- TEKsystems (Addison, TX)
- …to present a strong case for claim reconsideration. - Stay up-to-date with payer policies, regulations, and industry trends related to claim appeals and arbitration. ... insurance denials, appeals, and arbitration processes, including knowledge of payer -specific appeal requirements and guidelines. - Strong understanding of medical… more
- Fresenius Medical Center (Plano, TX)
- …+ Regularly conducts client meetings to review accounts receivable performance, payer issues and KPI trends, client's business strategies, and cash flow ... of all Client Management deliverables (including A/R measurement statistics and payer trends, fee schedules, ad hoc financial reports) ensuring their relevancy,… more
- Cognizant (Austin, TX)
- …with 20 to 24 years of expertise in Program Management, particularly in Healthcare Payer industry. The ideal candidate will manage and deliver complex projects in a ... impact on society. **Required Skills and Qualifications:** . US Healthcare Payer Delivery experience and domain expertise (20+ years). . Significant experience… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …and documentation compliance + Ensure compliance with federal, state, and payer -specific regulations, including CMS guidelines + Identify and address coding ... + Stay current with changes in coding guidelines, healthcare regulations, and payer policies + Assist in developing and refining audit tools, policies, and… more
- Baylor Scott & White Health (Dallas, TX)
- …or unscheduled service during the patient?s hosptial stay. Interprets complex payer coverage information including, but not limited to, network participation status ... production, accuracy, completeness and quality. Ability to understand and adhere to payer guidelines by plan and service type. Requires good listening, interpersonal… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …prior to service. + Submit pre-authorization requests and follow up with payer to ensure timely approvals. + Update resident providers and supervising faculty ... basic medical terminology. + Knowledge of CPT and ICD-10 coding. Familiarity with payer authorization processes. + Ability to apply a strong attention to detail to… more
- Guidehouse (Lewisville, TX)
- …ability to effectively review remittance advices and electronic billing reports from payer to determine the action required. This position performs all related job ... assigned. **Duties and Responsibilities** + Contacts third party payers and guarantors via payer websites or by phone to resolve account balances on all assigned… more
- BrightSpring Health Services (San Antonio, TX)
- …clinical outcome tools based on diagnosis.. Monitors patient, family, physician and payer /case manager, referral source satisfaction with the program on a regular ... and family members.. Communicates regularly with patient, family/ care partner, payer /case manager and physician regarding patient progress and any important issues… more
- HCA Healthcare (San Antonio, TX)
- …Inform Administration of any significant issues in the Billing area (eg, backlogs, payer issues, vendor issues, etc). + Stay abreast of regulatory requirements and ... policies, ensuring timely staff education. + Inform Billing staff regarding payer requirements, significant changes and developments. Develop and monitor charge… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …RWE, and other evidence generation initiatives to support regulatory, HTA, and payer submissions, and demonstrate the differentiated value of our products + Utilize ... associations etc. + Deep understanding of global HTA and payer requirements, regulatory frameworks, and healthcare systems. + Deep understanding… more
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