- Covenant Health (Lubbock, TX)
- **Description** ** Claims Appeals Representative ** **Works collaboratively with Case Management (CM) Leadership, Case Managers (CM), Complex Discharge ... 3 or more years of experience in managed care claims / reimbursement setting or experience working in another other...1 or more years of experience in managed care claims / reimbursement + 1 or more years of… more
- Texas Veterans Commission (Midland, TX)
- …rulings, and state law in the adjudication process. . Prepares and files claims and appeals with supporting evidence for successful adjudication. . Advises ... Financial Operations* **Organization:** **TEXAS VETERANS COMMISSION* **Title:** *TVC - Claims Benefit Advisor (Veterans Services Representative I)* **Location:**… more
- Guidehouse (Lewisville, TX)
- …San Antonio office and three days from home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + ... **Job Family** **:** Patient Account Representative **Travel Required** **:** None **Clearance Required** **:**...+ 1+ year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims… more
- Houston Methodist (Houston, TX)
- …functions, including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity or ... At Houston Methodist, the Account Representative position is responsible for resolving all outstanding third party primary and secondary insurance claims for… more
- Cardinal Health (Austin, TX)
- …as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and accurate ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Molina Healthcare (TX)
- …+ Provides coordination and processing of pharmacy prior authorization requests and/or appeals . + Explains Point of Sale claims adjudication, state, NCQA, ... member and providers with initiating oral and written coverage determinations and appeals . + Records calls accurately in call tracking system. + Maintains specific… more
- Caris Life Sciences (Irving, TX)
- …Receivable Specialist is responsible for reviewing and resolving outstanding denied claims with Medicare, Medicaid and Commercial insurance companies. This included ... following up on claims statuses, researching rejections and denials, handling medical records...rejections and denials, handling medical records request and submitting appeals within the timely filing. **Job Responsibilities** + Review… more
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