- Molina Healthcare (Fort Worth, TX)
- …excellent customer service; documents calls and interactions. + Assists in the reviews of state or federal complaints related to claims . + Supports the other ... and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. **Job Qualifications** **REQUIRED EDUCATION:** Associate 's Degree or… more
- Allied Solutions (Plano, TX)
- …as assigned. This position will involve the initial processing and investigation of 20-40 claims per day. This position ensures that all claim documentation is ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...evaluation process; + Ability to interpret and comply with all regulatory mandates within individual jurisdictions, including state… more
- Molina Healthcare (Fort Worth, TX)
- …with cost control standards. **KNOWLEDGE/SKILLS/ABILITIES** + Evaluates the adjudication of claims using standard principles and state specific policies and ... of claims . + Manages a caseload of claims . Procures all medical records and statements...Diploma or GED **Required Experience** 1-3 years **Preferred Education** Associate degree or equivalent combination of education and experience… more
- Ascension Health (Austin, TX)
- …audit of claims to ensure payment accuracy and adherence to state Medicaid guidelines. + Responsible for the comprehensive research and resolution of claim ... agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes. + Composes all… more
- USAA (San Antonio, TX)
- …Be part of what truly makes us special and impactful. **The Opportunity** It is all about learning and growing. Our Associate Auto Adjuster role may be a ... fully paid four-month training (12 week training) program includes all training materials, licensing costs, class discussions, hands-on training,...include the end-to-end claims process and settling claims in compliance with state laws and… more
- Walmart (Baytown, TX)
- **Position Summary ** **Are you currently a Walmart associate ?** Please login to your Workday account and use the Find Jobs report to apply for this job. + Find Jobs ... buildings and food safety audits Creates audit reports Acts as an associate interface for workers compensation issues Obtain necessary records Analyzes and reports… more
- NTT DATA North America (Plano, TX)
- …organization, apply now. We are currently seeking a HC and Insurance Operations Associate to join our team in Plano, Texas (US-TX), United States (US). Roles ... and Responsibilities: * Process Adjudication claims and resolve for payment and Denials * Knowledge...co-pay, out of pocket, maximum inside limits and exclusions, state variations * Ensuring accurate and timely completion of… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …performance at all levels + **Compliance Management:** + Must comply with all state and federal laws, regulations and guidelines including PhRMA Code on ... ** Associate Director, Field Strategy, Nephrology/Immunology** **Position overview:** The...ensure field teams are fully informed, equipped, and leveraging all available tools, insights, and strategic initiatives to maximize… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …complexity in both in-line brand stewardship and upcoming product launches, the Associate Director, Channel Strategy and Patient Affordability will serve as a key ... **Why This Role Now:** As Otsuka shifts from a steady- state brand model to a pipeline-driven growth strategy, this...-** Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka.… more
- R1 RCM (Austin, TX)
- …interprets expected reimbursement information from EOB's and learns legal parameters pertaining to all State and Federal Laws that pertain to the plan benefits ... automation, and workflow orchestration Job Description The Follow Up Associate II rep will be responsible for investigating and...the process went wrong, and keeps staff educated on all current trends in the appeals arena. Utilizes computer… more