- Healthfirst (TX)
- …York State regulations, job aides and HF policies. This includes review of performance audit reports in order to maintain superior and accurate care data for each ... programs such as MAP or MLTC + Knowledge of Medicare Regulations related to Long Term Care + Experience...care plan + Understanding of health plans such as Medicare , Medicaid and/or Managed Long-Term Care Plan (MLTCP) +… more
- Evolent (Austin, TX)
- …of utilization review determinations, including appeals. + Provides input into audit processes including development of questions. + Reviews statistical sample of ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Aveanna Healthcare (Dallas, TX)
- …communication standards within the office. + Payroll Assistance: Review weekly timesheets, audit payroll files, and serve as the primary contact for caregiver ... skills are a PLUS. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with...Aveanna's supportive and dynamic environment! As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
- Datavant (Austin, TX)
- …materials + Provide support to client relations for trainings needed for client audit findings + Research and analysis of coding error trends What you will ... and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of Medicare… more
- Houston Methodist (Katy, TX)
- …other areas according to department specifications. + Partners with Internal Audit , Business Practices, Health Information Management, Patient Access Services, and ... to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash… more
- Prime Therapeutics (Austin, TX)
- …Subject Matter Expertise in their areas of focus (Affordable Care Act, Medicare , Medicaid, Corporate Compliance, Compliance Assessment or Services etc.) + Develop ... employee and leadership expectations + May oversee and support audit action plans and/or corrective action plans for the...or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Datavant (Austin, TX)
- …outcomes, measure product impact, and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep ... **Quality, Compliance, and Scalability** + Ensure analytics products support audit defensibility, regulatory compliance, and documentation traceability. + Design… more
- Humana (Austin, TX)
- …+ Knowledge of Medicaid regulatory requirements + Experience with contracting, audit , risk management, or compliance **Additional Information** This position is open ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- HCA Healthcare (Houston, TX)
- …clinical documentation, making necessary corrections in Patient Accounting. Based on audit findings, present recommendations to Corporate and SSC Revenue Integrity ... calls, ensuring continuous education. + Possess working knowledge of Medicare guidance, inpatient/outpatient status, and observation requirements. + Knowledge of… more
- Cardinal Health (Austin, TX)
- …for every interaction using the appropriate database for the inquiry + Must self- audit intake activities to ensure accuracy and efficiency for the program + Make ... prior authorizations, and appeals, preferred (2+ years) + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, preferred… more