- Molina Healthcare (San Antonio, TX)
- …pricing configuration, claim adjudication or reimbursement processes + Experience processing or reviewing facility claims + Prior professional experience ... vendor, operations, health plan representatives, and other business teams involved in claim processing . Maintains expertise in all forms of reimbursement… more
- Woodforest National Bank (The Woodlands, TX)
- …banks in the country! The Dispute Specialist I is responsible for investigating and processing debit card and/or ACH dispute claims , and Stop Payments, initiated ... banks policies and procedures. Key Responsibilities: . Research customer dispute claims by reviewing card transactions, account records and information provided by… more
- Elevance Health (Houston, TX)
- …within the enterprise. Included are processes related to enrollment and billing and claims processing , as well as customer service written and verbal inquiries. ... complex audits. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries,… more
- Molina Healthcare (San Antonio, TX)
- …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive… 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
- CVS Health (Irving, TX)
- …is accountable for CVS Health's Health Care Benefits division (Aetna) commercial claim processing and the surrounding ecosystem of commercial claim ... and other IT partners. As part of the AT Claim Organization, you will be responsible for code deliverables...experience in one or more of these areas: + Claim Adjudication + Claim Payment/Banking, Electronic Funds… more
- CVS Health (Irving, TX)
- …is accountable for CVS Health's Health Care Benefits division (Aetna) commercial claim processing and the surrounding ecosystem of commercial claim ... and other IT partners. As part of the AT Claim Organization, you will be responsible for code deliverables...experience in one or more of these areas: + Claim Adjudication + Claim Payment/Banking, Electronic Funds… more
- Schlumberger (Houston, TX)
- …contract requirements to subcontractors by reviewing identifying, highlighting, and processing . Manage flow downs across the different stakeholders through ... but not limited to contract compliance, change management and claim mitigation strategies. + Analyzing the basis and extent...+ Analyzing the basis and extent of change Tracking claims and monitoring progress through the claims … more
- Health Care Service Corporation (Richardson, TX)
- … auditing experience is a strong plus. + Knowledge of or experience with BlueChip claims processing is a strong plus. + Knowledge of quality review processes is ... The Audit Specialist Intern responsibilities may include assisting with claim accuracy audits and performance tracking of Administrative Services Only… more
- Robert Half Finance & Accounting (Dallas, TX)
- …individual will be responsible for supervising a team, ensuring timely and accurate processing of medical claims , and driving efficiency in the accounts ... functions. + Manage the preparation, submission, and follow-up of medical claims and billing activities. + Monitor cash applications, reconciliations, and payment… more