- CenterWell (San Antonio, TX)
- …of hands-on healthcare experience in a clinical setting, preferably within the Medicare population + Experience with Payor Portals + Proficient with Microsoft Office ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- 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 ... the company. + Performs other duties as assigned and modified at manager 's discretion. **KNOWLEDGE, SKILLS & ABILITIES:** **Competencies for Success** + Availability… more
- Molina Healthcare (San Antonio, TX)
- …MCG, InterQual or other medically appropriate clinical guidelines, Medicaid, Medicare , CHIP and Marketplace, applicable State regulatory requirements, including the ... Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in Healthcare… more
- Molina Healthcare (Fort Worth, TX)
- …that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined ... HCS Department staff workload for adherence to the Policies, Procedures, Guidelines, Medicare Model of Care, and deadlines. Assures oversight and direction of… more
- CenterWell (Corpus Christi, TX)
- …experience * Basic knowledge of Population Health Strategy * Familiarity with Medicare * Experience managing a budget of $500,000 **Work Schedule:** Full Time ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- HCA Healthcare (Austin, TX)
- …down-time. 2. Work closely with the physician office staff and L&D Supervisor/ Manager to ensure that procedures are scheduled accurately. + Receive incoming precert ... and Value Statement". + Other duties as assigned including running iatrics on Medicare patients. 4. Communicates clearly and concisely, verbally and in writing. +… more
- WTW (Richardson, TX)
- …Fun Culture * Full Benefits The Sales Agent typically holds Health and/or Medicare Supplement insurance license and works directly with consumers to help them obtain ... works in a call center setting and reports to the Performance Manager . **Responsibilities:** * Contacts and qualifies prospective customers and explains features and… more
- CenterWell (Fort Worth, TX)
- …indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals *Personally ... largest providers of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing the physical,… more
- Sedgwick (Plano, TX)
- …limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests ... Assists in interviews of adjusters, clerical staff and provides feedback to hiring manager . + Provides limited assistance/support to team lead with monthly review of… more
- Highmark Health (Austin, TX)
- …system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare ... and research related to special projects and providing coverage for coding manager (s). (10%) + Depending on location provides or arranges for education/training of… more