Advantage, Managed Medicaid , or other Medical management organizations, hospitals/ Integrated Delivery Systems, ... medical management review organization, such as Medicare Advantage and managed Medicaid . + Physical Medicine and Rehabilitation, Internal Medicine, Family Practice,… more
- Molina Healthcare (Austin, TX)
- …director, and quality improvement staff. + Facilitates conformance to Medicare, Medicaid , NCQA and other regulatory requirements. + Reviews quality referred issues, ... license without restrictions to practice and free of sanctions from Medicaid or Medicare. **PREFERRED EDUCATION:** Master's in Business Administration, Public… more
- Zelis (Plano, TX)
- …claim data, with a focus on various pricing methodologies including Medicare, Medicaid , and commercial reimbursements. This role involves leveraging data to ensure ... and reporting. + Understand claim payment methodologies such as Medicare, Medicaid , and Commercial Reimbursement. + Create visualizations and dashboards to present… more
- Ascension Health (Austin, TX)
- …have a solid understanding of Marketing to grow Dell Children's Health Plan Medicaid and CHIP membership, and retain existing members. This position plays a critical ... south of Pflugerville), Manor, Lee and Bastrop Counties). + Educating Medicaid and CHIP-eligible communities about value-added services and program benefits. +… more
- TEKsystems (Dallas, TX)
- …to manage the enrollment and re-enrollment of healthcare providers across Medicare, Medicaid , and commercial insurance plans. This role ensures timely and accurate ... submit enrollment and re-enrollment applications for healthcare providers to Medicare, Medicaid , and commercial insurance plans. + Maintain accurate and up-to-date… more