- Christus Health (San Antonio, TX)
- …reduction in opportunity days to reach LOS ratioLOS: Impacts Medicare GMLOS by managing per Milliman/Interqual Care Guidelines. Resource/Utilization ... maintains current knowledge of regulatory agencies' relative to work process for compliance , ie IMM, Code 44. Timely communication with Admitting for status changes… more
- Sedgwick (Fort Worth, TX)
- …Description** + Set up new Medicare Lien Resolution (MLR) referrals in the Medicare Compliance System + Electronically sort and index Medicare mail in ... the SIR and Medicare Compliance systems + Responds to questions from examiners about Medicare Compliance processes and products + Documents activity in… more
- Molina Healthcare (Houston, TX)
- **(Sales) Compliance Analyst** Molina Healthcare's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a ... Operating Procedures and Training documents. . Lead regularly scheduled Sales & Compliance leadership meetings. . Interpret and analyze Medicare , Medicaid, and… more
- Humana (Austin, TX)
- …requirements development. + Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance, and compliance + Determine ... community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- UTMB Health (Galveston, TX)
- …government payor reimbursement-related calculations and estimates and ensures UTMB compliance with Medicare and Medicaid regulations. **Scope:** Institutional ... takes necessary actions to implement appropriate processes and procedures to ensure compliance with Medicare and Medicaid regulations. + Supports Director,… more
- Elara Caring (Dallas, TX)
- …staffing levels at branch locations to meet patient needs. + Ensures compliance of current Medicare , Medicaid, and third-party reimbursement regulations and ... all documentation is accurate, complete, timely and adheres to Medicare guidelines. + Assures compliance with the requirements of state licensure, Medicare … more
- Prime Therapeutics (Austin, TX)
- …every decision we make. **Job Posting Title** VP Government Programs - Medicare & Managed Medicaid (REMOTE) **Job Description** The Vice President Government ... Programs - Medicare & Managed Medicaid is responsible for the development,...objectives are met and/or exceeded; instill a culture of compliance , accountability, and superior service within the Government Programs… more
- HCA Healthcare (Conroe, TX)
- …American College of Cardiology, Society of Chest Pain Centers and governmental regulation for Medicare compliance . Manages all CV Data to include ACC, Action and ... STS data registries. **What you will do in this role:** + Develops and supports education to meet all requirements of Chest Pain Accreditation. + Develops and recommends protocol/guidelines for best practice of the cardiac patient across the continuum of care.… more
- Sedgwick (Houston, TX)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Medicare Inbound Contact Representative 2 represents the company by addressing incoming telephone, ... digital, or written inquiries. The Medicare Inbound Contact Representative 2 performs varied activities and...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
