- Molina Healthcare (Dallas, TX)
- …the product choices available to them, the enrollment process (eligibility requirements, Medicare review /approval of their enrollment application, timing of ID ... for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved… more
- BAYADA Home Health Care (Austin, TX)
- …while using the Medicare PDGM billing model and CMS guidelines. + Review and communicate OASIS edit recommendations to each clinician to promote OASIS accuracy. ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...review . + Knowledge of OASIS, Home Care and Medicare regulations + Excellent organizational, interpersonal and communication skills… more
- Guidehouse (San Antonio, TX)
- …Friday out of our San Antonio, TX office._** **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… more
- Humana (Austin, TX)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will...daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, … more
- Molina Healthcare (TX)
- …the benefits, operations, communication, reporting, and data exchange of the Medicare /MMP product in support of strategic and corporate business objectives. Support ... for all Medicare lines of business the annual Medicare ...Marketing Guidelines, initiating HPMS submission of materials for CMS review when required. Provides oversight and update of the… more
- St. George Tanaq Corporation (Austin, TX)
- …Requirements **Required Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, ... college or university in healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other related experience in… more
- St. George Tanaq Corporation (Austin, TX)
- …Experience and Skills** + Must have 2-3 years of medical dispute resolution or Medicare appeals, medical review , clinical, or related experience in a healthcare ... college or university in healthcare or related discipline. Additional experience in Medicare appeals, medical review , clinical, or other related experience in… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs **Job Description** Manages the coordination of benefits ... in the pharmacy program with Medicare Part D plans. Provides the technical and leadership...$74,000.00 - $118,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our… more
- System One (San Antonio, TX)
- Medicare Billing Specialist Remote Contract: 6 months Compensation: $22 hourly Contractor Work Model: Remote Hours: Full time, Monday- Friday 8 am - 4:30 pm MST (30 ... lunch) System One is seeking a detail-oriented and proactive Medicare Patient Accounts Specialist to join our dynamic team....include but are not limited to remit and EOB review , calling payer(s) and clinics, rebilling claims, navigating payer… more
- Humana (Dallas, TX)
- …exceed $115K depending on experience and location. Are you passionate about the Medicare population, looking for an opportunity to work in sales with the ability ... as well as, visiting prospects in their homes. Our ** Medicare Sales Field Agents** sell individual health plan products...protection. Please be aware that applicants selected for leader review may be asked to provide their social security… more