11 jobs found in San Antonio

The Compliance Auditor will assist in the overall quality, compliance, and auditing activities to ensure compliance of Health Plan Delegation contracts, organizational policies, industry standards, and applicable federal and state laws. Work with delegated teams (Utilization Management (UM), Claims, Network Development, Credentialing, Administrative Audits) to ensure readiness, well documented evidence, and reporting and policies are put in place. Assists with the submission of the Delegation documents. Tracks responses, scoring and oversees any Corrective Action Plan development & submissions. Duties: Conducts pre-delegation audits, annual audits, interim delegation reporting, training, etc. Reviews policies at least annually ensuring policies meet CMS standards. Updates departmental policy to meet delegation requirements Works alongside the Management staff of delegated teams to ensure policy is properly trained and operationalized. Responsible for monitoring and reporting...

The responsibilities of the Compliance Auditor include performing detailed audits of tenant files, the property, and site-level operations to determine compliance with program/project requirements of the applicable affordable housing programs. These programs include but are not limited to, the Low-income Housing Tax Credit (LIHTC) program, HUD programs (VASH, Section 8, HUD 236, HUD 202 PRAC), Bond, HOME, CHFA, AHP, MHP, special needs housing programs, and other housing programs (including state/local programs). The role includes oversight of all regulatory obligations, conducting monitoring reviews, and identifying noncompliance and effective corrective action measures. The Auditor produces written reports of deficiencies and works with property management team members to resolve issues to eliminate or substantially minimize noncompliance identified during a third-party review. The Auditor assists in developing other staff members by providing effective training, technical...

Job Description Job Description Orthopedic Physician Practice looking for a highly motivated individual. Experienced, Full-Time Medical Biller and Collector with collector experience needed for orthopedic/sports medicine office. The Medical Biller and Collector will be responsible for ensuring that all Billing for services rendered are processed timely and accurately on a daily basis and that the coding levels are reflective of the services performed by the Provider. Responsible for timely follow up for all claims according to State and Federal regulations. Will work the accounts receivable for denials or rejections. Ensures that all calls to Insurance companies are within a timely manner to ensure payment of claims. Requirements: Excellent oral and written communication skills. Knowledge of ICD-10 and CPT coding. Ability to communicate in a professional manner with outside representatives to resolve patient accounts. Ability to identify and resolve problems in...

Job Description Job Description Role : Medical Billing Specialist Hourly Pay Rate : $20-23/hr Hours : M-F 8am-5pm (1 hour lunch) Location : San Antonio, TX (3 days/week onsite, 2 days/week remote) Our client, a third-party medical billing company, is seeking a Billing Specialist to add to their robust revenue cycle department on a contract basis. Job Description: Responsible for accurate and timely filing of medical claims (paper and electronic) with third-party insurance payers for professional and facility services. Corrects claim errors and resubmits claims. Understands and remains current on contract guidelines related to packaging of services for proper billing to third-party administrators. Candidate profile and qualifications: Experience: 3+ years of medical billing experience Electronic and paper claim submission and medical billing experience Knowledge of CPT, ICD-10, and HCPCS coding and third-party payor reimbursement...

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. KNOWLEDGE/SKILLS/ABILITIES With limited supervision, the Sr. Analyst, Data is responsible for data compilation, data management,...

Bilingual Medical Billing Specialist – 100% Remote - Immediate Opening - Portuguese, Italian or German QUAD is currently seeking a bilingual Medical Billing Specialist for an organization in the Philadelphia area. This is a 100% remote position. Bilingual- fluent in English and one or more foreign languages required, such as Portuguese, German, or Italian The Medical Billing Specialist will be responsible for communicating with health institutions (pharmacies, hospitals, etc.) to ensure members are delivered appropriate services and will be resolving contracted claims and financial inquiries from providers, facilities, and vendors. This position accurately records bank account information and direct international payments , as well as other duties, as assigned. Responsibilities: Researches and resolves escalated claims issues reported by contracted providers and facilities. Works effectively with colleagues in Claims, Finance, the Global...

