- VetsEZ (TX)
- …care teams, payers, and providers to improve how patients experience care, how claims are processed, and how care coordination is managed across the continuum. By ... we enable smarter decisions, seamless patient engagement, and more efficient claims management. Together, we are shaping a healthcare ecosystem that delivers… more
- Highmark Health (Austin, TX)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly… more
- MD Anderson Cancer Center (TX)
- …of UB-04, including modifier logic, HCPCS/CPT codes, and revenue line code descriptions. * * Claims Processing * * Complete claims in daily billing work queues ... validate claim discrepancies. * Communicate with fiscal intermediary/MAC on claims issues. * Notify management immediately of all rejections or problems causing… more
- Molina Healthcare (San Antonio, TX)
- …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... maintain contract, benefit or reference table information into the claim payment system and other applicable systems. + Participates...**Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims … more
- UTMB Health (Galveston, TX)
- …Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or ... hospital claims . Identifies billing issues affecting hospital and/or physicians ...and takes necessary action to ensure timely and appropriate claim filing. Performs follow-up activities and identifies reimbursement issues… more
- UTMB Health (Galveston, TX)
- …Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or ... hospital claims . Identifies billing issues affecting hospital and/or physicians ...and takes necessary action to ensure timely and appropriate claim filing. Performs follow-up activities and identifies reimbursement issues… more
- Molina Healthcare (Houston, TX)
- …and test assumptions through data, and leads with contextual knowledge of claims processing , provider contracts, and operational realities. * Creates succinct ... all payment integrity (PI) solutions. * Independently leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial… more
- Molina Healthcare (Austin, TX)
- …Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to ... * Applies experience and knowledge to research and resolve claim /encounter issues and pended claims , and updates...updates/changes within a claims processing system. + Advanced experience validating… more
- Cardinal Health (Austin, TX)
- …reviewing, and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard ... for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following...and submitting claims to payers, correcting rejected claims , following up on unpaid and denied claims… more
- Kemper (Dallas, TX)
- …all activities for Accounts Payable, Billing, Escheatment, Travel & Entertainment Expense Processing , Vendor Processing , Payroll, Check Services, and 1099 ... input and advice as a subject matter expert across several topics including payment processing methods, NACHA Operating rules and Debit Card processing + Help… more