FULL_TIME

FEED

OTHER

Complies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).

TriWest Healthcare Alliance

Program Integrity Investigator

equestftpin

UNKNOWN

argenx is preparing for multi-dimensional expansion to reach more patients through a rich pipeline of differentiated assets, led by VYVGART, our first-in-class neonatal Fc receptor blocker approved for the treatment of gMG, and with the potential to treat patients across dozens of severe autoimmune diseases. The FRM partners closely with Patient Support Services, Regional Account Directors, Distribution, Market Head, Business Leader, Market Access, and other internal stakeholders to deliver a seamless customer experience and help remove barriers to therapy access.

YEAR

Argenx SE

Field Reimbursement Manager, Austin

This individual also analyzes eligibility media, utilizes various system applications for reporting purposes, interprets multiple medical plan benefits to maximize accurate collections, endorses mutual respect amongst all members of the healthcare team, practices positive guest/peer relationships and works with others to promote an efficient and effective team, and demonstrates a positive attitude and understands how this relates to creating a caring environment and a favorable impression regarding KSC commitment to the welfare of our patients. 3+ years general administrative experience and 2+ years medical insurance verification experience or experience scheduling operative procedures OR 1+ years of KSC experience in a position similar, but not limited to, DSS I, ASRs, Contact Center or Member Services reps, MAs/CMAs or Schedulers.

HOUR

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc.

DSS II Obgyn Summer Creek, Kingwood And Atascocita

ea_via_bold

Preferred Skills: People Leadership; Coaching & Talent Development; Team Culture; Performance Management; Accountability; Field Execution; Access & Reimbursement Expertise; Dual-Benefit Reimbursement Expertise; Specialty Pharmacy; Buy & Bill; Account Management; Analytical Reasoning; Competitive Landscape Analysis; Compliance Management; Cross-Functional Collaboration; Fact-Based Decision Making; Market Access Reimbursement; Market Opportunity Assessment; Operational Excellence; Performance Measurement; Relationship Building; Strategic Thinking; Inclusive Leadership; Leadership Through Influence; Change Leadership; Customer Access Experience. In addition to the base salary, Amgen offers a Total Rewards Plan, based on eligibility, comprising of health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities that may include: A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts.

At Amgen, we believe in a “biology first” approach. We use cutting-edge science and technology to study the subtlest biological mechanisms in search of therapies that will improve the lives of those who suffer from serious diseases. Amgen believes the cure for disease can be found inside each and every one of us.

Amgen Inc.

Field Reimbursement Specialist Senior Manager - West

Headquartered in King of Prussia, PA, UHS has 89,000 employees and through its subsidiaries operates 26 acute care hospitals, 334 behavioral health facilities, 39 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 38 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. To encourage pay transparency, promote pay equity, and proactively address regulations, UHS and all our subsidiaries will comply with all applicable state or local laws or regulations which require employers to provide wage or salary range information to job applicants and employees.

Founded in 1979 by our Chairman and CEO Alan B. Miller, Universal Health Services, Inc. (NYSE: UHS) is one of the largest and most respected hospital management companies in the nation. A pioneer and leader in our industry, UHS attributes our longevity and success to our unwavering commitment to putting patients first in all the communities we are proud to call home.

UHS and our affiliates provide high quality, compassionate care across 320+ acute care hospitals, behavioral health and residential treatment facilities and outpatient care centers across the U.S., Puerto Rico and then United Kingdom. UHS strives to be the provider and employer of choice in every community we call home and we are committed to continually enhancing our programs and service offerings. To this end, UHS invests hundreds of millions annually (and well over $1 billion in the past three years) in facility and technology upgrades to drive innovation, improve safety and optimize the patient experience. We are also proud to provide millions in uncompensated and charity care annually.

Universal Health Services

Patient Account Representative/Collector

IRecruitee

These steps include patient referral intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up with various partners including the insurance payers, specialty pharmacies, and support organizations to facilitate coverage and delivery of product in a timely manner. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location.

