- Molina Healthcare (Dallas, TX)
- …is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it ... applied to the appropriate modules within the core processing system (QNXT). * Conducts focal healthcare Medical claim...+ Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using… more
- Allied Solutions (Plano, TX)
- Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. ... claims per day. This position ensures that all claim documentation is thoroughly reviewed and assessed for coverage...This position will also review database information found in systems such as Unitrac, insurance company websites, Lexis Nexis,… more
- NTT DATA North America (TX)
- …the potential of dual coverage and determining which Insurance is primary. + Update Claims System according to Member insurance + Making outbound call to other ... DATA, Inc. currently seeks a **Coordination of Benefits (COB) Associate ** to join our team. Our Client is one...for this role include:** + 3+ years of medical claims processing experience + 5+ years of experience using… more
- Humana (Austin, TX)
- …Qualifications** + Associate or bachelor's Degree. + Previous experience with CAS claims systems . + Foundational knowledge of finance principles related to ... caring community and help us put health first** The Claims Review Representative makes appropriate claim decision...+ Ability to quickly adapt to and learn new systems and technologies relevant to claims processing.… more
- NTT DATA North America (Plano, TX)
- …DATA and for the people who work here. NTT DATA is seeking to hire a **Remote Claims Processing Associate ** to work for our end client. **NOTE** : This is a US ... candidate will be responsible for:** + Processing of Professional claim forms files by provider + Reviewing the policies...Work independently to research, review and act on the claims + Prioritize work and adjudicate claims … more
- NTT DATA North America (Plano, TX)
- …as part of an overall sourcing strategy. NTT DATA is seeking to hire a **Remote Claims Processing Associate ** to work for our end client and their team. **Note** ... NTT DATA only. **Role Responsibilities** + Processing of Professional claim forms files by provider + Reviewing the policies...Work independently to research, review and act on the claims + Prioritize work and adjudicate claims … more
- Molina Healthcare (Dallas, TX)
- …experience and knowledge to research and resolve claim /encounter issues, pended claims and facilitate system update(s) as necessary. + Works with fluctuating ... claims databases. Synchronizes data among operational and claims systems and application of business rules...housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Marriott (Plano, TX)
- …years claims adjusting or equivalent/relevant experience. _Preferred_ Knowledge of claims processing. Applicable industry licensing. Associate in Claims ... and Procedure Manual requirements Effectively utilize the Valley Oaks System (iVOS) to manage all claims electronically...Valley Oaks System (iVOS) to manage all claims electronically Enter action plan notes/website notes into iVOS… more
- Molina Healthcare (San Antonio, TX)
- …issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems . ... and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators. **Job Qualifications** **REQUIRED EDUCATION:** Associate 's Degree or… more
- Capital One (Plano, TX)
- …package from the associate . Requirements are subject to change, as new systems and technology is delivered. Capital One reserves the right to modify internet ... Work From Home Bilingual (Spanish) Senior Fraud Recovery Coordinator- Complex Claims **Are you looking for a challenging role that includes the convenience of… more