- Molina Healthcare (Houston, TX)
- JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
- CVS Health (Austin, TX)
- …representatives that are responsible for contacting payers to collect on unpaid claims in a timely and accurate manner, researching and resolving payment variances, ... and managing the accurate and timely filing of claims within payer function group. **Additional responsibilities of the Accounts Receivable Supervisor include:** +… more
- Kelly Services (Coppell, TX)
- …Medicaid, HMO, PPO, and third-party plans. + Communicate with patients regarding coverage, billing concerns, and payment options. + Submit and follow up on prior ... authorizations and clean claims . + Process referrals and ensure documentation is complete...accurate. + Enter and maintain accurate demographic, insurance, and billing information. + Identify and correct front-end billing… more
- Oracle (Austin, TX)
- …grow your career in this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical inputs to engineering for ... clinical validation) to lead the appeals initiative to review denied claims , create write-ups for appeals packets, identify trends/improvement opportunities to… more
- Molina Healthcare (Dallas, TX)
- …abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions only_ ) * Prepares, tracks ... to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of...days of error issuance. * Evaluates the adjudication of claims using standard principles and state specific policies and… more
- HCA Healthcare (Plano, TX)
- …relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims . This job requires regular outreach to payors and Practices. **In ... Benefits (EOB) information + Update patient accounts as appropriate + Submit uncollectible claims for adjustment timely and correctly + Resolve claims impacted… more
- KPH Healthcare Services, Inc. (Longview, TX)
- …balances. **Responsibilities** + Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other responsible ... written correspondence. + Investigate and resolve denied or partially paid claims , identifying root causes and implementing corrective actions. + Collaborate with… more
- Prime Healthcare (Farmers Branch, TX)
- …self-pay to Medicaid and other programs approval and conversion Billing /Collections: analyze, through large datasets, unusual billing /collection trends ... identify opportunities for process improvement and reimbursement optimization. Complex Claims Management:identifies, trends, and owns portfolios of complex claims… more
- System One (Frisco, TX)
- …a key part in maintaining the clinic's financial health by managing billing , coding, and reimbursement processes. If you're passionate about accuracy, compliance, ... on provider documentation. + Prepare, submit, and track electronic and paper claims to insurance carriers; post payments, adjustments, and refunds accurately in the… more
- Sedgwick (Houston, TX)
- …and government entities. The auditor will apply client specified billing guidelines and/or Generally Accepted Principles and Standards ("GAPS"). **ESSENTIAL ... RESPONSIBILITIES** + Ability to understand and apply clients' billing guidelines and standards. + Work with client to develop or enhance billing protocol. +… more