- PennyMac (Fort Worth, TX)
- …of homeownership through the complete mortgage journey. A Typical Day The Claims Supervisor is responsible for providing structure and oversight to the post-sale ... for the claim process including, filing all MI, investor, and insurer claims timely and accurately, providing all back-up as requested, and the reconciliation… more
- Ankura (Dallas, TX)
- …client delivery services across the firm . Ankura's Forensic Accounting and Claims Consulting (FACC) practice focuses on assisting corporations in the quantification ... and presentation of first party insurance claims as a result of a covered loss. Commonly...these insured losses, and then assists in the claim audit and settlement processes. Role Overview: Our Summer Internship… more
- Providence (TX)
- **Description** **Senior Claims Manager - Employment Practice Liability \*Remote * Candidates residing in Alaska, Washington, Montana, Oregon, California, Texas or ... New Mexico are encouraged to apply.** The Senior Claims Manager- Employment Practice Liability ("EPL") is responsible for...- they're invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused,… more
- TEKsystems (Addison, TX)
- Core Responsibilities 1. Heavy Research ( Audit & Analysis) + Execute vertical audits (multiple payers, same denial reason) to extract systemic underpayment trends. + ... requests. + Ensure timely and accurate generation of re-bills, prioritizing high-dollar claims when behind goal. 3. Follow-Up & Escalation + Conduct in-depth… more
- USAA (San Antonio, TX)
- …and Lean, business operations, risk management, quality assurance and control, or internal audit (in addition to the minimum years of experience required) may be ... substituted in lieu of degree. + 8 years business process execution/knowledge/experience, consulting, and/or process engineering/optimization. + 3 years of direct team lead, supervisory or management experience. + Experience leading and/or participating in… more
- Molina Healthcare (TX)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen....+ Assist in developing and refining internal SOPs and audit tools related to COB claim reviews. + Act… 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
- 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 ... coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of… more
- Molina Healthcare (San Antonio, TX)
- …and other guidance to assess compliance and support building regulatory compliance audit procedures. * At the direction of management, coordinates and performs ... with developing the Operational Oversight Work Plan, monitoring and reporting status of audit project tasks, and reporting on overall status of audit projects.… more
- Molina Healthcare (San Antonio, TX)
- …work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience, ... Duties** + Performs clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases, in which an appeal has been… more