- Elevance Health (Grand Prairie, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… more
- UTMB Health (Galveston, TX)
- …rejections from billing system daily to bill submit hospital and/or physicians' claims * Performs online corrections to edited claims according to procedures ... 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 … more
- Humana (Austin, TX)
- …cost reduction, by increasing the accuracy of provider contract payments in our payer systems , and by ensuring correct claims payment for appropriate CPT/ HCPCS ... cost reduction, by increasing the accuracy of provider contract payments in our payer systems , and by ensuring correct claims payment for appropriate CPT/ HCPCS… more
- USAA (San Antonio, TX)
- …guidelines and framework, protects USAA and our members from potential fraudulent claims by investigating questionable, suspect claims activity in compliance ... on any questionable or suspect first or third part claims . + Participates in the development of fraud prevention...extract data for analysis from relevant data sources and systems . + Knowledge of city, state and local regulations,… more
- CVS Health (Irving, TX)
- …will be responsible for designing, developing, and implementing digital solutions and systems . This role requires technical expertise to architect and code software ... applications, perform system testing and debugging, collaborate with cross-functional teams, and...and other IT partners. As part of the AT Claim Organization, you will be responsible for code deliverables… more
- Elevance Health (Grand Prairie, TX)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + ...required with understanding of health insurance policies, health insurance claims handling and provider network contracting. + Develops and… more
- Cardinal Health (Austin, TX)
- …Collections, is responsible for the timely follow-up and resolution of insurance claims . This role ensures accurate and efficient collection of outstanding balances ... insurance companies via phone, portals, or email to check claim status, request reprocessing or escalate issues. + Analyze...payment. + Document all collection activities in the billing system according to departmental procedures. + Follow up on… more
- Travelers Insurance Company (Austin, TX)
- …Imagine loving what you do and where you do it. **Job Category** Claim **Compensation Overview** The annual base salary range provided for this position is ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical environment… more
- Robert Half Accountemps (Houston, TX)
- …be a standard 8am - 5pm schedule. + Review, analyze, and interpret medical claim denials from insurance companies. + Investigate root causes of denials and work to ... + Communicate professionally with payers to gather needed information and negotiate claim resolution. + Collaborate with providers, coders, and revenue cycle staff… more
- The Hartford (San Antonio, TX)
- …helping people? Then you belong here. We currently have an excellent claims professional career opportunity available. Join our Short-Term Disability and Absence ... Disability Team. The Short-Term Absence Management Disability Analyst quickly investigates claims to determine if the insured person qualifies for short-term /… more
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