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Avosys is seeking a Bexar County Remote Registered Nurse - Medical Review Specialist to work remotely to review Medicare claims. Utilize the applicable Medicare policies (i.e., Local Coverage Determinations, National Coverage Determinations, Internet-Only Manual (IOM) citations, inpatient tools, etc.
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The applicant must have a working knowledge of the Centers for Medicare and Medicaid Services (CMS) guidelines for documentation, coding, and billing services provided by supervising physicians in a teaching setting.
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Knowledge of screening criteria such as InterQual as well as DRG, ICD-10 and CPT coding is preferred. Position Summary:Oversees clinical staff in the assessment, planning, implementation, coordination, monitoring, and evaluation of utilization management and service coordination activities that require interventions for Community First members.
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Patient panel is limited to geriatrics with Medicare Advantage coverage. A partner of the Optum Care network, WellMed Networks, Inc, is seeking a nurse practitioner or physician assistant to join our San Antonio Hospitalist Team in our Downtown Pod. At Optum, we are transforming healthcare nationally while providing Physician-led care locally.
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Demonstrate an excellent understanding of insurance (especially Medicaid, Medicare, and CHIP) and eligibility (Methodist Homeless) programs. Haven for Hope - Homeless specialty. CentroMed is 501(c) (3) non-profit organization that provides healthcare for all populations is a primary care provider and Federally Qualified Health Center (FQHC) with multiple locations throughout San Antonio and the New Braunfels area.
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The AVP will play a key leadership role on the HQRI team, partnering directly with the HQRI leadership team, leaders across the enterprise, including Market leadership, and external companies to create Medicare Risk Adjustment strategies to support Humana's industry leading position.
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Performs Host and/or Network Cyber Protection Team duties for a DoD client, to include CND, CNE, and CNA.
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Type of equipment - GE Carescape R860 ventilator, Covidien PB980 ventilator, Avea Ventilator, V60 noninvasive, Vapotherm, Blender HFNC, Vest CPT, MetaNeb, Cough Assist, Percussor CPT. Posted job title: travel registered respiratory therapist (rrt.
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Highly prefer candidates with experience in one or all areas, including: telehealth, virtual care, revenue cycle management, health plans (commercial/Medicare), health benefits administration, consulting and pharmacy benefit management (PBM.
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Must be up to date with all CPT and ICD-9 coding to process proper referral. Our highly specialized services meet the unique medical needs of children, from Pediatric and Neonatal Intensive Care to Children’s Emergency Services, the latest treatments for deformities of the spine including titanium rib implants and halo traction, a Heart Center, a specialized asthma program, a highly regarded Cancer and Blood Disorders Center, and growing maternal services to include consultation, delivery, and maternal fetal medicine.
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As a Personal Trainer (CPT) you will work one-on-one and in small groups with members to help them achieve their fitness goals. As a Personal Trainer (CPT) you will work one-on-one and in small groups with members to help them achieve their fitness goals.
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As a Medicare Sales Agent (internally titled Advocate Agent) you'll enjoy unlimited earning potential, the convenience to work from home, access to best-in-class paid training, and potentially the opportunity to move into a leadership role.
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WellMed is mostly a Medicare Advantage Plan that operates as a health system focused on quality/value-based outcomes. Comfortable managing a primarily Medicare-aged patient population. A partner of the Optum Care network, WellMed Medical Group, is seeking a nurse practitioner or physician assistant to join our WellMed at Windcrest clinic in San Antonio, TX.
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Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and How-To documents.
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TRICARE purchased care system, Medicare, Medicaid, Veterans Administration (VA), Public Health. TRICARE purchased care system, Medicare, Medicaid, Veterans Administration (VA), Public Health. Validates and implements MTF policy in support of hospital accreditation program and quality.
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cpt medicare jobs in San Antonio, TX
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