• Appeals & Grievances Specialist

    Molina Healthcare (San Antonio, TX)
    …**Essential Job Duties** * Facilitates comprehensive research and resolution of appeals , disputes, grievances, and/or complaints from Molina members, providers, and ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals more
    Molina Healthcare (12/14/25)
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  • Lead Specialist , Appeals

    Molina Healthcare (Dallas, TX)
    …* Serves as team lead for submission, intervention and resolution of appeals , grievances, and/or complaints from Molina members, providers and related outside ... and provides guidance to others with respect to complex appeals and grievances. * Researches and resolves escalated issues...etc. for use in presentations and audits; researches claims appeals and grievances using support systems to determine … more
    Molina Healthcare (01/18/26)
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  • Associate Specialist , Appeals

    Molina Healthcare (TX)
    …Services (CMS). **Essential Job Duties** * Enters denials and requests for appeals into information system and prepares documentation for further review. * ... systems and other available resources. * Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. * Requests and obtains… more
    Molina Healthcare (01/17/26)
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  • Referral Specialist I/Patient Access (Pre…

    Elevance Health (Plano, TX)
    **Referral Specialist I/Patient Access (Pre & Prior Authorizations, Appeals , Insurance) - Paragon Infusion** **Location:** 3033 W President George Bush HWY., STE ... our specialty pharmacies, our infusion centers, and the home setting. The **Referral Specialist I** is responsible for providing support to a clinical team in order… more
    Elevance Health (01/14/26)
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  • Senior Denials Mgmt Specialist

    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 (01/16/26)
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  • Appeal Support Specialist

    Baylor Scott & White Health (Dallas, TX)
    …to guidelines set forth by the payer. The Appeal Support Specialist processes submissions of reconsiderations, redeterminations, appeals , resubmissions of ... **JOB SUMMARY** The Denial Resource Center Appeal Support Specialist is responsible for ensuring that complete and... is responsible for ensuring that complete and accurate appeals of denied claims are submitted to the payer… more
    Baylor Scott & White Health (01/08/26)
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  • Revenue Cycle Specialist - Plastics…

    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 (01/16/26)
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  • Accounts Receivable Specialist (remote)

    Cognizant (Austin, TX)
    **Accounts Receivable Specialist (remote)** This is a remote position open to any qualified applicant in the United States. **Summary:** In this role the successful ... basket and follow up at regular intervals to collect outstanding Knowledge in writing appeals and following thru appeals process Resolve accounts to get paid… more
    Cognizant (01/16/26)
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  • Billing Specialist

    Aston Carter (Dallas, TX)
    Remote Billing Specialist Job Description We are seeking a dedicated Billing Specialist who will provide supplemental accounts receivable support and manage ... correspondence to resolve outstanding balances. + Submit corrected claims, appeals , and reconsiderations with appropriate documentation. + Perform timely follow-up… more
    Aston Carter (01/17/26)
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  • Admissions Specialist IV

    Texas A&M University System (Corpus Christi, TX)
    Job Title Admissions Specialist IV Agency Texas A&M University - Corpus Christi Department Office Of Enrollment Processing Proposed Minimum Salary Commensurate Job ... entry errors in admissions and registration records. + Prepare prospective student appeals and conduct review files for review by the Undergraduate Admissions… more
    Texas A&M University System (01/08/26)
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