- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …Responsible for auditing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in ... coding practices while maintaining compliance with healthcare laws and organizational policies. The Medical... with any relevant rules or regulations (including HIPAA,Medicaid, Medicare , and specific 3rd Party Payors) + Collaborate with… more
- Humana (Austin, TX)
- …together solution architects, product owners, engineering teams, operations and compliance stakeholders to ensure seamless, secure, and scalable integrations. This ... Success looks like faster time-to-launch, high client satisfaction, audit-ready compliance , and repeatable, scalable patterns. What you bring: healthcare/pharmacy… more
- Humana (Austin, TX)
- …cross-functionally with market leadership, accounting, actuarial, clinical, operations, and Medicare counterpart teams. + Work closely with market actuaries; assist ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- TEKsystems (Houston, TX)
- …* Document all patient interactions accurately and escalate clinical or compliance concerns to pharmacists or supervisors * Provide exceptional customer support ... registration, prior authorization, inbound call, administrative support, customer service, medicare , medicaid Top Skills Details insurance claim,call center,insurance verification,health… more
- Molina Healthcare (Dallas, TX)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with...may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If… more
- Texas Health Resources (Arlington, TX)
- … Compliance and Patient Advocacy Maintains current knowledge of Medicare , federal and state regulatory requirements for documentation, record keeping, and ... patient rights. Any observed deficiencies in Medicare , federal and state regulatory requirements are reported to supervisor and Administrative leaders as… more
- Humana (San Antonio, TX)
- …preferred. + Excellent Verbal Communication **Professional Requirements:** + Knowledge Medicare and Medicaid guidelines + Excellent communication skills and ability ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Evolent (Austin, TX)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... 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 (Houston, TX)
- …+ Collaborate with the operations and business development team. + Ensure compliance with State, Federal, Local, and Aveanna policies and procedures. Qualifications ... to infants, children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related… more
- Evolent (Austin, TX)
- …in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission ... 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
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