- Houston Methodist (Houston, TX)
- …language principles + Knowledge of community resources and health care financial and payer issues, and eligibility for state, local and federal programs + Maintains ... individual competencies around critical Social Work functions including; payor rules and regulations, psycho-social assessments and discharge planning methods + Ability to work independently and exercise sound judgment in interactions with physicians, payors,… more
- Select Medical (Houston, 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 Medical Office Experience + 1 Year of Front Desk Experience **Preferred Qualifications:** + Insurance Verification Experience **Additional Data** _Equal Opportunity Employer/including… more
- Houston Methodist (Houston, TX)
- …the appropriate system(s) timely and accurately. **FINANCE ESSENTIAL FUNCTIONS** + Notifies the payer of the patient's admission or procedure in a timely manner, to ... ensure third party reimbursement. + Evaluates patient liability and generates estimates as needed for patient financial responsibility communication. + Organizes time effectively, minimizing incidental overtime, and sets priorities. Utilizes time between heavy… more
- Cognizant (Austin, TX)
- …the timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client for ... issues related to claims adjudication and adjustments, Service Now and Inquiry resolution, and any basic questions regarding health coverage as stated in the Plan Document. **Role Responsibilities** + Responsible for reviewing the data in the claim processing… more
- HCA Healthcare (Webster, TX)
- …as an educational resource to patients, families, interdisciplinary team members, payer representatives, and other parties as appropriate about behavioral services. ... + Reviews, coaches, and helps with the training of new staff/interns as assigned within approved practice and program guidelines. Participates in developing department goals and clinical programming. + Performs utilization review as assigned. + Helps with… more
- Cognizant (Austin, TX)
- …for timely and accurate adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support to claims and client for ... issues related to claims adjudication and adjustments. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and other teams. **In this role, you will:** * Be Responsible for reviewing the data in the claim processing… more
- HCA Healthcare (Round Rock, 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
- IQVIA (Austin, TX)
- …with header bidding technology and integrations * Healthcare industry knowledge across payer , provider, pharma IQVIA is a leading global provider of clinical ... research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient… more
- Intermountain Health (Austin, TX)
- …1. Maintains a working knowledge of CVO and MSO functions, Payer Enrollment, Roster Management, Kyruus, Attestations, Credentialed and Non-Credentialed providers, ... Provider access to Intermountain Information Systems, Radiant Logic, and Providers data in iCentra and EPIC. 2. Demonstrates understanding of the operation and maintenance of Intermountain Healthcare's Verity Credentialing Data System and other sophisticated… more
- HCA Healthcare (Fort Worth, TX)
- …the established chain of command + Makes appropriate referrals to third party payer , disease and case management programs for recurring patients and patients with ... chronic disease states + Facilitates patient throughput with an ongoing focus on an effective care transition, quality and efficiency + Documents professional recommendations, discharge plan, care coordination interventions, and case management activities to… more