- Baylor Scott & White Health (Temple, TX)
- …on member issues, as needed. **KEY SUCCESS FACTORS** + Sales and regulatory experience in Medicare Advantage, Marketplace, and Commercial insurance. + ... **JOB SUMMARY** The Sales Training Specialist is responsible for developing and implementing an...Texas Department of Insurance (TDI) and the Center for Medicare and Medicaid Services (CMS) regulations; maintains training log… more
- Aveanna (Houston, TX)
- …Category: Compliance Salary: $90,000 per year Position Details Position Overview The Regulatory Compliance and Coverage Specialist will report to the ... Regulatory Compliance and Quality Review. The Regulatory Compliance and Coverage Specialist ...RN + Thorough knowledge of the home care industry, Medicare and Medicaid coverage requirements, clinical and operations practices,… more
- Molina Healthcare (Hidalgo, TX)
- …and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality ... of these quality improvement functions: Quality Interventions and Quality Improvement Compliance . **We are seeking behavioral health and nursing experience for this… more
- Houston Methodist (Sugar Land, TX)
- …among departments and disciplines to achieve and sustain ongoing accreditation and regulatory compliance . + In partnership with hospital leadership, establishes ... of regulatory , accreditation and certification to assess vulnerabilities to compliance with standards. + Collaborates with hospital leadership to assign teams to… more
- EssilorLuxottica (Austin, TX)
- …and within the credentialing database, and other duties required to maintain compliance with regulatory and accreditation requirements. **MAJOR DUTIES AND ... VisionWeb - Credentialing Specialist Date: Jul 9, 2024 Brand: Essilor and...and additional privilege request applications for completeness, accuracy, and compliance with federal, state, local, and Vision Web regulations,… more
- Houston Methodist (Houston, TX)
- …Services (CMS), OPTN, Health Insurance Portability and Accountability Act (HIPAA) regulatory compliance throughout the recovery and transplant event processes. ... At Houston Methodist, the Transplant Recovery Specialist position is responsible for supporting the organ...to meeting department and organ program targets for quality, compliance , and safety. **FINANCE ESSENTIAL FUNCTIONS** + Maintains and… more
- Elara Caring (Dallas, TX)
- …at the Right Time, in the Right Place. **Job Description:** **Patient Care Orders Specialist ** At Elara Caring, we care where you are and believe the best place ... to make a difference as the Patient Care Orders Specialist . Being a part of something this great, starts...resources. + Maintains current knowledge of, and effects of compliance with all federal, state, and local regulations. +… more
- Highmark Health (Austin, TX)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... responsible for the timely coordination and completion of regulatory and/or revenue-enhancing special projects as identified by the Revenue Cycle Managers. In… more
- Texas Health Resources (Denton, TX)
- …rendered. . **Educates patients and/or families** about applicable legal, ethical, and compliance documents; ensures regulatory consents are signed by the ... Admissions Specialist I _We're looking for qualified_ **_Admissions ...are completed correctly, particularly the MSPQ, Important Message from Medicare (IMM) and medical necessity checking (ABN and Letter… more
- Gentiva (Dallas, TX)
- …guidelines. + Knowledge of hospice operations, state and federal regulations and compliance + Strong regulatory affairs and governance requirements for ... day. **Overview** We are looking for an **Executive Director Specialist RN** . You will serve as the administrator...maintain standards of high quality and customer service in compliance with federal and state regulations and guidelines. +… more
- Sumitomo Pharma (San Antonio, TX)
- …employee encounters is considered confidential. ** Compliance ** :Achieve and maintain Compliance with all applicable regulatory , legal and operational rules ... motivated, and experienced individual for the position of **MSPEC** Portfolio Specialist . The successful candidate will be responsible for compliantly driving… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …modifiers and procedure codes for physician/provider services consistent with coding compliance policies, ICD-10-CM Official Coding Guidelines and regulatory ... **37316BR** **Extended Job Title:** Coding Specialist (Medical Coding/Alberta) **Org Level 1:** Texas Tech...and/or academic health sciences/medical center + Strong overview of Medicare and Medicaid billing compliance + Completion… more
- Texas Health Resources (Fort Worth, TX)
- …rendered. . **Educates patients and/or families** about applicable legal, ethical, and compliance documents; ensures regulatory consents are signed by the ... Admissions Specialist I _We're looking for qualified_ **_Admissions Specialist_**...are completed correctly, particularly the MSPQ, Important Message from Medicare (IMM) and medical necessity checking (ABN and Letter… more
- Texas Health Resources (Bedford, TX)
- …rendered. . **Educates patients and/or families** about applicable legal, ethical, and compliance documents; ensures regulatory consents are signed by the ... **Admissions Specialist I** _We're looking for qualified_ **_Admissions Specialist_**...are completed correctly, particularly the MSPQ, Important Message from Medicare (IMM) and medical necessity checking (ABN and Letter… more
- Banner Health (TX)
- …knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG), and Ambulatory Payment Classification (APC) or ... coding is accurate for proper reimbursement and that coding compliance is complete. Monitors coding work and trends, then...assessments. 6. Maintains a current knowledge in all coding regulatory updates, and in all software used for coding… more
- Conviva (Corpus Christi, TX)
- …departmental and physician budgets. + Assess, develop, and recommend strategies for compliance with regulatory requirements. + Develop and maintain an effective ... + 99% Leadership, 1% limited/occasional coverage + Build strong relationship with specialist , hospitalist, SNF and other providers to form a narrow network of… more
- The Cigna Group (Houston, TX)
- **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment & Stars program for assigned populations in an operational ... subject matter expertise to assigned providers and internal matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It… more
- Texas Health Resources (Fort Worth, TX)
- …recognized evidence based practice standards Actively incorporate measures to obtain compliance with regulatory and accreditation standards and requirements ... Services Management Upon Hire Required **Skills** Knowledge of industry standards TJC, Medicare , OSHA. Regulatory standards for affected area of responsibility.… more