- St. George Tanaq Corporation (Austin, TX)
- …Requirements **Required Experience and Skills** + One (1) year of Medicare appeals, medical review , clinical, healthcare regulatory interpretation/application, ... Dispute Resolution Reviewer I Fully Remote*GA Job Type Full-time Description...university in healthcare or related discipline Additional experience in Medicare appeals, medical review , clinical, or other… 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 ... Dispute Resolution Reviewer III Fully Remote*GA Job Type Full-time Description...and impartial and supports the determination made, and documents review + Makes sound, independent decisions based on medical… more
- Elevance Health (Grand Prairie, TX)
- …for Medicare fee for service and assisting nurses as needed with review of claims. Works with other Medicare Administrative Contractor (MAC) Medical ... **Medical Director- Medicare Fee for Service** Location: This role enables...collaborative policies. May participate in MAC policy workgroups to review coverage criteria for existing services or new services… more
- Humana (Austin, TX)
- …group practice management + Utilization management experience in a medical management review organization, such as Medicare Advantage and managed Medicaid + ... other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and will understand how… more
- Humana (Austin, TX)
- …and Managed Medicaid. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **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
- Molina Healthcare (San Antonio, TX)
- …Summary** Responsible for leading, organizing and directing the activities of the Medicare Contracted Provider Post-Pay Claim Appeals and Disputes in accordance with ... the standards and requirements established by the Centers for Medicare and Medicaid. **Knowledge/Skills/Abilities** * Leads, organizes, and directs the activities of… more
- HCA Healthcare (Georgetown, TX)
- …you find this opportunity compelling, we encourage you to apply for our Medicare Specialist opening. We promptly review all applications. Highly qualified ... is recognized. Submit your application for the opportunity below: Medicare Specialist Parallon **Benefits** Parallon, offers a total rewards...benefits may vary by location._** We are seeking a Medicare Specialist for our team to ensure that we… more
- Houston Methodist (Katy, TX)
- …HB Epic AR management experience + Strong working knowledge of Facility Medicare (Part A) guidelines. + Problem solving thought leader with proven execution ... competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees,… more
- Humana (El Paso, TX)
- …our caring community and help us put health first** Are you passionate about the Medicare population, looking for an opportunity to work in sales with the ability to ... 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