- Lincoln Financial (Austin, TX)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will… more
- Actalent (Dallas, TX)
- Job Title: Specialist , Appeals & GrievancesJob Summary: Responsible for reviewing and resolving member and provider complaints and communicating resolutions. Key ... Responsibilities: + Conduct comprehensive research and resolve appeals , disputes, grievances, and complaints. + Use internal systems to determine outcomes of claims … more
- Cognizant (Austin, TX)
- …. Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes. ... Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims/ appeals information on relevant tracking systems . Utilize critical thinking… more
- Molina Healthcare (Fort Worth, TX)
- …DESCRIPTION** **Job Summary** Responsible for reviewing and resolving Medicare member appeals and Medicare claims in communicating resolution to members and provider ... + Responsible for the comprehensive research and resolution of the appeals from Molina members, providers and related outside agencies to ensure… more
- Molina Healthcare (Fort Worth, TX)
- …+ Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers and related ... ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance outcomes.… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... denial management and appeals process, as applicable, in collaboration with clinical team...and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information utilizing various resources and… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... management and appeals process in a collaborative environment with revenue cycle...of the following: + * CCS - Certified Coding Specialist (AHIMA) + * CPC - Certified Professional Coder… more
- Ascension Health (Austin, TX)
- …Responsible for reviewing, investigating and resolving health-care claim payment appeals and communicating resolution/determination in accordance with the standards ... guidelines. + Responsible for the comprehensive research and resolution of claim appeals from health-care providers and related outside agencies to ensure that… more
- Urology Clinics of North Texas (Mesquite, TX)
- Oncology Accounts Receivable Specialist Job Details Job Location 1650 Republic Pkwy Ste 150, Mesquite, TX 75150 - Mesquite, TX Description Position:Oncology Accounts ... ManagerLocation:Urology Clinics of North Texas Position Summary: The Oncology Accounts Specialist is responsible for managing and resolving insurance and patient… more