- Houston Methodist (Houston, TX)
- …study budgets, coverage analyses, etc. - Performs detailed claims testing and medical review . - Reviews Medicare Coverage Analysis to ensure completion prior to ... competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees,… 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
- 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. ... Utilization Review , Quality Assurance, Remote, Home Health Coding, Coder, Medicare **As an accredited, regulated, certified, and licensed home health care… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of care using...local and national coverage determinations + Comprehensive knowledge of Medicare , Medicaid, and Managed Care requirements + Comprehensive knowledge… more
- Houston Methodist (Houston, TX)
- …reviews the filing of Federal and State Charity Report. + Directs the coordination, review and filing of Medicare and Medicaid cost reports and associated audits ... internal and external financial and governmental reporting requirements. Requirements include Medicare cost reports, Federal Tax Returns Health and Human Services… more
- Humana (Austin, TX)
- …group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to influence department's… more
- HCA Healthcare (Houston, TX)
- …**Introduction** Do you have the career opportunities as a Revenue Integrity Charge Review Analyst you want with your current employer? We have an exciting ... group of colleagues. Do you want to work as a Revenue Integrity Charge Review Analyst where your passion for creating positive patient interactions is valued? If you… more
- HCA Healthcare (Round Rock, TX)
- …to join an organization that invests in you as a Pro Fee Coding Quality Review Educator? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... are looking for a dedicated Pro Fee Coding Quality Review Educator like you to be a part of...of unique coding requirements for major payers such as Medicare , Medicaid, HMO's, PPO's, IPA's, employers, etc. + Demonstrate… more
- Intermountain Health (Austin, TX)
- …Billing, Follow-Up, Collections) required + Knowledge of Medicaid and Medicare billing regulations required **Physical Requirements** + Operate computers and ... other office equipment requiring the ability to move fingers and hands. + Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment. + May require lifting and transporting objects and office supplies,… more
- Molina Healthcare (Fort Worth, TX)
- …Company's assigned contact to log tickets for premium restoration such as Medicare Secondary Payer and ESRD. **JOB QUALIFICATIONS** **Required Education** HS Diploma ... or GED **Required Experience** 1-3 years' experience in an administrative support. **Preferred Education** Associate degree **Preferred Experience** 3+ years' experience in an administrative support role. To all current Molina employees: If you are interested… more