- UTMB Health (Galveston, TX)
- …commercial and government payers, including HMOs, PPOs, ACOs, and Medicaid/ Medicare Advantage plans. * Analyze reimbursement methodologies and contract performance ... to ensure profitability and operational effectiveness. * Develop and maintain strong relationships with payer representatives to facilitate contract negotiations and dispute resolution. * Collaborate with finance, legal, revenue cycle, and clinical operations… more
- HCA Healthcare (Corpus Christi, TX)
- …leadership + Work with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assign interim DRGs for in-house ... patients at month end + Complete MOCK abstracts as necessary (eg, combining the codes for outpatient and inpatient claims subject to the payment window) + Assist the Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC)/Hold Reasons +… more
- CenterWell (Mineral Wells, TX)
- …and be able to problem solve effectively. + Must possess knowledge of Medicare guidelines governing home health and hospice agencies. + Must have exceptional ... customer service skills and be able to communicate well with referral sources, patients, family members, and agency employees. + Must be organized, detail-oriented, and possess effective communication skills both orally and in writing. + The ability to… more
- HCA Healthcare (El Paso, TX)
- …Plans/OSHA guidelines, Handbook, and standards of regulatory bodies (JCAHO, Medicare , CARF, etc.) + Other duties as assigned. REQUIRED LICENSURE/CERTIFICATIONS ... Licensed by the Texas State Board of Occupational Therapy Examiners, BCLS REQUIRED EDUCATION/EXPERIENCE MS/MA in Occupational Therapy PREFERRED EDUCATION, LICENSURE, CERTIFICATION, EXPERIENCE, SKILLS,KNOWLEDGEAND ABILITIES Bilingual Spanish preferred… more
- Philips (Houston, TX)
- …evidence and obtaining medical record documentation. + Be an expert on Medicare , Medicaid and private insurance coverage-criteria for InCourage vest therapy. Be able ... to effectively educate healthcare teams in identifying patients who meet coverage criteria. + Ability to analyze data to effectively target priority healthcare teams and create sales call routing. Capable to be flexible and adjust routing to fit pipeline… more
- Gentiva (Paris, TX)
- …experience in hospice, palliative care, or geriatrics + Strong understanding of Medicare hospice regulations and eligibility criteria + Experience providing care in ... home-based or facility settings + Prior experience completing F2F or recertification visits in hospice or home health + Confident, independent practitioner with excellent communication and documentation skills **We Offer** **Benefits for All Associates… more
- Kelsey-Seybold Clinic (Cypress, TX)
- …identify, understand and communicate plan details to patients with HMO, PPO, EPO, Medicare Advantage and other plans. 1+ years of cash handling or collections ... experience in a medical office setting. 2+ years of direct face to face customer service experience. **License(s)** Required: N/A Preferred: N/A **Special Skills** Required: Experience with computers and Windows-based software including Word and Excel.… more
- Sumitomo Pharma (South Houston, TX)
- …knowledge and understanding of the payer landscape including commercial, Medicaid, and Medicare or relevant experience. + Demonstrates the ability to analyze complex ... data to develop strategic and actionable business plans to deliver sales results. + Candidates must have excellent communication & organizational skills and be proficient with technology platforms and business hardware/software. **Education and Experience** +… more
- Datavant (Austin, TX)
- …+ Proficient in ICD-10 coding. + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors. + In-depth knowledge of medical terminology, ... abbreviations, pharmacology, and disease processes. + Ability to excel in a fast-paced production environment while upholding high-quality standards. + Strong written and verbal communication skills, adeptness in remote work, and exceptional time management… more
- Gentiva (Spring, TX)
- …ability to apply hospice principles, industry standards, and regulatory compliance ( Medicare , Medicaid, JCAHO, ACHC) * Knowledge and compassion for terminally ill ... patients and their families * Ability to lead a diverse care team while adapting to the emotional and clinical needs of patients from various backgrounds * Strong interpersonal, organizational, and leadership skills * Competency in clinical documentation and… more