Description. Verda Healthcare, Inc. has a contract with the Center of Medicaid and Medicare Services (CMS) and Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are committed to the idea that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is...
Description. Position Overview. The Medicare Enrollment Reconciliation Analyst. is responsible for reconciling the monthly CMS – Monthly Membership Report (MMR) and Transaction Reply Report (TRR) - to membership data. This reconciliation process is crucial to enrollment being correct and accounted for as well as ensuring payment from the government is complete and accurate to recognize revenue appropriately. This position identifies variances, pe...
Job Description. Job Description. Description : Position Overview. This position reports to the Accounts Payable Clerk as part of the Verda Healthcare, Inc. overall Finance team. The Accounts Payable clerk is responsible for processing all invoices received for payment and for undertaking the payment of all creditors in an accurate, efficient and timely manner. Responsibilities. Completes payments and controls expenses by receiving, processing, v...
Job Description. Job Description. Description. Member Experience Representative – Bilingual (Spanish or Vietnamese). Job Description. Provide quality customer service. Educates members, family, providers and caregivers regarding benefits and plan options. Accurately explains benefits and plan options in person, via email or telephonically. Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying a...
Job Description. Job Description. Description. The Operations Analyst is responsible for accurate and timely maintenance of provider information across all provider databases and systems, and continuously validating the data to ensure adherence to business and system requirements of customers as it pertains to contracting, network management, and credentialing. This position reports to the Sr. Manager, Contracting & Provider Network Administratio...
Job Description. Job Description. Description. The Nurse UMQI Director is responsible for overseeing and directing the Utilization Management and Quality Improvement programs within the healthcare organization. This role ensures that the highest standards of patient care are met while optimizing resource utilization and maintaining compliance with regulatory requirements. The Nurse UMQI Director collaborates with medical staff, nursing staff, and...
