- 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 Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Guidehouse (Lewisville, TX)
- …None **What You Will Do** **:** The **Insurance Patient Account Representative** **( Hospital Claims)** is an extension of a client's business office staff. ... from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/ Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS… more
- Humana (Austin, TX)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... years of experience in negotiating managed care contracts with physician specialty, hospital and/or other provider contracts. + Proficiency in analyzing,… more
- Molina Healthcare (Austin, TX)
- …* Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. * ... contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, ie physician, group and hospital contracting,… more
- Molina Healthcare (Dallas, TX)
- …when providers have issues or complaints (eg claims and encounter data, eligibility, reimbursement , and provider website). * Serves as a resource to support ... government-sponsored health plans. * Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare… more
- Humana (Austin, TX)
- … Contracting serves as a strategic leader overseeing contracting activities for physician, hospital , and other provider agreements within two of the largest ... Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms.… more
- Baylor Scott & White Health (Dallas, TX)
- …payer requirements, applications and workflows + Familiarity with PECOS and State Medicaid Provider Enrollment and Management Systems preferred + Experience ... **Job Summary** The Director, Provider Enrollment, is responsible for the strategic planning,...Ensures CMS attestations and applications are filed timely for hospital -based department designations + Oversees the build and maintenance… more
- Baylor Scott & White Health (Rowlett, TX)
- …credentialed and privileged, and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid within the healthcare ... of the provider ) as delegated by supervising Physician. May conduct hospital rounds, assist with admissions and discharges, and provide on-call support.… more
- Texas Health Resources (Arlington, TX)
- …the Medicaid ,DSH,UC and S-10 audits. Assist in financial audits. 20% Provide financial consulting and representation on Medicare/ Medicaid issues to assigned ... office personnel and required. Filing of CHAMPUS medical education and capital reimbursement forms. Medicaid enrollments and re-enrollments. Annual wage index… more
- Abbott (Austin, TX)
- …policies (Medicare, Medicare Advantage, Medicaid and Private Payer) to provide coverage and reimbursement guidance for Investigational Device Exemption ... processes and other related matters requiring a specialized knowledge of Medicare, Medicaid and Private Payer reimbursement procedures and requirements. + Heavy… more
- Houston Methodist (Katy, TX)
- …the workplace + Ability to serve as a subject matter expert in assigned area to provide support for staff + Knowledge of full revenue cycle + Proven track record of ... Prospective Payment Systems, etc. + Stays informed of the latest Medicare, Medicaid and commercial payor news, updates, and regulations and adjusts processes and… more
- Community Hospital Corporation (Greenville, TX)
- …contract performance of managed care contracts. + Administration of all Medicare & Medicaid Reimbursement issues, including the completion and review of the ... capital planning, revenue cycle management, and financial compliance. The CFO will provide executive-level guidance to support the hospital 's strategic goals,… more
- Molina Healthcare (Austin, TX)
- …subject matter expert on developing financial models to evaluate the impact of provider reimbursement changes * Provides data driven analytics to finance, ... (UB04/1500 form). * Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS… more
- Baylor Scott & White Health (Temple, TX)
- …credentialed and privileged, and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid within the healthcare ... of the provider ) as delegated by supervising Physician. May conduct hospital rounds, assist with admissions and discharges, and provide on-call support.… more
- HCA Healthcare (Webster, TX)
- …department managers in preparation of their budgets. 9. Prepares workpapers to assist Reimbursement staff in filing annual Medicare/ Medicaid Cost Reports. 10. ... spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal… more
- Baylor Scott & White Health (Temple, TX)
- …credentialed and privileged, and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid within the healthcare ... of the provider ) as delegated by supervising Physician. May conduct hospital rounds, assist with admissions and discharges, and provide on-call support.… more
- Baylor Scott & White Health (Marble Falls, TX)
- …* Manage and round on 8-15 neonatal patients per day * Perform hospital rounding, circumcisions, and neonatal resuscitation * Provide inpatient care in ... and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid ...hospital rounds, assist with admissions and discharges, and provide on-call support. KEY SUCCESS FACTORS Knowledge of information… 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
- Baylor Scott & White Health (Dallas, 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