- Cardinal Health (Austin, TX)
- …a call center or customer service environment, preferred + Clear knowledge of Medicare , Medicaid & Commercial payer policies and guidelines for coverage, preferred + ... Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred + Clear understanding of...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- Cardinal Health (Austin, TX)
- …about long and short-range changes in the reimbursement environment including Medicare , Medicaid, Managed Care, and Commercial medical and pharmacy plans while ... High School diploma or equivalent preferred + Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers...other status protected by federal, state or local law._ _To read and review this privacy notice click_ here… more
- HCA Healthcare (Round Rock, TX)
- …with the patient, including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important Medicare ... you to apply for our Case Management Assistant opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more
- Humana (Austin, TX)
- …residence + Eligibility to participate in federal prescription programs (eg, Medicare /Medicaid) + Self-directed with the ability to work effectively both ... + Experience in managed care pharmacy, particularly in utilization management review **Additional Information:** **Interview Format** : As part of our… more
- Kelsey-Seybold Clinic (Stafford, TX)
- …of clinical practice guidelines/standards in support of quality palliative care + Timely review , oversight, and documentation of patient care by team NP (s) or RN ... and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with… more
- CVS Health (Austin, TX)
- …to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are ... of 1 year recent and related experience in medical record documentation review , diagnosis coding, and/or auditing. + Completion of AAPC/AHIMA training program for… more
- HCA Healthcare (Irving, TX)
- …with the patient, including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important Medicare ... to apply for our Case Management Clerical Assistant opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews.… more
- Humana (Austin, TX)
- …Prior experience in provider education + Strong knowledge of medical record review + Understanding of billing, claims submission, and related processes + Proficient ... is higher. **Preferred Qualifications** + Bachelor's Degree + Previous experience in Medicare Advantage or Value-Based Care + AAPC CRC (Certified Risk Adjustment)… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF,… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing… more