- Baylor Scott & White Health (Waco, TX)
- …on all required forms Consistently completes the Medicare Secondary Payer (MSP) questionnaire, if applicable. Verifies insurance to determine coordination ... service experience Ability to determine patients' primary, secondary, and tertiary payer sources. Knowledge of all major governmental and non-governmental payer… more
- Devereux Advanced Behavioral Health (League City, TX)
- …executing comprehensive marketing strategies to increase program visibility, build payer and referral agency relationships, and drive referrals. Additionally, the ... the admissions and utilization management team in managing inquiries, referrals, and payer processes. * Ensure a smooth and client-centered admissions experience for… more
- Community Health Systems (Corsicana, TX)
- …Submits and processes claims accurately and efficiently, ensuring compliance with payer requirements and company policies. + Communicates with insurance companies, ... corrective actions. + Reviews and corrects claim filing edits based on payer requirements and electronic health record (EHR) system alerts. + Maintains accurate… more
- Cognizant (Austin, TX)
- …Oracle Golden Gate and Oracle. This role requires domain experience in Membership (HC- Payer ) and proficiency in English. The position offers a hybrid work model with ... + Ensure compliance with industry standards and best practices in Membership (HC- Payer ) domain. + Troubleshoot and resolve technical issues to minimize downtime and… more
- Norstella (Austin, TX)
- …etc.) across multiple brands and Market Access functions (Insights & Analytics, Payer Marketing, Field Teams, Contracting/Rebating, etc.). CSMs are the face of MMIT ... Access domain expertise (deep understanding of current and future payer trends; intimate knowledge of Payer , PBM,...and future payer trends; intimate knowledge of Payer , PBM, and IDN organization structures and offerings; understands… more
- UTMB Health (Galveston, TX)
- …and understanding of all state and federal laws, rules, and regulations regarding payer billing guidelines + Demonstrates a basic understanding of CPT, ICD-9, HCPCS, ... payers and/or clients for hospital and/or Professional Patient Accounts + Resolves Payer rejections from billing system daily to bill submit hospital and/or… more
- Caris Life Sciences (Irving, TX)
- …requests, and apply acquired knowledge of Medicare, Medicaid, and other Third-Party Payer requirements **Job Responsibilities** + Adheres to all company policies and ... eligibility to ensure claims are billed accurately and in accordance to payer guidelines. + Ensures timely and accurate insurance authorizations are in place… more
- Baylor Scott & White Health (Temple, TX)
- …subqueries, performance tuning + Basic to intermediate PL/SQL + **HealthEdge HealthRules Payer ** + Hands-on experience with HealthRules Payer (HRP) + Knowledge ... of claims processing, benefit configuration, and payer workflows + **Troubleshooting & Support** + Strong analytical and problem-solving skills + Experience… more
- Cardinal Health (Austin, TX)
- …collections + Ensure all oncology-related claims are submitted accurately and within payer timelines to prevent denials and delays + Support change management with ... implement strategies to safeguard reimbursement, including proactive AR management and payer follow-up + Collaborate with operations, clinical, and financial teams… more
- Cardinal Health (Austin, TX)
- …to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage the daily ... of escalation for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends… more
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