- ChenMed (Houston, TX)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... work closely with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and quality management… more
- Houston Methodist (Houston, TX)
- …and provides support to other team members as advised by the manager and/or supervisor. Resolves routine insurance billing inquiries and problems within departmental ... Identifies claim processing issues and general billing trends. Notifies supervisor and/or manager regarding trends to avoid further delay in claims processing. +… more
- Molina Healthcare (Dallas, TX)
- …cases appropriately regarding complexity of medical or psychosocial needs and case manager experience (RN, LSW, other allied fields). + Oversees the staff use ... of the electronic case management documentation system in compliance with standard Molina processes, standard documentation styles, and HIPAA. Arranges training as… more
- Molina Healthcare (TX)
- …**Highly Qualified Candidates Will Have the Following Experience-** Digital Tag Manager Programs Salesforce Marketing Cloud Google or Adobe analytics (or similar) ... Google AdWords, Tag Manager systems, (Adobe or Google) CMS (content management system)...utilizing best practices to increase lead conversion + Ensure compliance with consumer protection laws (CAN-SPAM, TCPA, etc.) and… more
- Fresenius Medical Center (San Antonio, TX)
- …staff member present Position functions as an onsite Patient Educator and Case Manager for patients with various shifts and work hours **PURPOSE AND SCOPE:** ... a licensed nurse under organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies.… more
- Molina Healthcare (Houston, TX)
- …reviews and appeals. * Supports behavioral health committees for quality compliance . * Implements behavioral health specific clinical practice guidelines and medical ... review criteria. * Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for … more
- HCA Healthcare (Dallas, TX)
- …and facility processes. . Prepares documentation for Notification of Non-covered Medicare Services or Advance Beneficiary notices to patients and follows practice ... education. . Refers conflicts and procedural questions to Practice Manager or designee as they arise. . Attends required...adheres to HCA Code of Conduct, related Ethics and Compliance policies, and HIPAA requirements. . Supports and adheres… more
- HCA Healthcare (Dallas, TX)
- …and facility processes. . Prepares documentation for Notification of Non-covered Medicare Services or Advance Beneficiary notices to patients and follows practice ... education. . Refers conflicts and procedural questions to Practice Manager or designee as they arise. . Attends required...adheres to HCA Code of Conduct, related Ethics and Compliance policies, and HIPAA requirements. . Supports and adheres… more
- Banner Health (TX)
- …assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state ... Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG)...make needed corrections and ensure accurate coding, reimbursement, and compliance . 7. Provides mentoring for less experienced staff members… more
- CenterWell (Houston, TX)
- …primary care "on-call" program of CenterWell as needed. + Ensure personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your ... TB. **** **Preferred Qualifications** + Active and unrestricted DEA license. + Medicare & Medicaid Provider Number. + Bilingual in English/Spanish, with the ability… more