- 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
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of dual contract requirements (eg, Medicare -Medicaid plans)_** + **_Experience managing external audits and communicating with ... for its Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to… more
- CVS Health (Austin, TX)
- …day. **Position Summary** As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. ... information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a… more
- Humana (Austin, TX)
- …medical review by physician or nurse, with a focus on our 5+ million Medicare members. You will also facilitate the delivery of high quality, appropriate, and ... to assist and facilitate new hires and remediation of medical directors performing Medicare utilization management processes and be the liaison for the Medicare … more
- Texas Health Resources (Arlington, TX)
- …aspects of assessment and plan of care in accordance with departmental, TJC, Medicare , and other applicable regulatory guidelines. . Documents all aspects of each ... treatment session in accordance with departmental, TJC, Medicare , and other applicable regulatory guidelines. . Accurately submits patient charges and records… more
- CenterWell (San Antonio, TX)
- …role, you will be required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five years ... directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more
- Texas Health Resources (Denton, TX)
- …assessment, plan of care, and re-certifications in accordance with departmental, TJC, Medicare , and other applicable regulatory guidelines . Documents all aspects of ... each treatment session in accordance with departmental, TJC, Medicare , and other applicable regulatory guidelines . Obtains physician signature on all plans care and… more
- BAYADA Home Health Care (Austin, TX)
- …as it relates to the OASIS and ICD 10 coding while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations ... of MCM. + Prevent or decrease the occasion of Medicare denials by assuring proper coding on the plan...Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, Home… more
- Molina Healthcare (TX)
- …achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for ... MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the… more
- Humana (Austin, TX)
- …determining objectives and approaches to assignments. This role is within the Medicare Finance organization. This role will be required to collaborate with various ... requests and perform valuations that help inform financial strategy related to the Medicare Advantage line of business. **Use your skills to make an impact**… more