- Houston Methodist (Houston, TX)
- …and written communication. + Identifies denial trends and notifies supervisor and/or manager to prevent future denials and further delay in payments. Collaborates ... and provides support to other team members as advised by the manager and/or supervisor. **SERVICE ESSENTIAL FUNCTIONS** + Completes special projects to improve… more
- Molina Healthcare (TX)
- …answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. + Ensures that adequate staffing coverage is present ... leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. + Responsible for key… more
- HCA Healthcare (Corpus Christi, TX)
- …Reasons + Communicate coding revisions to the applicable party (eg, CIS, lead, manager , international log) + Periodically works with manager to review individual ... full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000… more
- Elara Caring (Abilene, TX)
- …communication skills both written and verbal (example) + Working knowledge of Medicaid , home care benefits, policies and procedures preferred + Excellent computer ... timely manner; escalates to the attendant coordinator and/or office manager + Reviews open shifts daily to ensure shifts...written and verbal reports concerning any employee or case manager issues + Maintains patient and staff privacy and… more
- Houston Methodist (The Woodlands, TX)
- …care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. **PEOPLE ESSENTIAL ... guidelines. Manages assigned patients and communicates and collaborates with the case manager to assist with appropriate interventions to avoid denial of payment. +… more
- Gentiva (Nacogdoches, TX)
- …relationships with supportive care team (eg, Social Worker and RN Care Manager ), as applicable, and involve team (internally and externally) when patient's care ... patient may be appropriate for home health or hospice care; Medicare/ Medicaid regulations; and interdisciplinary process; value based and/or accountable organization… more
- Molina Healthcare (TX)
- …National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), policies and procedures, quick reference guides (QRGs), audit ... skills. * Strong interpersonal skills. **PREFERRED QUALIFICATIONS:** * Certified Case Manager (CCM). To all current Molina employees: If you are interested… more
- Humana (Austin, TX)
- …a critical moment of truth in the customer lifecycle. As Onboarding Program Manager , you will serve as the program lead for this enterprise-wide effort, reporting ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Elara Caring (Brownwood, TX)
- …with all federal, state, and local regulations along with current Medicare, Medicaid , and third-party reimbursement regulations and changes. + Assures the continuity ... able to lift 50-100 lbs. You will report to the Branch Director, Clinical Manager , Clinical Supervisor or designee. _We value the unique skills of veterans and… more
- Banner Health (TX)
- …with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General ... prior to referral to coding analyst, coding educator or coding manager /supervisor. MINIMUM QUALIFICATIONS High school diploma/GED or equivalent working knowledge and… more