- Molina Healthcare (Houston, TX)
- **Job Description** **Job Summary** Provides leadership to the Medicare Duals team and plays a critical role in advancing the Medicare Integrated Duals segment ... strategic priorities. Develops and executes Medicare strategies, including state-specific and product-specific growth initiatives. Leads high-priority projects… more
- Humana (Austin, TX)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid/ Medicare . Looks for long term improvements of encounter submission processes. Understands… more
- CVS Health (Austin, TX)
- …Tracking Module (CTM) Senior Coordinator, you will be part of the Medicare Complaints Tracking Module (CTM) Team, responsible for researching and resolving ... complaints received via the Centers for Medicaid and Medicare Services (CMS). In this role, you will manage...In this role, you will manage a queue of Medicare complaints. These complaints can include various issues ranging… more
- Texas Health Resources (Arlington, TX)
- …other programs. + Oversees or supports departments and entities with various Medicare and Medicaid Supplemental Payment and incentive programs including but not ... including but not limited to the review and preparation on of Medicare /Medicaid cost reports, regulation appeals, Disproportionate Share Hospital (DSH), and Wage… more
- BAYADA Home Health Care (Austin, TX)
- …Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information Set (OASIS) ... to policies and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role...the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review… more
- Humana (Austin, TX)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...HR. DVACO's MSSP participation accounts for the region's largest Medicare ACO grouping, with more than 2,000 physicians and… more
- CVS Health (Houston, TX)
- …will sell, cross-sell, up-sell, and retain through the use of the Aetna IVL Medicare product portfolio.This role will deploy an operating model that supports 3 days ... shopper initiatives, and state, federal, and CMS requirements for Medicare sales agents and programs + 0-3 Years Experience...or 1 to 2 years' experience of selling multiple Medicare products (ie, Medicare Advantage, Medicare… more
- Humana (Austin, TX)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid/ Medicare . Looking for long-term improvements of encounter submission processes. Begins to… more
- Kelsey-Seybold Clinic (TX)
- …Member Service Representatives II-KSPA handles member and provider calls for our Medicare Advantage plan and have demonstrated ability to interpret Medicare ... limited to Late enrollment penalty, low income subsidy, enrollment/disenrollment guidance, Medicare beneficiary protections and Medicare coverage rules. MSR… more
- Providence (TX)
- …training, job aides and technical support for caregivers regarding Centers for Medicare and Medicaid Services (CMS) Medicare Secondary Payer reporting, ... as to training topics + Act as a resource to fellow caregivers for Medicare Secondary Payer reporting of third-party claim payments and write-offs and serve as our… more