- Evolent (Austin, TX)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Robert Half Legal (Richardson, TX)
- …you. Responsibilities: * Manage and oversee legal cases assigned by the Claims Department, ensuring timely and effective handling. * Develop comprehensive case ... pleadings, briefs, and memorandums. * Prepare and deliver regular status reports to claims handlers, ensuring updates occur at least every 60 days or as significant… more
- BrightSpring Health Services (San Angelo, TX)
- …personnel costs, consultant services, etc + Monitors worker's compensation and unemployment claims for assigned service site(s) + Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas + Other duties as assigned Qualifications + BA/BS in Business, Health Care Administration, or Social… more
- PulteGroup (Coppell, TX)
- …determine insurability of real estate transactions and minimize exposure arising from claims on policies issued by Premier and the other title underwriters. Support ... with significant national/multi-state title underwriting experience and some title claims , general litigation, general corporate and title/insurance regulatory experience;… more
- Highmark Health (Austin, TX)
- …leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , and clinical data to uncover hidden patterns, propagate insights ... to prototype. + **Healthcare Data Familiarity:** Understanding of healthcare data domains ( claims , clinical, EMR) and related ontologies or standards (eg, SNOMED CT,… more
- Insight Global (San Antonio, TX)
- …assigned MRO for technical matters, delivery schedules, invoice discrepancies, warranty claims , and disposition of airline-owned materials. * Maintains and applies ... and accurate records of discrepancies to support requests for procedural changes and claims for charge adjustments. * Maintains a thorough working knowledge of the… more
- Sedgwick (Austin, TX)
- …for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The ... advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With… more
- Walgreens (Cypress, TX)
- …and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), ... for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims . + Completes execution of all pricing activities including price changes,… more
- Adecco US, Inc. (Irving, TX)
- …access and reimbursement barriers. + Manage benefit investigations, prior authorizations, claims escalations, and appeals. + Deliver payer insights and education on ... insurance, and specialty pharmacy. + Experience with prior authorizations, claims processing, and appeals. + Strong communication, presentation, and organizational… more
- TEKsystems (Plano, TX)
- …and denials, ensuring timely resolution and follow-up. + Process approximately 15-40 claims per day, depending on volume. + Support collections efforts by ... identifying and addressing outstanding claims . + Ensure compliance with all applicable regulatory guidelines, payer policies, and internal procedures. + Collaborate… more