- Texas Health Resources (Bedford, TX)
- **Admissions Specialist I** _Bring your passion to Texas Health so we are Better + Together_ **Work Location:** Texas Health HEB, 1600 Hospital Pkwy, Bedford, TX ... elements are completed correctly, particularly the MSPQ, Important Message from Medicare (IMM) and medical necessity checking (ABN and Letter of Non-Coverage).… more
- KPH Healthcare Services, Inc. (Longview, TX)
- **Overview** **Scope of Responsibilities:** The Intake Specialist is an experienced individual who is able to assist and manage the referral intake process. **Job ... plans and any changes that possibly may occur within the Insurance Payor, Medicare , or Medicaid + Responsible for completing all mandatory and regulatory training… more
- Aveanna Healthcare (Dallas, TX)
- Research & Resolution Specialist ApplyRefer a FriendBack Job Details Requisition #: 206745 Location: Dallas, TX 75254 Category: Medical Billing/Collections Salary: ... be prepared to come into the office periodically. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in… more
- 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 Medical, Supplemental, and pharmacy… more
- Molina Healthcare (Dallas, TX)
- …to determine if providers have sanctions/exclusions. * Reviews and processes daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of ... Medicare . * Reviews and processes daily NPDB Continuous Query reports and takes appropriate action when new reports are found. **JOB QUALIFICATIONS** **Required… more
- Highmark Health (Austin, TX)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Cardinal Health (Austin, TX)
- …+ Cell/Gene therapy and/or Oncology experience, preferred + Knowledge of Medicare , Medicaid and Commercially insured payer common practices and policies, preferred ... + Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred + Knowledge of ICD9/ICD10 coding is preferred + Critical and creative thinking, preferred + Important to have a strong attention to detail **TRAINING AND WORK SCHEDULES:**… more
- Molina Healthcare (Fort Worth, TX)
- …Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports. + Generates other ... provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation. + Develops and maintains documentation and guidelines for all… more
- Humana (Austin, TX)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...Board + Leads strategic planning efforts to develop a specialist network within the ACO + Develops a health… more
- ChenMed (Houston, TX)
- …approved (when needed). + Schedules patient (Preferred Providers List of Specialist ) and notifies them of appointment information, including, date, time, location, ... and how patient was notified. + Referrals have been sent to specialist office & confirmed receipt. + Prepares and actively participates during physician/clinician… more