- Zelis (Plano, TX)
- …gained, and the personal interests that shape who you are. Position Overview The Sr . Medicaid Reimbursement Regulatory Analyst will collaborate with ... timely fashion. What you'll do: + Research and decipher regulatory sources such as legislative rules, state registers, waiver...a related field + Five+ years of experience in Medicaid billing, reimbursement , claim payment or cost… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Healthcare/Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, maintenance of, and adherence ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
- Molina Healthcare (Fort Worth, TX)
- … reimbursement models in concert with direct management and senior leadership/management. * Communicates new strategies to corporate provider network leadership ... activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider… more
- Texas Health Resources (Arlington, TX)
- …safety-net services through various supplemental payment programs. The VP Government Reimbursement Medicaid Payments has the following duties and ... in negotiations with the fiscal intermediary. + Sets annual Medicare and Medicaid reimbursement rates for budget and extended forecasting. Estimates and… more
- Methodist Health System (Dallas, TX)
- …and state laws relating to healthcare, including but not limited to Medicare/ Medicaid reimbursement , HIPAA, AKS, self-referral prohibitions, and fraud and abuse. ... management, health information management, litigation support related to operations and regulatory matters, medical staff services, marketing, and supply chain. This… more
- Fresenius Medical Center (Plano, TX)
- …philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Under direct supervision, enters payment, ... according to department and company specifications and in compliance with regulatory requirements. Escalates more complex transactions and issues to Team Lead… more
- The Cigna Group (Plano, TX)
- …for Coverage Review and Determinations for Medicare Part B and Part D, Medicaid , Marketplace or Healthcare Reform (HCR) and Commercial. This position will have ... of technical requirements to ensure ongoing compliance, Center for Medicare and Medicaid (CMS) Audit support and end-to-end ownership of Coverage Review letters,… more