- Cardinal Health (Austin, TX)
- …done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as ... and support from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow-up &… more
- Molina Healthcare (San Antonio, TX)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... Analysis** + Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Applies understanding of… more
- CVS Health (Austin, TX)
- …heart, each and every day. **Claim Benefit Specialist** Reviews and adjudicates claims in accordance with claim processing guidelines. Claim Benefit Specialists have ... by providing accurate and timely resolution in processing medical claims . You will be a key link in providing...screens to obtain and record claim information + Review claims information to determine the nature of a member's… more
- Sedgwick (Houston, TX)
- …work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of all ... claims to ensure information substantiates disability. + Provides clear...and appropriate follow-up recommendations for ongoing medical management of claims ; ensures appropriate recommendations are made on claims… more
- Methodist Health System (Dallas, TX)
- …cycle management, with a particular emphasis on addressing and resolving no response claims , rejected or denied claims , and managing correspondence. This role ... medical billing, or medical reimbursement Proven experience in managing no response claims , denied claims , and billing correspondence. Knowledgeable with payors;… more
- Molina Healthcare (Dallas, TX)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... Analysis** + Use a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. + Apply understanding of… more
- Allied Universal (San Antonio, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... Investigations Unit (SIU) Investigator. Special Investigations Unit (SIU) Specialists investigate claims with red flags that suggest fraudulent behavior In relation… more
- Zurich NA (Austin, TX)
- …investigates, evaluates, and concludes low exposure, low complexity, mechanical breakdown claims by following established protocols to ensure that claims ... handled in the most efficient, effective way while delivering a customer-centric claims service. Determines causes of failures and reviews specific contract language… more
- Southland Holdings (Grapevine, TX)
- …strategic thinking, and problem-solving skills. The manager supports dispute resolution, claims , and contract compliance, serving as a trusted advisor to business ... responses. + Draft formal contract correspondence, including notices and claims , to protect company entitlements. + Collaborate with scheduling and… more
- CVS Health (Austin, TX)
- …and key litigation activities. + Utilizing legal skills to oversee and manage claims against CVS from the initiation of suit through resolution. + Managing all ... etc. **Preferred Qualifications** + Experience overseeing or defending product liability claims and litigation. + Familiarity or experience with insurance and… more