- CVS Health (Dallas, TX)
- …with managed care and/or value-based practice and familiarity with payer -provider collaboration. Experience using a metrics-driven approach to analyze cost, ... quality, and satisfaction data to drive clinical strategy and program redesign. Excited by developing and implementing new processes. Self aware and confident in their leadership skills and eager to share those with a fast growing, passionate team on the… more
- Houston Methodist (Houston, TX)
- …a fast-paced environment, to review clinical documentation for Medical Necessity and payer requirements, and have a high level and knowledge of medical terminology, ... CPT, International Classification of Diseases ICD-10 preferred. Knowledge of Medicare, Medicaid, and managed care reimbursement methodologies + Ability to work under pressure and balance many competing priorities + Adapts to multiple ongoing priorities with… more
- Evolent (Austin, TX)
- …5 years of professional experience in claims-based healthcare analytics with a payer , provider, vendor, managed care, or related healthcare consulting entity . ... Extensive knowledge of healthcare claims; specifically, differences between institutional vs professional billing and various sites of care/service . Previous Experience with healthcare reimbursement methodologies and calculations such as Fee for Service,… more
- Select Medical (Denton, TX)
- …Planning + Care Planning Management + Fiscal Management + Payer /Referral Management **Qualifications** **Minimum Qualifications** + Current Licensure per state ... guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline. **Preferred Qualifications** + Previous experience in Case Management and Discharge Planning preferred. + CCM Certification Preferred.… more
- Select Medical (Kingwood, TX)
- …business development team + Collect co-pays from patients, manage payer approvals and conduct insurance authorizations and verifications **Qualifications** **Minimum ... Qualifications:** + High School Diploma/GED required **Preferred Qualifications:** + 1 Year of Medical Office Experience + Bilingual **Additional Data** _Go Anywhere with Us! 1900 centers in 39 states offering internal movement._ _Equal Opportunity… more
- R1 RCM (Paris, TX)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- TEKsystems (Houston, TX)
- …carriers to management + Contact patients when documentation does not meet payer guidelines Qualifications + Strong attention to detail and problem-solving skills + ... Ability to navigate multiple systems efficiently + Excellent communication skills + Previous customer service experience preferred Why Join Us? + Remote work flexibility + Opportunity to make a meaningful impact in patient care + Supportive team environment… more
- Lilly (Houston, TX)
- …grow and own business outcomes. + Navigates the ever-changing healthcare environment and payer landscape to increase understanding of accounts and be able to impact ... key stakeholders to become trusted partners. + Utilizes appropriate business insight tools, data, and analytics to identify trends, priorities, opportunities, and potential obstacles. + Implements and adopts new technologies, including the integration of AI… more
- R1 RCM (Cedar Park, TX)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- MD Anderson Cancer Center (Houston, TX)
- …One Connect cash drawer daily * Perform validation of the Medicare Secondary Payer Questionnaire (MSPQ) * Ensure coordination of benefits and assignment of Hospital ... Account Record (HAR) * Follow standard operating procedures for institution and center * Protect the security and confidentiality of patient information at all times * Other duties as assigned Education Required: High school diploma or equivalent. Education… more