- Baylor Scott & White Health (Dallas, TX)
- …are completed in a timely way. . Responds to inquiries utilizing applicable Medicare and Medicaid guidance. Serves as a compliance resource to BSWH departments and ... entities on compliance matters. _Third Party Compliance_ . Assists in assessing and mitigating risks related to third-party relationships, including bribery, corruption, sanctions, and reputational concerns. . Supports the implementation and maintenance of… more
- HCA Healthcare (Irving, 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
- HCA Healthcare (San Antonio, 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
- Humana (Austin, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ... **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic… more
- Molina Healthcare (TX)
- …with the standards and requirements established by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal ... into information system and prepares documentation for further review. + Research issues utilizing systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- Elara Caring (Texarkana, TX)
- …2 years of coordinating, and management experience is preferred + Knowledge of Medicare and Medicaid, home health care benefits, policies and procedures + Excellent ... computer and communication skills, with ability to work in fast-paced environment + Reliable transportation to perform job responsibilities You will report to the Branch Director, Alternative Branch Director, or Regional Branch Director. _This is not a… more
- Baylor Scott & White Health (Dallas, TX)
- …authority. They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid. This is in accordance with the appropriate board. The ... Advanced Practice Provider offers medical care based on the supervising physician's scope of practice. They typically care for adult and pediatric cardiovascular and cardiothoracic surgery patients outside the operating room. **Essential Functions of the… more
- UTMB Health (Galveston, TX)
- …plan of care that encompasses evidence-based practice guidelines, practice protocols, Medicare , Medicaid, and other state and federal regulations. + Prescribes ... appropriate pharmacological and non-pharmacological treatments + Provides appropriate education for current health diagnoses as well as anticipatory guidance for health promotion and disease prevention applicable to the individual's health and socioeconomic… more
- Sedgwick (Plano, TX)
- …limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests ... of directions in a professional and timely manner. + Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. + Ensures claim files are properly documented and claims coding is correct. + Refers… more
- Kelsey-Seybold Clinic (TX)
- …handle member and provider calls for self-funded, fully insured and Medicare Commercial plans. **Job Title: Managed Care Representative II** **Location: Pearland ... Administrative Office** **Department:** **Member Provider Service** **Job Type: Full Time** **Salary Range: $42,697 - $52,744 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)** **Qualifications**… more