- 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
- ConvaTec (Spring, TX)
- …phone calls from clients regarding orders & customer service issues + Request Medicare documentation on Medicare clients + Contacts HH agencies to coordinate ... + Must have a high school diploma, college degree preferred , not required. + Six months to one year...with professionals in clinics and hospitals + Sales experience preferred + Ability to reason, problem solve, and think… more
- Molina Healthcare (Houston, 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...systems. * Experience with professional written and verbal communication. ** Preferred Experience:** Experience in the health care industry To… more
- TEKsystems (Dallas, TX)
- …and submit enrollment and re-enrollment applications for healthcare providers to Medicare , Medicaid, and commercial insurance plans. Maintain accurate and up-to-date ... associate or bachelor's degree in healthcare administration or related field preferred . 2-4 years of experience in provider enrollment, credentialing, or healthcare… more
- Molina Healthcare (Houston, TX)
- …facility members in custodial beds to return to the community. * Initiates referrals for Medicare and waiver process if member is not already Medicare or waiver ... suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications * Certified Medical Assistant (CMA). * Long-term care… more
- Molina Healthcare (Houston, TX)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and ... communication skills. * Microsoft Office suite/applicable software program(s) proficiency. ** Preferred Qualifications** * Customer/provider experience in a managed care… 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 ... codes, etc. + Access and Excel - intermediate skill level (or higher) ** Preferred Education** Bachelor's Degree ** Preferred Experience** + 5+ years managed care… more
- Molina Healthcare (San Antonio, TX)
- …tools such as Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources ... * Microsoft Office suite and applicable software programs proficiency. ** Preferred Qualifications** * Claims recovery experience. * Health insurance experience… more
- Novo Nordisk (Houston, TX)
- …impact + Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... experience working in one or more of the following areas preferred : Pharmaceutical/Healthcare, Sales, Consulting, Customer Service or Military + Intermediate… more
- Health Care Service Corporation (Mcallen, TX)
- …+ Ability to travel 20% - 30% of the time in and out of state ** PREFERRED JOB REQUIREMENTS:** + Associate or Bachelor's degree + CRC + Experience in health insurance ... + Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail Exchange business + Prior experiences teaching/training others… more