- Baylor Scott & White Health (Dallas, TX)
- …Manages the review of patient account records and resolves third-party payer issues. Monitors charge capture information related to charge triggers, controls, ... and charge edits to validate the accuracy of information and compliance with payer requirements. + Uses editing outputs from EPIC and other revenue cycle systems.… more
- Methodist Health System (Dallas, TX)
- …* Be engaged and eager to build a winning team * Ability to interpret Payer Clinical Policies in reference to practice procedures. * Contacts Payer (s) in a ... timely manner to obtain, monitor, expedite, and track pre-authorization/pre-certification requests for planned services. Monitors changes in Authorization requests daily, to ensure a faster mode of notification retrieval. * Identifies and provides accurate… more
- HCA Healthcare (El Paso, TX)
- …thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes, and possesses a thorough understanding of managed-care ... thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes. You will possess a thorough understanding of managed-care… more
- BrightSpring Health Services (Fort Worth, TX)
- …documentation within established agency guidelines + Ensures compliance with state/local/ payer requirements and that documentation reflects the care provided and ... meets company, regulatory and payer standards + Requisition and management of equipment and supplies required to increase the client's function and independence as… more
- Moore County Hospital District (Dumas, TX)
- …are reviewed and revised to maintain compliance with regulatory and payer Agencies. ESSENTIAL DUTIES AND RESPONSIBILITIES: Demonstrates and monitors competency, ... describe the results or outcomes necessary to meet the standard of acceptable performance and competency according to established policies, procedures, and guidelines for the Departments. Maintains scheduling records & training of staff. EDUCATIONAL/EXPERIENCE… more
- San Antonio Behavioral Health (San Antonio, TX)
- …Word and Excel. + Has knowledge of governmental and managed care payer requirements. + Demonstrates understanding of the various "Self-Pay" account classifications ... and their applicable patient statement processes. + Understands the data elements required to generate a clean bill. + Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards. + Must have the ability to… more
- Highmark Health (Austin, TX)
- …data + 1 year of Project leadership in a complex, matrixed environment ( payer and/or provider preferred) + 1 year of Providing analytical consultation to clinical, ... administrative, operational and financial stakeholders **Preferred** + None **SKILLS** + Demonstrated record of data-driven discovery, intense intellectual curiosity, and a passion for working with data to answer important questions about clinical care and… more
- Evolent (Austin, TX)
- …initiatives, strategies, and developing/managing performance scorecards and action plans ( payer , provider, initiative, etc.). + Ability to travel as needed ... (up to ~40%) **.** **To comply with HIPAA security standards (45 CFR sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant… more
- MD Anderson Cancer Center (Houston, TX)
- …drawer on a daily basis. . Performs validation of the Medicare Secondary Payer Questionnaire (MSPQ). . Ensures coordination of benefits and assignment of Hospital ... Account Record (HAR). . Follows standard operating procedures for institution and center. . Protects the security and confidentiality of patient information at all times. . Marginal Job Functions - Other duties as assigned. SUPERVISION Received: Supervisor,… more
- Option Care Health (Austin, TX)
- …to new state or federal legislation. Resolve reimbursement issues identified by Payer Liaisons that may be related to contract compliance. Strategize with AVP ... MMS on plans to update and grow a sales representative's understanding of the scope and intent of assigned managed care or facility contracts. Attends client meetings where appropriate and in collaboration with assigned managed markets representative.… more