Mindlance

Case Manager

jobdiva

The largest Federally Qualified Health Center (FQHC) in Southeast Texas, Legacy Community Health has delivered affordable, high-quality care for nearly 40 years across 50+ clinics in Greater Houston and the Gulf Coast. By guiding pharmacy operations, developing your team, and partnering with pharmacists, providers, and staff, you will make a meaningful difference for patients and the broader community.

Legacy Community Health Services

Manager - Pharmacy (Southwest)

Position Summary: The HGB Program Quality Assurance Specialist plays a critical role in ensuring every patient encounter is documented accurately and completely prior to claim submission. This position serves as the final quality checkpoint by auditing medical documentation, validating compliance with Medicare guidelines, and ensuring operational excellence across all HGB program locations.

HealthGrades Analytics

Quality Assurance (QA) Specialist

Betterteam

Manages the compliance, strategic planning, financial strength, and overall performance of the HIM department in professional coding, hospital coding, release of information (ROI), chart preparation and indexing, physician deficiency management, and chart compliance and integrity through chart correction and auditing processes. Assist Medical Staff with rules and regulations on Incomplete Chart Requirements to meet regulatory agencies' requirements as well as legal documentation requirements, monitors and reports non-compliance to Executive Staff and Senior Leadership.

United Regional Health Care

HIM MANAGER

Broadbean

Scan, fax and or email results to clients and attachmentsFollow all DOT and MRO protocols to ensure PRIME is in complianceMay be required to travel and work at different PRIME locationsMust have reliable transportationMay be required to work overtime and or holidaysOther duties as assigned Required skills and qualifications2+ years of experience at a healthcare facility in a medical receptionist or medical assistant role (essential).Working knowledge of medical terminology, HIPAA regulations, and medical coding (highly advantageous).Knowledge of SystocCommunication skills to converse clearly over the telephone and in person. Mental Requirements:Learn new tasks, remember processes, maintain focus, complete tasks independently, make timely decisions in the context of a workflow, ability to communicate with employees and visitors, ability to complete tasks in situations that have a speed or productivity quota.

Prime Occupational Medicine

Clinic Receptionist

Talent Acquisition

Provides status, leads discussion of change requests, and organizes routine and ad-hoc meetings with Suspecting Governance, Working Group Committee and Clinical Actions leaders. Primary Responsibilities: Evaluates clinical and medical coding appropriateness of the suspecting engines with the goal of defining improvement needs and escalation to leadership.

<h3>We’re Building the Future of Healthcare</h3>
Come join Reliant Medical Group, where transforming the delivery of health care across Central Massachusetts and MetroWest is our passion. Exceptional care and service for our patients distinguishes us from other health care providers. We employ the best and brightest people to provide care for more than one million patient visits each year across our 19 clinical locations.
Each and every employee contributes to our patients in special ways. We pledge that your career will be challenging, rewarding, and personally satisfying if your commitment to patient care, customer service, and excellence is unwavering.
<h3>Mission</h3>
The mission of Reliant Medical Group is to maximize the health of our patients and the community through expert medical care, compassion, innovative delivery models, medical research and education, and the appropriate use of health care resources.
<h3>Vision</h3>
We will be the preeminent provider in our market. We will achieve this through patient-centered, team-based, coordinated health care, building on the strengths of our physician-led organization. We will recruit and retain highly skilled medical professionals and support staff who take great pride in providing exceptional service and personalized care to our patients and their families.

Reliant Medical Group

Lead Clinical Nurse Analyst - San Antonio, | Antonio, |

In-depth knowledge of healthcare systems, pricing and reimbursement processes, identifying health economics evidence generation needs, crafting payer value propositions, billing and coding processes, specialty product sales, brand marketing, new product planning / lifecycle management and regulatory landscapes required. The Vice President, Global Market Access will lead the strategic development and execution of market access and health policy initiatives and engagement supporting the successful launch of and sustainable patient access to Immatics' targeted TCR-based immunotherapies for solid tumors.

