- Guidehouse (Lewisville, TX)
- …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare / Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & ... CMS 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and patients in all requested… more
- Prime Therapeutics (Austin, TX)
- …drives 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, administration, and execution of strategic plans that advance Prime's… more
- Humana (Austin, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Humana (Austin, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical… more
- Humana (Austin, TX)
- …**Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. +… more
- Humana (Austin, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... a part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer… more
- Humana (Houston, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... The MarketPoint Career Channel Team is looking for skilled Medicare Sales Field Agents. This is a **field** **-based**...community. As part of a collaborative team of 8-12 Medicare Sales Field Agents, you'll work under the guidance… more
- Houston Methodist (Katy, TX)
- …Inpatient/ Outpatient Prospective Payment Systems, etc. + Stays informed of the latest Medicare , Medicaid and commercial payor news, updates, and regulations and ... needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash… more
- Molina Healthcare (Dallas, TX)
- …with clinical leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid , NCQA and other regulatory requirements. * Reviews ... quality referred issues, focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing,… more
- UTMB Health (Galveston, TX)
- …calculations and estimates and ensures UTMB compliance with Medicare and Medicaid regulations. **Scope:** Institutional **Responsibilities:** ... + Responsible for technical aspects, calculations and analyses of multiple areas of Medicare and Medicaid reimbursement components including, but not limited to,… more