- Molina Healthcare (TX)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **Job ... + 5+ years of related experience in healthcare + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Analytical work… more
- Aveanna Healthcare (Houston, TX)
- …in English; bilingual skills are a PLUS. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related ... and Sick Days + Quarterly Bonus Opportunities + Mileage Reimbursement + 401(k) Savings Plan with Employer Matching +...Aveanna's supportive and dynamic environment! As an employer accepting Medicare and Medicaid funds, employees must comply… more
- Houston Methodist (Katy, TX)
- …knowledge of claims reimbursement and collection efforts for Managed Care, Medicare , Medicaid , Workers Comp, Commercial plans, etc.; knowledge of how to ... interpret a managed care contract, Medicare and Medicaid and Workers Compensation +...and Workers Compensation + Extensive knowledge of billing, collections, reimbursement , contractual agreements and the appeals process + Understanding… more
- Humana (Austin, TX)
- …day to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare , Medicaid , and/or and Group Account members and create actionable ... match * Generous Paid Time Off accrual * Tuition Reimbursement * Parent Leave * Go365 perks for well-being...to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel,… more
- Cardinal Health (Austin, TX)
- …insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare , Medicaid , Managed Care, and ... + High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred… more
- HCA Healthcare (El Paso, TX)
- …NCD/LCD guidelines, CMS/AHCA policies and regulations + Federal Register, Center for Medicare and Medicaid Services, American Hospital Association, Food and Drug ... and resolving coding related denials from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials...Administration, Medicare Administrative Contractors and payer websites + Escalates problem… more
- Houston Methodist (The Woodlands, TX)
- …a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid , and Managed Care requirements + Progressive knowledge of ... of utilization management, case management, performance improvement, and managed care reimbursement + Ability to work independently and exercise sound judgment in… more
- Houston Methodist (Cypress, TX)
- …focus and application of positive language principles + Comprehensive knowledge of Medicare , Medicaid and Managed Care requirements + Comprehensive knowledge of ... stay are medically necessary, communicating clinical information to payors to ensure reimbursement . In addition to performing the duties of a CM, this position… more
- Houston Methodist (The Woodlands, TX)
- …by capacity to prioritize multiple tasks and role components + Knowledge of Medicare , Medicaid and Managed Care requirements + Comprehensive knowledge of ... are medically necessary and communicates clinical information to payors to ensure reimbursement . The CM PRN helps drive change by identifying areas where performance… more
- HCA Healthcare (Round Rock, TX)
- …and communicate nuances of unique coding requirements for major payers such as Medicare , Medicaid , HMO's, PPO's, IPA's, employers, etc. + Demonstrate and share ... to improve the accuracy, consistency, and efficiency of code assignment for reimbursement and reporting purposes. This individual will assist in training and support… more