- Centene Corporation (Austin, TX)
- …related field. + 3+ years of related analytical experience in managed health care, Medicare or Medicaid . + Experience with concepts of information management and ... an in depth knowledge of pharmacy/medical terminology, pharmacy claims processing, NDC/GPI/GCN, coding issues and practices, including ICD-9, CPT4, HCPCS Level II. +… more
- Baylor Scott & White Health (Austin, TX)
- …and reporting to stakeholders across all lines of business (Commercial, DTE, Medicare , and Medicaid ). Candidate will oversee extracting and analyzing medical ... and pharmacy claims data, translating output into business recommendations. This individual...plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 Note: Benefits… more
- Kelly Services (Coppell, TX)
- …insurance benefits, deductibles, and eligibility with a variety of payers including Medicare , Medicaid , HMO, PPO, and third-party plans. + Communicate with ... and payment options. + Submit and follow up on prior authorizations and clean claims . + Process referrals and ensure documentation is complete and accurate. + Enter… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …while ensuring compliance with any relevant rules or regulations (including HIPAA, Medicaid , Medicare , and specific 3rd Party Payors) + Collaborate ... to resolve identified issues + Ensure abstracted data impacting reimbursement for all clinical locations is accurate: discharge disposition,indicators, procedure… more
- Molina Healthcare (Austin, TX)
- …observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. ... care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) * Advanced understanding on health care financial… more
- Centene Corporation (Austin, TX)
- …of government-sponsored healthcare coverage, providing access to affordable, high-quality services to Medicaid and Medicare members, as well as to individuals ... to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, or unusual or new services in order to… more
- Ascendis Pharma (TX)
- …collaboration with US payers, including both commercial and public payers such as Medicare and Medicaid . + Collaborate with commercial and medical in responding ... RWE and HEOR research activities (including retrospective/prospective research concepts, claims analyses, and economic modeling, etc) to support HEOR objectives.… more