- Providence (TX)
- …the PSJH System Revenue Integrity Chargemaster (RICDM) Dept. team, the Senior CDM Specialist shall ensure that the Chargemaster (CDM) is consistent with all coding ... and billing regulations and accurately represents services provided. The Senior CDM Specialist acts as the liaison between the Hospital ministry and the PSJH System… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality focused interventions and programs… 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 ... to validate overpayments made to providers. * Completes basic validation prior to offset to include, eligibility, coordination of benefits (COB), standard of care (SOC) and diagnosis-related group (DRG) requests. * Enters and updates recovery applications and… more
- Datavant (Austin, TX)
- …to realize our bold vision for healthcare. As an **Inpatient Auditing Specialist ** you will be instrumental in addressing consulting and educational needs related ... presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help...workspace! **Preferred: In need for a FT IP auditing specialist . Auditing specialist will be responsible for… more
- MD Anderson Cancer Center (TX)
- …of the PBS Billing Specialist position is to bill and follow-up on Medicare claims within regulatory guidelines. The PBS Billing Specialist must ensure that ... and employees throughout the revenue cycle. *SUMMARY* The PBS Billing Specialist provides professional expertise in daily governmental billing and follow-up… more
- Elara Caring (Dallas, TX)
- …at the Right Time, in the Right Place. **Job Description:** **Engage Clinical Care Specialist ** The Engage Clinical Care Specialist is part of the ElaraConnect ... programs that aims to improve patient outcomes on-service. The Engage Clinical Care Specialist supports the PCS Engage and PCS Branches, acting as a liaison for… more
- Elara Caring (Dallas, TX)
- …at the Right Time, in the Right Place. **Job Description:** Member Engagement Specialist **Monday-Friday, 8am-5pm** ** Remote Opportunity** BSW or CCHW required + ... day, right where they live. As a **Member Engagement Specialist ** , you'll play a key role in leading...on client needs. + Stay current on industry trends, Medicare /Medicaid regulations, and company service offerings. + Maintain compliance… more
- Highmark Health (Austin, TX)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- Aveanna Healthcare (Dallas, TX)
- TPL Specialist ApplyRefer a FriendBack Job Details Requisition #: 209482 Location: Dallas, TX 75254 Category: Medical Billing/Collections Salary: $20.00 per hour ... Position Details This is a temporary remote position set to end 2/28/2026. Join a Company...Requirements Position Overview The primary responsibility of the TPL Specialist is to assist with quality assurance and accuracy… more
- Aveanna Healthcare (Dallas, TX)
- Research & Resolution Specialist ApplyRefer a FriendBack Job Details Requisition #: 209772 Location: Dallas, TX 75254 Category: Medical Billing/Collections Salary: ... may change at any time with or without notice. Remote and hybrid work is limited to the United...a signed agreement with Aveanna. As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
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