- Houston Methodist (Katy, TX)
- …Fry Rd. Katy, TX 77450** **. (Hybrid position)** At Houston Methodist, the CBO Regulatory Compliance Specialist position is responsible for working with ... Medicare compliance experience is preferred** **Note:...Center for Medicare /Medicaid Services (CMS), other applicable regulatory agencies, and/or Houston Methodist Internal Audit compliance… 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
- Houston Methodist (Houston, 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
- 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
- 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
- Prime Therapeutics (Austin, TX)
- …templates. + Develops and customizes correspondence according to regulatory requirements and contractual requirements including coordinating Compliance ... every decision we make. **Job Posting Title** Enrollment Correspondence Policy Specialist **Job Description Summary** Responsible for the development, approval and… more
- Highmark Health (Austin, TX)
- …Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including but ... Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines. Works closely with team… more
- Apex Health Solutions (Houston, TX)
- Summary The Commercial Health Plan Enrollment Specialist is responsible for maintenance of eligibility data, resolving all issues or requests regarding eligibility, ... procedures according to current business needs as well as industry and regulatory requirements; assists management with the preparation of training materials and… 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
- 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
- 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
- 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 (Austin, 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 (Arlington, 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 (Fort Worth, TX)
- …services rendered Educates patients and/or families about applicable legal, ethical, and compliance documents; ensures regulatory consents are signed by the ... **Admissions Specialist I / PRN** _Are you looking for...are completed correctly, particularly the MSPQ, Important Message from Medicare (IMM) and medical necessity checking (ABN and Letter… more
- Texas Health Resources (Stephenville, TX)
- …rendered 10% Educates patients and/or families about applicable legal, ethical, and compliance documents; ensures regulatory consents are signed by the ... **Admissions Specialist ** **_We're looking for a qualified Admissions ...are completed correctly, particularly the MSPQ, Important Message from Medicare (IMM) and medical necessity checking (ABN and Letter… more
- CVS Health (Austin, TX)
- …of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and ... Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range...+ CRC, CDMS, CRRN, COHN, or CCM certification + Medicare and Medicaid experience + Managed care experience +… more
- CVS Health (Austin, TX)
- …of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and ... Special Needs Plan (DSNP) members, who are enrolled in Medicare and Medicaid and present with a wide range...+ CRC, CDMS, CRRN, COHN, or CCM certification + Medicare and Medicaid experience + Managed care experience +… more
- Ascension Health (Waco, TX)
- …in situations such as Caregiver Model of the Future responsibilities. May monitor compliance with regulatory standards and be responsible for inventory and drug ... controlled substanceoversight, and billing including, Long Term Care (LTC) billing and Medicare D claim adjudication. + Serve as a resource for automation… more