- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements… more
- Highmark Health (Austin, TX)
- …to accepted and established coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the delivery of ... claim review with the goal of proper and timely payment to provider and member satisfaction. The incumbent is...claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure… more
- Elevance Health (Grand Prairie, TX)
- …into meaningful provider and market-level action, with the overall goal of increasing medical savings and improving payment accuracy. Primary duties may include, ... **Manager Process Improvement - Payment Integrity** **Location** : It is highly preferred...provider engagement that supports recovery optimization, compliance, and sustainable medical savings. **Minimum Requirements:** Requires a BA/BS in a… more
- HCA Healthcare (Plano, TX)
- …accounts receivable follow-up, insurance follow-up and appeals, insurance posting, professional medical /billing, medical payment posting, and/or cash ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...both written and telephonically + Overcome objections that prevent payment of the claim and gain commitment for … more
- Centene Corporation (Austin, TX)
- …involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment . + Develops alliances with the ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
- Elevance Health (Grand Prairie, TX)
- ….Experience working with ICD-9/10CM, MS-DRG and APR-DRG. .Broad knowledge of medical claims billing/ payment systems provider billing guidelines, payer ... an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance...Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Managers of DRG Coding & Clinical… more
- CVS Health (TX)
- …quality, constituent focused medical care with a focus on clinical and payment policy. This Medical Director provides subject matter expertise to provide ... CVS Health company, has an outstanding opportunity for a Medical Director. Ready to take your career to the... Director provides subject matter expertise in clinical and payment policy to provide clinical support and business direction… more
- Amazon (Austin, TX)
- …Bid/Capture team. The position will have primary responsibility of contractual payment obligations across the diverse Amazon Business B2B portfolio of agreements. ... Responsibilities will include contract interpretation, external customer communications, internal payment process ownership, sharing of best practices, and process… more
- Realtor (Austin, TX)
- …the right connections, and building confidence through expert guidance. Manager, Payment Operations Location: Austin, TX At Avail by Realtor.com(R), we're seeking ... a skilled Payment Operations Manager to join our team. In this...but are not limited to: + Inclusive and Competitive medical , Rx, dental, and vision coverage + Family forming… more
- HCA Healthcare (San Antonio, TX)
- …UT, VA). Do you want to join an organization that invests in you as a Payment Compliance Analyst? At Parallon you come first. HCA Healthcare has committed up to $300 ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...make a difference. We are looking for a dedicated Payment Compliance Analyst like you to be a part… more
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