- Oracle (Austin, TX)
- …payers. Specific responsibilities include gathering payer system requirements, understanding Medicare and Medicaid benefits structures, and working with Fast ... Healthcare Interoperability Resources (FHIR) standards. These requirements must be translated into a working system within OHI applications, including Claims, Policies, Authorizations, Product Definition, and Oracle Insurance Gateway. Configuration of OHI… more
- Elara Caring (Richardson, TX)
- …of experience in fast-paced office is preferred + Working knowledge of Medicare /Medicaid, home care benefits, and applicable state policies and procedures preferred ... + Excellent computer and communication skills, with ability to work in fast-paced environment + Passion for patient care + Must have a dependable vehicle, a valid driver's license, and current auto insurance in accordance with the laws of the State You will… more
- Healthfirst (TX)
- …Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of Centers for Medicare & Medicaid Services (CMS) or New York State + Department of Health ... (NYSDOH) regulations governing medical management in managed care + Relevant clinical work experience + Intermediate Outlook, Basic Word, Excel, PowerPoint, Adobe Acrobat skills. + Demonstrated critical thinking and assessment skills to ensure member care… more
- Oracle (Austin, TX)
- …our clients' to track compliance with the requirements of the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC). The compliance rate ... of the CMS and TJC measures by clients identified with these dashboards helps in tracking that the provider patients are receiving highest quality of care. In addition to improving patient care, the successful regulatory submission of the generated report data… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …and benefits through various payers, including commercial insurances, Medicaid, and Medicare . + Obtains the necessary prior authorizations, referrals, and other ... insurance documentation needed for all visits as required by the insurance carrier. + Performs all Time-of-Service collections including collecting copays, deductibles, and outstanding balances due on the account. + Educates the patient/responsible parties… more
- Texas Health Resources (Arlington, TX)
- …(AACN). We are proud to be rated 5 stars by the Centers for Medicare & Medicaid Services (CMS). Our specialties include coronary artery bypass grafting (CABG), valve ... surgeries, Impella and intra-aortic balloon pump (IABP) support, and various lung procedures. We also provide comprehensive cardiac care, including treatment for heart failure, cardiomyopathies, acute myocardial infarction (AMI), and post-cardiac… more
- HCA Healthcare (Fort Worth, TX)
- …+ You will maintain a thorough working knowledge of the rules of Medicare , Medicaid, and private payer regulations and processes. You will possess a thorough ... understanding of managed-care concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or… more
- HCA Healthcare (Austin, TX)
- …to providing patients with quality care during their recovery at home. We are Medicare certified. Our patients are under the supervision of a physician and our team ... of professionals develop an individualized plan of care. Our professionals include registered nurses, licensed practical nurses, therapists, and social workers. We provide the care you need in the comfort of your own home to restore your independence.… more
- Aveanna Healthcare (Brownsville, TX)
- …Contractors, and Employees Residing in California As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements ... in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate. Notice for Job Applicants Residing in California (https://www.aveanna.com/CaliforniaPrivacyNotices.html) Apply more
- Community Health Systems (Corsicana, TX)
- …diagnostic tests. + Verifies the medical necessity of scheduled tests for Medicare patients and ensures compliance with payer requirements. + Refers uninsured and ... underinsured patients to financial assistance programs as appropriate. + Reviews and verifies personal and insurance information for pre-certification orders, including CPT and ICD codes, obtaining clinical details from physicians as needed. + Contacts… more