- HUB International (Argyle, TX)
- …Provides benchmarking reports to client (annually, quarterly or monthly) + Manages claims and coverage issue resolution for clients' employees when elevated from HR. ... these audits for clients independently if not handled or escalated by Account Administrator + Advises and guides clients in compliance matters and sends monthly… more
- HUB International (Fort Worth, TX)
- …Provides benchmarking reports to client (annually, quarterly or monthly) + Manages claims and coverage issue resolution for clients' employees when elevated from HR. ... these audits for clients independently if not handled or escalated by Account Administrator + Advises and guides clients in compliance matters and sends monthly… more
- Elevance Health (Houston, TX)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... submitted DRG. **How you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in… 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
- Canon USA & Affiliates (Austin, TX)
- …and review of collaterals for clinical accuracy and adherence to clinical claims . Effectively interacts with multiple teams including R&D, global and local business, ... expertise, and reviewing study/test-plan design. Influence regulatory specifications and claims strategy by providing clinical consultation during early phase… more
- Elevance Health (Grand Prairie, TX)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …and accreditation standards. + Monitor and update policies to align with evolving regulations. Claims & Revenue Cycle Support + Review claims data to ensure ... coding and documentation meet payer requirements. + Resolve denied claims through research and collaboration with providers and payers. + Utilize specialized… more
- UIC Government Services and the Bowhead Family of Companies (San Antonio, TX)
- …+ Sr. Systems Engineer + Cable and Wire Specialist + Systems Administrator + Video Telecommunication Specialist + Information Assurance Engineer + Information ... and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual… more
- Baylor Scott & White Health (Dallas, TX)
- …facilitates and support pricing and repricing activities for various third-party administrator (TPA) platforms. The leader will collaborate regularly with Health ... to ensure consistency between contract terms and adjudication of authorizations and claims . - Plays a critical role in overseeing pricing and repricing exercises… more
- Raymond James Financial, Inc. (Houston, TX)
- …to a more senior officer as an Associate Trust Officer/Trust Administrator during the development process. **Essential Duties and Responsibilities:** . Reads ... records for annuity contracts and life insurance held in Trust. . Files death claims on annuity, life and pension contracts as necessary. . Secures and confirms… more