- Molina Healthcare (Austin, TX)
- …and prepares written response to incoming provider reconsideration request is relating to claims payment and requests for claim adjustments or to requests from ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
- Cardinal Health (Austin, TX)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Molina Healthcare (San Antonio, TX)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- Southland Holdings (Grapevine, TX)
- …strategic thinking, and problem-solving skills. The manager supports dispute resolution, claims , and contract compliance, serving as a trusted advisor to business ... responses. + Draft formal contract correspondence, including notices and claims , to protect company entitlements. + Collaborate with scheduling and… more
- CVS Health (Austin, TX)
- …and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all ... identify the litigation strategy in every case assigned. + Creating a plan for claim evaluation to most efficiently resolve or defend cases against CVS while working… more
- Sedgwick (Dallas, TX)
- …& Insurance OSS Coordinator **PRIMARY PURPOSE** : To support and maintain the claims management system for a local office or multiple office locations; and to ... **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Completes examiner update reports, claim adjustments, provider requests and operational expense check requests. +… more
- Sedgwick (Austin, TX)
- …General Adjuster - Southwest Region **PRIMARY PURPOSE** **:** To handle losses or claims nationally regardless of size, including having the ability to address any ... Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine insurance coverage. + Administers… more
- Allied Universal (Houston, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... the premier destination for a career in insurance claim investigation. As a global leader, we provide dynamic opportunities for claim investigators, SIU… more
- CVS Health (Austin, TX)
- …related to Network contracts and agreements. + Research identified issues; submit claim adjustment requests and determine the root cause of disputes. + Serve ... and responding to provider participation and pricing inquiries. + Analyze post-paid healthcare claims as it relates to pricing needs. + Apply in-depth research to… more
- Amazon (TX)
- …needs via 1Life's tasking system to provide the best customer service. Investigating claims through insurance to ensure they were processed according to the patient ... from One Medical patients (customers) regarding their medical bills, insurance claims , and payment inquiries. Daily activities include reviewing patient accounts,… more