- CVS Health (Austin, TX)
- …responsible for predetermination reviews and reviews of claim determinations. This includes Prior Authorization / Pre Certification / Concurrent Reviews / Peer ... to Peer Calls / First Level Appeals / Special Projects and Committee participation when needed. The Medical Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. In this role you will provide… more
- Molina Healthcare (Austin, TX)
- …Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services access issues. + Articulates ... Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff and others as needed. **Job Qualifications** **REQUIRED EDUCATION:** High School Diploma or GED equivalent **PREFERRED EDUCATION:** Associate's Degree **REQUIRED… more
- Baylor Scott & White Health (Johnson City, TX)
- …approaches** to reduce provider burden: + **RX Workgroup** (handles refill and prior authorization requests) + **RN Case Management** (continuity support for ... patients with chronic conditions) + **AI-powered support tools** to streamline care: + **Augmented Response Technology** (AI-generated responses to patient messages) + **Curation** (AI-generated diagnosis suggestions to support accurate coding) **About the… more
- Strata-G, LLC (San Antonio, TX)
- …investigation by the Federal government may be required to obtain an access authorization prior to employment. Strata-G is an Equal Employment Opportunity (EEO) ... be required to submit evidence of identity and employment authorization . Tests for the absence of any illegal drug...veteran or disabled status. All job descriptions are evaluated for physical/mental standards prior to posting based on AAP… more
- Urology Clinics of North Texas (Mesquite, TX)
- …clearly and accurately into medical billing system + Obtains referral and or authorization prior to scheduled appointment + Advises patient of their ... responsibility prior to scheduled appointments Qualifications Qualifications and Skills + High School Diploma + Medical billing experience, preferably insurance… more
- Chevron Corporation (Houston, TX)
- …given **Required Intern Qualifications** * Geographically mobile * Permanent US Work Authorization Prior interns typically have completed a bachelor's degree in ... and Business Unit roles. Assignments are driven by business needs. ** Prior internship assignments include:** * Business Intelligence & Data Visualization (eg,… more
- Catholic Health Initiatives (The Woodlands, TX)
- …Representative is responsible for verifying patient's insurance information and obtains authorization prior to scheduled visits in accordance with HIPAA ... guidelines, internal standards and procedures, and other regulatory requirements. Responsible for interpreting coverage limitations, patient versus insurance coverage, follows up with payors/patients to secure account and responds to insurance verification… more
- Lamar University (Beaumont, TX)
- …history check, and off-list reference checks. Applicants are required to sign an authorization for release of prior employment records to Lamar University. We ... will only contact prior employers and off-list references for finalists. more
- Lamar University (Beaumont, TX)
- …history check, and off-list reference checks. Applicants are required to sign an authorization for release of prior employment records to Lamar University. We ... will only contact prior employers and off-list references for finalists. more
- Lamar University (Beaumont, TX)
- …history check, and off-list reference checks. Applicants are required to sign an authorization for release of prior employment records to Lamar University. We ... will only contact prior employers and off-list references for finalists. more