Immatics NV

Vice President, Market Access

About this Role: Mercer Technical Services (MTS), a Quanta Services company, is seeking an Assistant Project Manager (APM) to support the execution of pipeline logistics, material management, and field services projects. The Assistant Project Manager serves as a key support resource for rail offload operations, yard management, pipe sorting and re-racking, stringing operations, and haul-to-right-of-way (ROW) logistics.

MTS Quanta, LLC

Assistant Project Manager

[AW]-iCims

This role will help build and scale product and platform security practices while turning technical findings, researcher insights, and emerging threats into stronger engineering controls, clearer priorities, and measurable improvements to Nscale's security posture. We are seeking a Staff Security Engineer, Product and Platform Security to lead security initiatives across Nscale's products, cloud platforms, hyperscale GPU clusters, and critical infrastructure.

Nscale AS

Staff Security Engineer, Product & Platform Security

ADAPTED_NOW

The ideal candidate will have hands-on experience building Flutter applications for iOS and Android, a strong understanding of software engineering principles, and experience working within Agile development teams. The Flutter Developer will collaborate with product managers, UI/UX designers, QA engineers, and backend developers to deliver scalable, secure, and user-friendly applications that support business objectives.

Sarnova

Flutter Developer

Ivy Exec

Strong candidates may then be introduced to the client team for additional conversations focused on RCM depth, provider-facing communication, team/vendor management, process improvement, location/travel fit, and compensation alignment. You will work with leadership, internal billers, outsourced teams, physicians, and practice operators to make sure billing, coding, collections, denials, communication, and follow-through are reliable.

Urrly

Business Manager (Remote)

Business Manager

BreezyHR

Minimum of 5 years' experience in registration, physician or hospital billing, third party reimbursement, benefits verification and pre-authorization processing required management experience is required in a hospital setting. Integrates the functions of registration, benefit verification and payor pre-authorization, as well as payment arrangements and cash collection with ambulatory services utilization in order to achieve optimal reimbursement.

Surgery Partners

Financial Counselor, Full-Time (Hybrid)

This is an exciting opportunity to be part of a high-acuity neurosurgical service caring for critically injured trauma patients who require specialty neurosurgical management—all while enjoying a predictable schedule and coastal lifestyle. Surgical Affiliates Management Group (SAMGI) is a physician-led organization dedicated to supporting surgeons and advanced practice providers through strong hospital partnerships, operational excellence, and collaborative clinical models.

Surgical Affiliates Management Group

Neurosurgery Advanced Practice Provider (APP)

Processes Provider contracts, run reports, and responds to inquiries regarding contract compliance issues; images and indexes contracts and return images to network subcontractors; conducts quality assurance activities to ensure image quality and completion of image activities. Technical Skills: Proficient with key databases, including Claims System, Medical Management System, Authorization/Referral Systems, and Provider Information Management System(s); working knowledge of claims reimbursement methodology and medical coding; healthcare or managed care experience.

Medical Billing And Coding Jobs in Texas

Program Integrity Investigator TriWest Healthcare Alliance

Field Reimbursement Manager, Austin Argenx SE

DSS II Obgyn Summer Creek, Kingwood And Atascocita UnitedHealth Group Inc.

Field Reimbursement Specialist Senior Manager - West Amgen Inc.

Patient Account Representative/Collector Universal Health Services

Case Manager Mindlance

Manager - Pharmacy (Southwest) Legacy Community Health Services

Quality Assurance (QA) Specialist HealthGrades Analytics

HIM MANAGER United Regional Health Care

Clinic Receptionist Prime Occupational Medicine

Lead Clinical Nurse Analyst - San Antonio, | Antonio, | Reliant Medical Group

Vice President, Market Access Immatics NV

Assistant Project Manager MTS Quanta, LLC

Staff Security Engineer, Product & Platform Security Nscale AS

Flutter Developer Sarnova

Business Manager (Remote) Urrly

Business Manager Urrly

Financial Counselor, Full-Time (Hybrid) Surgery Partners

Neurosurgery Advanced Practice Provider (APP) Surgical Affiliates Management Group

Provider Data Resolution Spec TriWest Healthcare Alliance

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