Associate Director, OPEX, Lean, Manufacturing, Medical Device Austin, TX. San Antonio, TX. McAllen, TX. El Paso, TX. May reside in any of these areas HYBRID, Travel State and PR. Competitive Salary [about $174K] Full Benefits, World Class Global Corporation Do you have a passion for leading change and driving operational excellence? Are you a master of strategy development and deployment? Associate Director, Excellence Leader! In this exciting Hybrid role , you will lead the strategy development and deployment. Working closely with our ISC Leaders to create a culture of operational and customer excellence. You'll be responsible for driving continuous improvement across our network, challenging existing paradigms, and promoting internal and external benchmarking. Responsibilities: Lead strategy development and deployment (SDD). Ensure strategic alignment through cascading Key Performance Indicators top down and bottom up. Support...

Job Description - Registered Nurse Shift Supervisor Medical Oncology Full Time Nights (2105047143) **Job Description** Registered Nurse Shift Supervisor Medical Oncology Full Time Nights - 2105047143 **Description** : **Summary** The Registered Nurse / RN Medical Oncology Shift Supervisor is part of the departmental leadership team that provides clinical supervision on a shift basis including: coordination and assignment of patient care; functions as a unit patient flow coordinator, facilitating admissions, discharges and transfers; coordinates unit staffing for next shift with the Director/Clinical Manager, Coordinator and/or House Officer; serves as a clinical and leadership resource and role model for the staff; provides supervisory input into department staff evaluations and performance reviews. Registered Nurse / RN Medical Oncology Shift Supervisor Completes established competencies for the position within designated introductory period. Other related...

Feeling stuck professionally? Lacking education and certification? SA: Ready to Work is exactly what you have been waiting for! San Antonio: Ready to Work is an educational and job placement program designed to do one thing: Connect you to in demand professions to improve your quality of life. SA: RTW will provide you with guidance, direction, and assistance to enroll in an approved course to jumpstart a whole new world of earning opportunities!! Are you READY to start earning $15.00 dollars or more per hour?! Visit the Workforce Solutions Alamo location at 3652 Bluemel Rd. San Antonio, TX 78229 to take advantage of this amazing program. You may also call us directly at, 210-438-0581. Additionally, every Thursday from 1:00 pm - 5:00 pm, there will be live SA: RTW info sessions at the address listed above, where you can speak one-on-one with one of our career counselors who will help answer your questions, share best practices, and advise on next steps to expedite the process. If...

Job Description $4000 Sign on Bonus for experienced Medical Biller - Medical Collector The Medical Biller - Medical Collector provides support functions as assigned by billing management team. Assists with submission of appropriate documentation to insurances to facilitate claim processing including functions such as pulling of documents, faxing, scanning and mailing, communicating with health insurance providers and assisting with other processes in the billing cycle. Completes established competencies for the position within designated introductory period. Other duties as assigned. MINIMUM EDUCATION: High School Graduate PREFERRED EDUCATION: Graduate of Medical Office/Billing Program PREFERRED EXPERIENCE: 1 year of medical billing with ability to perform remittance review and medical billing #LI-JH5 Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under...

Job Summary: Under direct supervision, responsible for conducting review of inpatient and outpatient coding, assuring coding compliance with federal regulations, and maintains up-to-date coding guidelines and coding policy changes. Performs all tasks required to facilitate medical billing to include abstracting complex patient related data from medical records and coding of diagnoses and procedures using the ICD-10 and CPT classification systems. Job Duties: Reviews, interprets, and assigns diagnostic and procedural codes based upon medical record documentation according to correct coding principles. Provides technical work in documentation and coding for medical billing, abstracts patient-related data from medical records and coding of diagnoses and procedures using ICD-10 and CPT codes. Works coding related charge review and claim edits daily to ensure timely and accurate billing. Obtains medical records and...