- Elevance Health (Grand Prairie, TX)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Molina Healthcare (San Antonio, TX)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- Humana (Austin, TX)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Utilities Service, LLC (Longview, TX)
- …the crew. + May be delegated the authority to investigate incident reports, damage claims , etc., and to settle minor damage claims . + Maintains accurate records, ... benefits available for this role, please contact the recruiter or hiring manager . **Individuals with a disability who desire a reasonable accommodation can contact… more
- Houston Methodist (Katy, TX)
- …Confers with Billers, as necessary, to obtain additional information/clarification. + Informs manager of payer trends or any problems or changes in payor ... **FINANCE ESSENTIAL FUNCTIONS** + Follows up on assigned delinquent insurance claims . Ensures maximization of collection dollars from insurance companies in… more
- HCA Healthcare (Houston, TX)
- …collections for patient services. Under the supervision of the Business Office Manager /Business Office Supervisor, you will obtain payment from third party payers ... and work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims + You will update the patient account record to… more
- Southland Industries (Schertz, TX)
- …and Fire Protection industry. Primary responsibility is to assist the Safety Manager in enforcing and regulating all safety procedures to ensure that Southland ... equipment training. + Report and manage all company vehicle claims . + Assist in reporting workers compensation claims... claims . + Assist in reporting workers compensation claims . + Update Material Safety Data Sheets (MSDS) manual.… more
- Southland Industries (Houston, TX)
- …and Fire Protection industry. Primary responsibility is to assist the Safety Manager in enforcing and regulating all safety procedures to ensure that Southland ... equipment training. + Report and manage all company vehicle claims . + Assist in reporting workers compensation claims... claims . + Assist in reporting workers compensation claims . + Update Material Safety Data Sheets (MSDS) manual.… more
- Mass Markets (Killeen, TX)
- …collaborate with other teams as needed + Accuratelydocument and process customer claims and interactions + Follow scripts, policies, and procedures while using ... andmaintain confidentiality + Escalate complex cases to the appropriate team or manager + Stay updated on products and processes by attendingongoing training +… more
- Robert Half Finance & Accounting (Houston, TX)
- …located in Downtown, Houston, TX is seeking a dedicated and experienced Assistant Risk Manager to join our team. The ideal candidate will possess a strong background ... strategies and policies. Oversee insurance programs, including policy renewals, claims management, and coverage analysis. Collaborate with fleet managers to… more