- Cardinal Health (Austin, TX)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of Medical, Supplemental, and pharmacy… more
- Cardinal Health (Austin, TX)
- …about long and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while ... experience preferred + High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for… more
- Actalent (Austin, TX)
- …Technician to join our team. In this role, you will primarily support Medicare and Medicaid patients by managing the intake and processing of prior authorizations. ... and complete processing. + Manage intake of prior authorizations, primarily for Medicare and Medicaid patients. + Maintain accurate records and documentation for all… more
- Kelsey-Seybold Clinic (Houston, TX)
- …and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with ... achieved an overall 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.… more
- Kelsey-Seybold Clinic (Richmond, TX)
- …and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with ... achieved an overall 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.… more
- HCA Healthcare (Irving, 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. + Delivers the Beneficiary Notice to patients identified as being in the BPCI-A program (Bundle Payment hospitals only). + Obtains physician signature on required Case Management documents and forms. + Based on… more
- CVS Health (Austin, TX)
- …and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D, and Public Exchange lines of business. + Conduct market ... of different lines of business (ex. fully insured, ASO, Medicaid, Medicare , Exchanges) to provide relevant recommendations and to influence client adoption… more
- Humana (Austin, TX)
- …or Bachelor's degree in a related field + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage experience + Bilingual is a ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (Austin, TX)
- …and the site of service. This position will be supporting our Washington State Medicare plan. We are seeking a candidate with previous Case Management experience and ... proficient knowledge of MS Suite, organized and analytical thinking. Experience with Medicare /Medicaid, MS 365 and familiarity with claims is highly preferred. The… more
- Kelsey-Seybold Clinic (Houston, TX)
- …and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with ... achieved an overall 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.… more