- Humana (Austin, TX)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
- Molina Healthcare (Austin, TX)
- …* Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and ... live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development… more
- Humana (Austin, TX)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts + Proficiency in analyzing,… more
- Humana (Austin, TX)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... + 2+ years of network management experience including but not limited to: provider and hospital contracting, network administration in a healthcare company or… more
- Humana (Austin, TX)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the… more
- J&J Family of Companies (Austin, TX)
- …. Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship. . ... to payer approval processes and business acumen. . Understanding of Medicare, Medicaid , and private payer initiatives affecting reimbursement of pharmaceutical… more
- Baylor Scott & White Health (Pflugerville, TX)
- …credentialed and privileged, and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid within the healthcare ... conduct hospital rounds, assist with admissions and discharges, and provide on-call support. **KEY SUCCESS FACTORS** + Knowledge of information and techniques… more
- Option Care Health (Austin, TX)
- …as indicated by location and service line including governmental payers (ie, Medicare, Medicaid ). + Provider NPI will be credentialed in association with the ... Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Baylor Scott & White Health (Austin, TX)
- …The Nurse Practitioner (NP) Primary Care is a licensed, certified healthcare provider . They provide direct patient care and have prescriptive authority. ... They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid . The Advanced...provider as delegated by supervising Physician. + May provide care to patients in a team-based model. Focus… more
- Baylor Scott & White Health (Pflugerville, TX)
- …Summary** The Nurse Practitioner (NP) Urgent Care is a licensed, certified healthcare provider . They provide direct patient care and have prescriptive authority. ... shifts + Duties: Outpatient clinic care only - no hospital rounding or surgical duties + Experience Preferred: Seeking...They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid . The Advanced… more
- Baylor Scott & White Health (Austin, TX)
- …**Job Summary** The PA Surgical Specialty-Operative is a licensed, certified healthcare provider . They provide direct patient care and have prescriptive ... plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 _Note: Benefits...They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid . The Advanced… more
- Baylor Scott & White Health (Round Rock, TX)
- …The Nurse Practitioner Medical Specialty is a licensed, certified, non-physician healthcare provider . They provide direct patient care and have prescriptive ... They are credentialed, privileged, and billed as independent providers by Medicare and Medicaid . The Advanced Practice Provider offers medical care based on the… more
- Baylor Scott & White Health (Round Rock, TX)
- …The Physician Assistant Medical Specialty is a licensed, certified, non-physician healthcare provider . They provide direct patient care and have prescriptive ... They are credentialed, privileged, and billed as independent providers by Medicare and Medicaid . The Advanced Practice Provider offers medical care based on the… more
- Humana (Austin, TX)
- …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more
- Molina Healthcare (Austin, TX)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Humana (Austin, TX)
- …ensure medical documentation and coding are precise, compliant, and support optimal reimbursement . This is an exciting opportunity to apply your advanced technical ... Applies clinical and coding experience to conduct reviews of provider codes and billing. + Decisions are typically related...or more years of clinical RN experience in a hospital setting. + 3 or more years of experience… more
- Centene Corporation (Austin, TX)
- …on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, ... and personal assistance/social services, and providing patient advocacy and education to Medicaid members * Experience in FIELD-BASED Social Worker or Case Managers… more
- HCA Healthcare (Georgetown, TX)
- …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... Center (HSC) staff, and shared service center departments. You will also provide support to coding leadership by coordinating coding and education activities within… more