- Option Care Health (Dallas, TX)
- …**Travel Requirements** Not Applicable **Preferred Qualifications & Interests** Healthcare/medical billing experience preferred. May perform other duties as assigned ... Due to state pay transparency laws, the full range for the position is below: Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data. Pay Range is… more
- Molina Healthcare (TX)
- …standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/ billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts ... and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. * Understanding of… more
- Option Care Health (Austin, TX)
- …expected to lead the collaboration with Revenue Cycle Management to ensure billing requirements are contracted appropriately and timely resolutions are achieved with ... outstanding Accounts Receivable. This role has direct supervisory experience for Contract Managers. **Job Description:** **Job Responsibilities** + Leads the Contracting Process and acts as Lead Negotiator for all Targeted Accounts within the defined area.… more
- Molina Healthcare (Fort Worth, TX)
- …and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. + Manages a ... caseload of claims. Procures all medical records and statements that support the claim. + Makes recommendations for further investigation or resolution. + Reduces defects via pro-active identification of error issues as it relates to pre-payment of claims… more
- Molina Healthcare (Austin, TX)
- …standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/ billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts ... and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. * Understanding of… more
- Option Care Health (Austin, TX)
- …insure health plan agreements are current in order to facilitate clean claim billing . Initiate and lead meetings with health plans and corporate teams, including ... Managed Markets and Contracting leadership, to review provider agreement performance data and scorecards. Informs contracting leadership of contract risks for assigned third party contracts. Recommends course of action to reduce/minimize risk to the… more
- Teleperformance USA (TX)
- …first level representatives on high level issues.** + **Assist policy holders with billing questions and concerns** + **Provide support to policy holders with any ... policy changes requested** **Support policy holders needs by providing recommendations and adjusting as necessary** **We're looking for** **fearless people - people who are inspired to deliver only the best in all that we do.** **Qualifications:** + **High… more
- The Cigna Group (Austin, TX)
- …+ Enrollment solutions: Internal capabilities and external options + Administrative solutions: Billing and claim processes The NSD role is responsible for proactive ... and consultative outreach designed to increase the institutional knowledge of Cigna Supplemental Health Solutions in the large case segment. The NSD partners with internal colleagues in distribution, marketing, product, compliance, underwriting, and other… more
- Molina Healthcare (Fort Worth, TX)
- …chart reviews and abstracts diagnosis codes + Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are ... submitted accordingly + Documents results/findings from chart reviews and provides feedback to management, providers, and office staff + Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as… more
- Sharecare (Austin, TX)
- …accounts for an assigned portfolio. + Provide resolution of issues related to billing inquiries, disputes. + Identify, research, and resolve collection issues in a ... timely manner. + Provide assistance with unidentified payment applications. + Meet company deadlines for month end close responsibilities. + Assist with updating and improving documentation of policies and procedures related to assigned responsibilities.… more
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