- HCA Healthcare (Mcallen, TX)
- …offered. + Participates in preparation of the Laboratory for CAP and JCAHO Medicare inspections. + Verifies the validity of patient test results through the ... evaluation of quality control values prior to reporting patient test results. + Performs maintenance, troubleshooting, and calibration procedures related to each test performed. **What qualifications you will need:** + Bachelor's Degree in Medical Technology,… more
- The Cigna Group (Fort Worth, TX)
- …insurance network filings to state Departments of Insurance (DOIs) and the Centers for Medicare & Medicaid Services (CMS). This position plays a key role in ensuring ... the accuracy, completeness, and timeliness of provider network data required for regulatory approval and compliance. **Primary Responsibilities:** + Project management coordinating with multiple matrix partners and compiling, formatting, and validating… more
- Centene Corporation (Austin, TX)
- …and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of business, which includes implementation of elements of an effective ... compliance program. Oversee the development of risk assessments oversight and the monitoring work plans pertaining to Risk Adjustment. Partners with business areas to ensure and implement effective prevention, detection and correction of compliance issues. +… more
- Prime Therapeutics (Austin, TX)
- …consultants, key state leaders, industry trade associations, and Centers for Medicare and Medicaid Services (CMS); establish an effective communication and ... collaboration cadence to respond to market/competitive threats (ie coalitions) and ensure program compliance, operational best practices and industry leading innovation + Develop a recurring process to solicit product, financial and contracting feedback from… more
- Baylor Scott & White Health (Fort Worth, TX)
- …whose service is billed as an independent billing provider, as recognized by Medicare and Medicaid within the healthcare systems, and in accordance with the ... appropriate board. The Advanced Practice Provider provides medical care based upon the scope of practice as delineated by the supervising physician. Typically provides care to patients in an urgent care or convenient care clinic. **Key Responsibilities:** +… more
- Gentiva (Pasadena, TX)
- …including budget development and monitoring required + Understanding of Medicare /Medicaid and Commercial insurance billing and reimbursement **We Offer** + ... Comprehensive Benefits Package: Health Insurance, 401k Plan, Tuition Reimbursement, PTO + Opportunity to Participate In a Fleet Program + Competitive Salaries + Mileage Reimbursement + Professional Growth and Development Opportunities **Legalese** + This is a… more
- Gentiva (Pasadena, TX)
- …including budget development and monitoring required + Understanding of Medicare /Medicaid and Commercial insurance billing and reimbursement **We Offer** + ... Comprehensive Benefits Package: Health Insurance, 401k Plan, Tuition Reimbursement, PTO + Opportunity to Participate In a Fleet Program + Competitive Salaries + Mileage Reimbursement + Professional Growth and Development Opportunities **Legalese** + This is a… more
- San Antonio Behavioral Health (San Antonio, TX)
- …expected to do presentations as directed. Working knowledge of criteria for Medicare , Medicaid, HMO, and private insurance carrier's coverage details. * Ability to ... advocate for patients. Ability to operate office equipment. Possess critical thinking skills. * Leadership skills required for role include effective mentoring, coaching, counseling, time management, problem solving, and strategic planning. * Demonstrates… more
- CommonSpirit Health (Houston, TX)
- …planning and quality care management. + Understand the intricacies of the Medicare Inpatient Prospective Payment System (IPPS) to make medical determinations on ... severity of illness, acuity, risk of mortality, and communicate with treating physicians in cooperation with the utilization team and health information staff. + Understand the intricacies of ICD-9-CM, ICD-10-CM/PCS, MS-DRG, and APR-DRG. + Contacts Case and… more
- HCA Healthcare (El Paso, TX)
- …by ASCP, or any licensure recognized by the laboratory certification agency (eg Medicare , JCAHO, CAP, etc.) required + Degreed Medical Technologist with 3-5 year's ... experience. + Must meet CLIA requirements. + Bachelors Degree Del Sol Medical Center (https://laspalmasdelsolhealthcare.com/location/del-sol-medical-center/) is a full service, acute-care hospital in east El Paso, Texas. We have **a Level II trauma… more