- CVS Health (Austin, TX)
- …DME, and helps to ensure timely physician follow-up. - Understands Payer /Plan benefits, policies, procedures, and can articulate them effectively to providers, ... members, and other key personnel. Our TOC Coaches are frontline advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management and eligibility status. Focus assessments… more
- HCA Healthcare (San Antonio, TX)
- …thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes. You will possess a thorough understanding of managed-care ... concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or psychosocial needs. + You… more
- Cardinal Health (Austin, TX)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification, and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas,… more
- Select Medical (Pearland, 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 + 1 Year of Front Desk Experience + 1 Year of Scheduling Experience **Preferred Qualifications:** + Bilingual + Health Care Experience **Additional Data** _Equal Opportunity Employer/including… more
- CVS Health (Richardson, TX)
- …Environment team, focusing on Non-Production Support: + Claims system: Health Rules Payer (HRP) + Enrollment systems: Market Prominence (MP) & Softheon The position ... requires collaboration with business, QA, release delivery, infrastructure, and vendor partners, driving system stability and maintaining code releases. Key Responsibilities + Monitor system upgrades. + Analyze defect reports across the Non-Production… more
- Elevance Health (Houston, TX)
- …knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology ... preferred. + Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred For candidates working in person or virtually in the below location(s), the salary* range for this specific… more
- Intermountain Health (Austin, TX)
- …aligned with procedure performed, and charges/coding are consistent with Federal, State, and payer guidelines. 9. Acts as a subject matter resource to team and ... escalates to leadership as needed. Supports SCL and future acute care sites with Epic, downstream system, upgrades and new functionality. 10. Promotes mission, vision, and values of SCL Health, and abides by service behavior standards. 11. Performs other… more
- Datavant (Austin, TX)
- …and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, and coding workflow operations reviews. In this ... role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare… more
- Cardinal Health (Austin, TX)
- …need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient ... markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas,… more
- Teva Pharmaceuticals (San Antonio, TX)
- …and coach others on regional business focus areas, including settings of care, payer and pull through opportunities, and flawless execution of the marketing strategy ... + Develop effective business plans to meet and exceed regional sales goals . Coach/train others on different settings of care to identify key business opportunities + Demonstrate a collaborative sales approach and coordinate efforts between sales leadership,… more