- Evolent (Austin, TX)
- …The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be Doing:** ... coding team and operations, ensuring accurate and timely ICD-10 coding of claims via progress note clinical documentation review. + Ensure compliance and quality… more
- CVS Health (Austin, TX)
- …queue of Medicare complaints. These complaints can include various issues ranging from claims that are adjudicated incorrectly to rude customer service. You will be ... with complaints and/or Center for Medicare and Medicaid Services (CMS) + Medical /RX claim processing knowledge + Bachelors Degree **Education:** High School Diploma… more
- CVS Health (Austin, TX)
- …levers, underwriting and financial models. + Understanding of healthcare and pharmacy claims data and common tools used to manipulate data. + Exceptional ... varying levels of client contacts, including executive leadership, Chief Medical Officers, pharmacy department leadership, provider networks, actuaries, financial… more
- Molina Healthcare (Austin, TX)
- …organized and analytical thinking. Experience with Medicare/Medicaid, MS 365 and familiarity with claims is highly preferred. The Case Manager must be able to work ... case managers. + RNs are assigned cases with members who have complex medical conditions and medication regimens + RNs conduct medication reconciliation when needed.… more
- Robert Half Legal (Mckinney, TX)
- …on clients' lives. Key Responsibilities: + Manage a caseload of personal injury claims in the pre-litigation stage. + Conduct detailed intake interviews with clients ... statutes of limitations. + Gather and analyze essential case information, including medical records, accident reports, and other evidence. + Draft complex demand… more
- Caris Life Sciences (Irving, TX)
- …candidate will possess a deep understanding of molecular pathology billing, medical necessity requirements, and payor-specific policies related to laboratory and ... + Lead the appeals and reconsideration process for denied Caris claims , including those for CGP (comprehensive genomic profiling) and other proprietary… more
- Texas Tech University Health Sciences Center - Lubbock (Lubbock, TX)
- …Functions:** + Provide patient care, in an outpatient setting, performing such medical examinations as are necessary and appropriate for all patients. + Precept ... family medicine residents and medical students in the family medicine clinic. + Maintain...the family medicine clinic. + Maintain appropriate records, reports, claims and correspondence necessary in connection with all professional… more
- HCA Healthcare (Houston, TX)
- …will work with defense legal counsel to coordinate claim investigations; Process claims against the facility, including the preparation of records, documents, and ... You will assist in identifying, trending, and investigating patient safety incidents, medical errors and potential risks in the facility.** **What qualification you… more
- NASCO (Austin, TX)
- …with US Healthcare payer analytics use cases (eg, risk stratification, claims analytics, provider network optimization) + Certifications in cloud technologies (AWS ... Health Benefits** + Choice of Blue Cross Blue Shield Medical , Dental, and Vision Plans + Telehealthcare - for..., Dental, and Vision Plans + Telehealthcare - for Medical and Behavioral visits + Generous PTO with buy/sell… more
- Methodist Health System (Dallas, TX)
- …maintaining organized employee files. + Proactively manage and process FMLA/LOA claims across the organization, ensuring compliance with Methodist policies and ... of 12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center, multi-organ transplantation,… more