- HCA Healthcare (San Antonio, TX)
- …plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving ... assistance, pet insurance and more. + Free counseling services and resources...Two years of experience within a licensed and certified ( Medicare ) home health agency requiredCompetent in Federal ( Medicare… more
- Molina Healthcare (Houston, TX)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid/ Medicare /Marketplace health coverage audit policies and be able to apply them in ... data from all types of healthcare providers that bill Medicaid/ Medicare /Marketplace. **KNOWLEDGE/SKILLS/ABILITIES** + Ensure investigators are managing their cases… more
- Houston Methodist (Houston, TX)
- …services following review of relevant medical documentation, medical guidelines, and insurance benefits and communicates information to payers in accordance with ... of local and national coverage determinations + Comprehensive knowledge of Medicare , Medicaid, and Managed Care requirements + Comprehensive knowledge of community… more
- Houston Methodist (Houston, TX)
- …FUNCTIONS** + Assists the department in distributing required notices, including the Medicare Notice of Discharge to patients, securing signatures on the form from ... and answering questions regarding the appeal process + Distributes the Medicare Notice of Discharges to identified patients, including capturing patient and… more
- Allied Universal (Mcallen, TX)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim… more
- CenterWell (Corpus Christi, TX)
- …two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... environment in a value-based relationship environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality...+ Minimal Call + Comprehensive benefit package - _health insurance is effective on your first day of employment_… more
- Sedgwick (Austin, TX)
- …Certified as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Examiner | General Liability BI | Captive | Remote As a Claims ... Injury General Liability Claims Examiner** working within **commercial (** **captive) insurance program(s)** ? Are you skilled in **coverage determination** ,… more
- Humana (Austin, TX)
- …+ Accounting/Finance knowledge/experience + Advanced SQL or similar + Medicare /Medicaid experience + Data architecture/solution architecture experience + Project ... with Service Ops (claims, B&E, etc. **Preferred Qualifications** + Health insurance operations expertise + Value based provider arrangement experience + Certified… more
- Sedgwick (Austin, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claim Examiner - Liability | Remote **PRIMARY PURPOSE** : To analyze complex or ... limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests… more
- Gentiva (San Angelo, TX)
- …ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide leadership and operational oversight ... operations leadership + Strong understanding of hospice regulations, compliance, and Medicare conditions of participation + Proven ability to manage teams, budgets,… more