- CVS Health (Irving, TX)
- …with a collaborative, close-knit reporting team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... of the reporting. You will report to the Sr. Manager within the Reporting Solutions team. To be successful...and document requirements, agreements and changes with business users Preferred Qualifications: + Experience with any of these a… more
- 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 ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions 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, ... or older + High School Diploma or GED equivalent preferred . + A minimum of 3120 hours of working...for this role, please contact the recruiter or hiring manager . **Individuals with a disability who desire a reasonable… more
- Mass Markets (Killeen, TX)
- …coordinate with other departments as needed + Accurately document and process customer claims and interactions + Use training and knowledge base to answer questions ... + Escalate complex issues to the appropriate team or manager + Stay current with updates by attending training...the ability to build rapport with customers and colleagues Preferred (Not Required) + 1+ year of experience in… more
- Sedgwick (Irving, TX)
- …deliverables for assigned projects, including serving in role of project manager as assigned; ensures all projects follow Sedgwick software development lifecycle ... in IS or Management required. Major in Information Systems or Management strongly preferred . + Ten (10) years of related experience required to include seven (7)… more
- Veterans Affairs, Veterans Health Administration (Fort Worth, TX)
- …care for Veterans. In conjunction with the Clinical Directors and Nurse Manager of this Mental Health Team, organizes, and directs administrative, operational, ... supervision for Social Workers, Psychologists, Peer Support, and Nursing staff. Preferred leadership experience of a multi-disciplinary team. Work Schedule: Monday -… more
- Elevance Health (Houston, TX)
- …or documentation is unclear. + Trains and educates others on coding documentation, claim payment guidelines, and related issues. + Reviews CPT and ICD-9 codes ... an equivalent background. + Certified Medical Code (CPC or CCS-P) required. ** Preferred Skills, Capabilities and Experiences** : + Knowledge of medical terminology… more
- HCA Healthcare (Austin, TX)
- …Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, ... center patients. Under the supervision of the CBO Director or Business Office Manager , you will be responsible for payment collection and reimbursement. **What you… more
- Covr Financial Technologies (Houston, TX)
- POLICY SERVICES COORDINATOR REPORTS TO: Licensing & Customer Satisfaction Manager DEPARTMENT: Operations FLSA STATUS: Non-Exempt TRAVEL: None WORK SCHEDULE: M-F, may ... Our platform has processed close to $5 billion in claim benefits for end-consumers. Covr's platform provides a simpler...required + Insurance-related certifications (eg, Life & Health licenses) preferred , but not required + 2+ years of experience… more