- Elevance Health (Grand Prairie, TX)
- …associated with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies ... prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses...investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations. + Collaborates… more
- Elevance Health (Houston, TX)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...interventions such as recovery of overpayment, pre-payment audit of claims or putting providers on notice. + Assists with… more
- DR Horton, Inc. (Arlington, TX)
- …paper files for claims and lawsuits * Assist with the review of billing for defense of claims *Required Qualifications * Bachelor's degree from four-year ... following. Other duties may be assigned. * Research background of claims * Monitor status of claims and update litigation database * Gather information needed to… more
- Sanofi Group (Dallas, TX)
- …procurement as it relates to medical payer policy requirements, buy & bill processes, billing and coding education, claims and adjudication by site of care, ... matter expert relating to product procurement, buy & bill processes, billing and coding, financial assistance offerings, patient support, access, payer medical… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …in planning, developing and implementing computer applications, upgrades to coding and billing systems, dictionary databases, claims submission, and other bolt ... clinical Department administrators, physicians/providers, hospital partners/administration, third party intermediaries, billing staff, PFS, and patients. + Initiate researches topics… more
- Highmark Health (Austin, TX)
- …for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead ... bank receipts, checks, invoices, amounts, group numbers, etc., using the Billing system, Maintenance of bank lockbox accounts, Developmentand analysis of aging… more
- CVS Health (Austin, TX)
- …benefit business environment. + Respond to customer benefits questions, and clarifications on billing , eligibility, and claims processes. + Retain and grow the ... client relationship and effectively position our products with an emphasis on expanding our book of business. **Required Qualifications** + 2-5 years industry experience, with experience in Self- funded customers preferred. + Customer service experience,… more
- ADP (El Paso, TX)
- …changes. + Resolution support for benefit service issues such as enrollments, carrier billing , coverage, and claims . + Maintain accurate and up-to-date records ... of all client interactions, benefits plans, and compliance documentation. + **Client Retention:** + Maximize client retention by working with clients, carriers, and external ADP partners to resolve issues that may impact the client relationship. + You will… more
- Methodist Health System (Dallas, TX)
- …seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing to join our team at our Central Business Office (CBO) location. ... background in A/R follow up for family and specialty claims , able to identify, address, and resolve no response...in healthcare revenue cycle management. - Proficiency in medical billing software EPIC and electronic health record (EHR) systems.… more
- Highmark Health (Austin, TX)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... hospital or health insurance setting + 1 year in professional billing , facility Patient Financial Services, HIM, Internal Audit, Professional/Facility Reimbursement… more