- Cardinal Health (Austin, TX)
- …+ Cell/Gene therapy and/or Oncology experience, preferred + Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred + ... Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of ICD9/ICD10 coding is preferred + Critical and creative thinking, preferred + Important to have a strong attention to detail **TRAINING AND WORK SCHEDULES:**… more
- Molina Healthcare (San Antonio, TX)
- …Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits, ... Care Organization (MCO) or health plan setting, including experience in Medicaid and/or Medicare, or equivalent combination of relevant education and experience… more
- Prime Therapeutics (Austin, TX)
- …management. Enforces teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate programs, trends, and ... state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each...department are achieved. + Works with Quality and Training specialist to refine and improve any processes that effect… 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
- STG International (Temple, TX)
- …on all accounts 9. Perform duties to ensure timely conversion to Medicaid 10. Immediately communicate correspondence from fiscal intermediaries and others 11. ... 22. Observe resident rights 23. Ensure timely/accurate re-certs of Medicaid benefits 24. Manage Patient Trust with Administrator 25....Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse Corps -… more
- CVS Health (Austin, TX)
- …the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, ... + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) required. + Experience with International Classification of Disease (ICD)… more
- Humana (Austin, TX)
- …accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus other commercial and ... Board + Leads strategic planning efforts to develop a specialist network within the ACO + Develops a health...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the achievement of ... all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for facilitating appropriate length of… 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 ... least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Registered… more
- Kelsey-Seybold Clinic (Missouri City, TX)
- …a family doctor is not necessary to schedule an appointment with a Kelsey-Seybold specialist , but the family doctor is an important part of the multispecialty team. ... rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024. Kelsey-Seybold has… more