- Owens & Minor (Austin, TX)
- …**POSITION SUMMARY:** This representative will be required to request Medical documentation and assure received documentation meets insurance payer guidelines. ... including: + Prepayment audits/development letters + Post payment requests for documentation + Overpayment refund requests + Medical necessity documentation … more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Senior Transplant Recovery Specialist position facilitates and coordinates organ procurement services required for transplantation and ... In addition to performing the duties and responsibilities of a Transplant Recovery Specialist , this position serves as a mentor and resources for team members.… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** Client Audit Specialist , Sr. - Remote **Job Description** The Client Audit Specialist Sr is ... regulatory, client, and/or functional audit expectations. The Client Audit Specialist Sr provides consultation and strategic advice regarding audit management… more
- Texas A&M University System (Dallas, TX)
- Job Title Clinical Coding Specialist I Agency Texas A&M University Health Science Center Department Oral Surgery Proposed Minimum Salary $22.00 hourly Job Location ... What we want The College of Dentistry is looking for a Clinical Coding Specialist I to serve in the Comprehensive Dentistry department. We desire an individual who… more
- Apex Health Solutions (Houston, TX)
- Summary: The Commercial Health Plan Enrollment Specialist is responsible for maintenance of eligibility data, resolving all issues or requests regarding eligibility, ... management, enrollees, other departments, etc., and ensures that requisite documentation is maintained within the document management system. Addresses broker,… more
- Baylor Scott & White Health (Austin, TX)
- **JOB SUMMARY** The Internal Sales Specialist obtains new enrollments and facilitates community outreach in the assigned service area. **ESSENTIAL FUNCTIONS OF THE ... ROLE** Coordinates and conducts sales activities for Individual and Medicare Advantage plans to enroll prospective members into the health plan to increase… more
- The Arora Group (Fort Sam Houston, TX)
- Medical Billing Specialist Admin Currently recruiting a Medical Billing Sepcialist to provide Financial Labor Services in support of the Resource Management Division ... thirty minute or one-hour (non-compensable) lunch break. DUTIES OF THE MEDICAL BILLING SPECIALIST : + Monitors insurance claims and patient accounts in work queues to… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** Client Audit Specialist , Sr. - Remote **Job Description** As a member of the Client Audit ... Management (CAM) team, the Client Audit Specialist , Sr is accountable for managing regulatory and/or client-initiated audits. This role maintains a thorough… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Senior Insurance Authorization Specialist position is responsible for obtaining and managing insurance authorizations for medical services, ... stakeholders. + Collaborate with healthcare providers to gather necessary documentation for insurance authorization requests. + Responds promptly to requests… more
- Apex Health Solutions (Houston, TX)
- …workflows related to the premium billings of both commercial groups and Medicare Advantage members. Develops and maintains an understanding of premium billing ... and other information to ensure timely communication with accounts. Maintains documentation on all fact finding and resolution efforts resulting from premium… more
- CenterWell (Dallas, TX)
- …+ Oversee daily operations of physician services. + Build strong relationship with specialist , hospitalist, SNF and other providers to form a narrow network of ... consumer experiences . **Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of three to… more
- ChenMed (Houston, TX)
- …approved (when needed). + Schedules patient (Preferred Providers List of Specialist ) and notifies them of appointment information, including, date, time, location, ... IVR for authorization processing). + Completes orders with proper documentation on where patient is scheduled and how patient...patient was notified. + Referrals have been sent to specialist office & confirmed receipt. + Prepares and actively… more
- Stantec (Plano, TX)
- …functions related to health and welfare benefits, including plan documentation , reporting, and non-discrimination testing. The Consultant will collaborate with ... including the San Francisco Health Care Ordinance, including reporting and documentation requirements. + Draft, review, and maintain Business Associate Agreements… more
- CVS Health (Austin, TX)
- …health care more personal, convenient and affordable. **Position Summary** The Health Survey Specialist plays a critical role within the DSNP team. The Health Survey ... Specialist outreaches DSNP members via phone to introduce the...work schedule to meet business needs **Preferred Qualifications** - Medicare /Medicaid/DSNP experience - Strong organizational skills, including effective verbal… more
- Baylor Scott & White Health (Dallas, TX)
- …Joint Commission for Accreditation of Healthcare Organizations (JCAHO) and Center for Medicare and Medicaid Services (CMS) and other regulatory agencies as they ... current and policies and procedures have been followed to obtain required documentation and verification during 90 day probationary period. Performs monthly random… more
- HealthEdge Software Inc (Austin, TX)
- **Overview** **Position Overview:** We are seeking a Senior Payment Integrity Specialist to play a key role in building and implementing proprietary healthcare edits ... payment integrity, and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration… more
- UTMB Health (Galveston, TX)
- …care provider. + Under supervision, completes accurate, concise, and legible documentation on patient clinic record. + Assist with medication reconciliation as ... distributed and authorized deferments, + Registration including eligibility, demographics and Medicare and third party coverage, communicates any obstacle to access… more
- Texas Health Resources (Fort Worth, TX)
- …all aspects of each treatment session in accordance with departmental, TJC, Medicare , and other applicable regulatory guidelines + Completes all documentation ... Program + Advanced Total Knee Program Staff Certifications: + Sports Clinical Specialist (ABPTS) + Vestibular Rehab Certified Therapist + Pelvic Floor Certified… more
- HCA Healthcare (Austin, TX)
- …and understand the medical staff bylaws, Joint Commission, and Centers for Medicare and Medicaid Services (CMS) standards, and monitor the latest regulatory ... and procedures related to the functions of the department. + You will manage documentation systems for medical staff files. + You will maintain and distribute the… more
- University of Texas Rio Grande Valley (Rio Grande, TX)
- …and benefits through various payers, including commercial insurances, Medicaid, and Medicare . + Obtains the necessary prior authorizations, referrals, and other ... insurance documentation needed for all visits as required by the...Education Bi-lingual (English/Spanish) Licenses/Certifications Preferred: Completion of Medical Office Specialist certificate program or Medical Administrative Assistant or closely… more