• Medicare Documentation

    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
    Owens & Minor (01/18/25)
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  • Client Audit Specialist , Sr. - Remote

    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
    Prime Therapeutics (01/01/25)
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  • Internal Sales Specialist

    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
    Baylor Scott & White Health (01/09/25)
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  • Client Audit Specialist , Sr. - Remote

    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
    Prime Therapeutics (01/07/25)
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  • Escalation Response Specialist II

    Centene Corporation (Austin, TX)
    …departments to ensure timely and appropriate issue resolution. + Supports the documentation , tracking, and resolution to all assigned complaints and inquiries in ... escalations or resolution experience in healthcare is highly preferred. Knowledge of Medicare rules and guidelines is preferred. Pay Range: $17.50 - $27.50 per… more
    Centene Corporation (02/01/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Austin, TX)
    …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (01/30/25)
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  • Product Owner 2

    Humana (Austin, TX)
    …Owner 2 who is interested in becoming Salesforce Marketing Cloud Email Specialist certified to join the Marketing Regulatory and Operational Communications (MROC) ... Ensure clear and effective communication with existing or concurrent projects **SFMC Email Specialist Certification must be gained within 6 months of hire date.** To… more
    Humana (01/31/25)
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  • Senior Payment Integrity Analyst

    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
    HealthEdge Software Inc (01/15/25)
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