- Cognizant (Austin, TX)
- …and member onboarding for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA), ensuring compliance with CMS, ACA, and other regulatory ... sales and enrollment processes for individual, group, and government-sponsored health plans ( Medicare , Medicaid, ACA). * Strong understanding of CMS, ACA, and other… more
- Kelsey-Seybold Clinic (Houston, TX)
- …commercial health plans. KelseyCare Advantage (https://www.kelseycareadvantage.com/) , a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated ... Clinic, has achieved the coveted 5-out-of-5-star rating from the Centers for Medicare and Medicaid for six consecutive years. Kelsey-Seybold has been recognized by… more
- Robert Half Office Team (Fort Worth, TX)
- …processes for IV medications and specialized treatments. * Handle inquiries regarding Medicare Parts B and D benefit plans. * Coordinate with team members ... insurance verification and authorization processes. * Familiarity with insurance plans, including Medicare Parts B and D. * Strong knowledge of infusion and IV… more
- Humana (Austin, TX)
- …Coder + Demonstrate ability to problem-solve complex coding issues + Experience with Medicare and Medicaid coding guidelines + Strong data entry and attention to ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- HCA Healthcare (Pasadena, TX)
- …with the patient, including having the Patient Choice letter signed. . Monitors Medicare patient's planned discharge dates and delivers the Important Medicare ... Message (IMM) to the patient per facility policy. **What qualifications you will need:** + Associate Degree preferred. + Medical knowledge and terminology required. + Minimum of one year experience in a healthcare setting required. + Healthcare professional… more
- Molina Healthcare (Austin, TX)
- …Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically ... appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access and interpret… more
- Humana (Austin, TX)
- …improving consumer experiences **Preferred Qualifications** + Health insurance experience + Medicare Advantage experience Travel: While this is a remote position, ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Evolent (Austin, TX)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- Molina Healthcare (TX)
- …compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all ... delegated groups. + Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee for Quality… more
- CenterWell (Austin, TX)
- …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life… more