- Baylor Scott & White Health (Dallas, TX)
- …audits and assessments to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action ... are completed in a timely way. . Responds to inquiries utilizing applicable Medicare and Medicaid guidance. Serves as a compliance resource to BSWH departments and… more
- Banner Health (TX)
- …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services ( CMS ), Office of the Inspector General (OIG) and the ... (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification… more
- Molina Healthcare (TX)
- …inquiries. + Performs Plan Required Reporting. + Interpret and analyzes Medicare , Medicaid and MMP Required Reporting Technical Specifications. + Create and ... quarterly Key Performance Indicator (KPI) reports. + Support the management of the regulatory memo distribution process Ability to...notices of proposed rulemaking. + Manages user access to CMS . + Analyze data use critical thinking + Ability… more
- Wolters Kluwer (Coppell, TX)
- …market insights into actionable product requirements, collaborates closely with Engineering, Content , and go-to-market teams, and ensures that our solutions meet the ... long-term advocacy. **Cross-Functional Collaboration** * Coordinate with Engineering and Content teams to ensure product requirements are well understood,… more
- Banner Health (TX)
- …and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services ( CMS ), Office of the Inspector General (OIG) and the ... certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Requires… more
- Centene Corporation (Austin, TX)
- …Continental United States. **Position Purpose:** Provides strategic leadership and management of department overseeing compliance with regulations and laws related ... to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of business, which includes implementation of elements...health care programs. + Participates in mock and actual CMS and other regulatory audits and coordinates with Internal… more
- Fresenius Medical Center (Fort Worth, TX)
- …specific certification as defined by Center for Medicaid/ Medicare ( CMS )Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated ... machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system . **RECORD KEEPING:** + Complete and document ongoing… more
- Cognizant (Austin, TX)
- …ICD-10 * Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims * Knowledge of Medicare / Medicaid payment and ... Responsible for reviewing the data in the claim processing system and comparing with corresponding UB or HCFA paper...Assigning special projects or other duties as determined by management . **What you need to have to be considered:**… more
- Baylor Scott & White Health (Temple, TX)
- **Job Description :** We are seeking a detail-oriented and experienced ** System Analyst 2** to join our team. The ideal candidate will be responsible for testing, ... ensure that claims data meets internal standards and regulatory compliance (HIPAA, CMS , etc.). **Key Responsibilities:** + Analyze, test, and validate healthcare EDI… more
- Cognizant (Austin, TX)
- …+ Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims. + Knowledge of Medicare /Medicaid payment and coverage ... and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA paper...and external SLAs. + Other duties as assigned by management . **Qualifications:** + A minimum of 2 years' claims… more