- Evolent (Austin, TX)
- …into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant ... findings. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate raw unadjudicated claims data.… more
- AON (The Woodlands, TX)
- …questions, and handling complaints for Debt Cancellation programs + Initiate benefits ( claims ) and process benefit related transactions as well as work cancellation ... inbound calls, top-notch experience based on client parameters. + Initiate benefits ( claims ) and process benefit related transactions as well as work cancellation… more
- Samsung SDS America (Plano, TX)
- …advanced supply chain solutions. As Junior Legal Counsel, you will focus on claims management and HR-related legal matters while also supporting contract review and ... other commercial agreements + Handle and manage transportation and cargo claims , including drafting demand letters, settlement agreements, and coordinating with… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …benefits, updating account information, correcting edits, performing follow up on unpaid claims , billing or re-billing claims to appropriate payer source and ... and navigation of insurance provider portals for verification of eligibility, benefits, claims status and appeals. **Campus:** HSC - El Paso **Department:** MPIP… more
- The Hartford (TX)
- …within a matrixed business environment where you will have direct interaction with Claims Partners and insureds, we want to speak with you! RESPONSIBILITIES: * ... of defense strategies with autonomy. * Partner with our Claims Partners to achieve the best results for our...Huddles. * Provide in-house training to junior associates and/or claims partners. * Participate in claims file… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims and ... FUNCTIONS** + Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes… more
- Sedgwick (Fort Worth, TX)
- …combination of education and experience required to include two (2) years of claims management, managed care or other related experience. **Skills & Knowledge** + In ... depth knowledge of claims management, managed care and/or absence management processes and...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Zurich NA (Addison, TX)
- …Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- BrightSpring Health Services (Lubbock, TX)
- …the pharmacy. + Identifies and resolves issues of denials or follow-up of claims . + Maintains current knowledge of Medicaid claim regulations and processes. + ... Produces reports and keeps management informed of unpaid claims and claims pending follow-up. + Understands all dispensing systems used in the pharmacy and their… more