- KPH Healthcare Services, Inc. (Longview, TX)
- …balances. **Responsibilities** + Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other responsible ... written correspondence. + Investigate and resolve denied or partially paid claims , identifying root causes and implementing corrective actions. + Collaborate with… more
- Schlumberger (Houston, TX)
- …matters including but not limited to contract compliance, change management and claim mitigation strategies. + Analyzing the basis and extent of change Tracking ... claims and monitoring progress through the claims ...undertakings, etc are in the commercial interest of the Company and in accordance with the relevant contract. +… more
- Health Care Service Corporation (Richardson, TX)
- …rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. This ten-week paid internship ... The Audit Specialist Intern responsibilities may include assisting with claim accuracy audits and performance tracking of Administrative Services Only… more
- Kemper (Dallas, TX)
- …knowledge of automobile policies, statutes and trends. + A thorough knowledge of Company claims handling procedures. + Must have excellent communication skills. ... controls litigation within assigned region and ensures that all claims are handled in accordance with established corporate and...the disposal of those cases. + Ensures that uniform claim procedures are used for file handling including compliance… more
- Prime Therapeutics (Austin, TX)
- …to elicit, define, and document the requirements for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT ... and serve as subject matter expert and mentor for other members of Claims IT team, including cross-training assigned BSAs on system requirements phase of assigned… more
- Sedgwick (San Antonio, TX)
- …Rec Marine Adjuster **PRIMARY PURPOSE** **:** To investigate and process marine claims adjustments for clients; to handle complex losses locally unassisted up to ... documentation, and issues settlement. + Receives and reviews new claims and maintains data integrity in the claims...+ Prepares settlement documents and requests payment for the claim and expenses. + Assists in preparing loss experience… more
- Houston Methodist (Houston, TX)
- …Methodist, the Senior Risk Attorney position is responsible for risk, claims , and litigation management involving high-exposure and high-profile matters. **This ... and acting as the organization's corporate representative in litigation and claims management. This position provides counsel to prevent, mitigate, and eliminate… more
- Elevance Health (Grand Prairie, TX)
- …in order to recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible for identifying and developing ... specific healthcare investigations that may impact more than one company health plan, line of business and/or state +... health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review,… more
- Humana (Austin, TX)
- …community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare claims ... Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to stakeholders. The… more
- Elevance Health (Plano, TX)
- …period of time. + Inputs appropriate progress/billing note (test claim , real claim OOP, payment plan). + Adjudicate real claims daily and ensure credit ... Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and...and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry,… more