- Humana (Austin, TX)
- …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates… more
- Cardinal Health (Austin, TX)
- …is responsible for verifying patient insurance and benefits, preparing and submitting claims to payers, correcting rejected claims , following up on unpaid ... insurance providers + Researching and appealing denied and rejected claims + Preparing, reviewing, and transmitting claims ...experience as a Medical Biller or within Revenue Cycle Management preferred + Strong knowledge of Microsoft Excel +… more
- Sedgwick (Irving, TX)
- …and voicemails from claimants, providers, clients, attorneys, etc., resolving their claims related questions and issues in accordance with designed guidelines and ... policies. + Communicates claims status and current claim activity with client and...a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change… more
- Highmark Health (Austin, TX)
- …the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. + Conduct research beyond medical policy ... review to make decisions on medication coverage requests. + Other duties as assigned. **EDUCATION** **Required** + Bachelor's degree in Pharmacy **Substitutions** + None **Preferred** + Doctorate degree in Pharmacy **EXPERIENCE** **Required** + 1 - 3 years in… more
- Molina Healthcare (San Antonio, TX)
- …Certified Professional in Healthcare Quality (CPHQ) or other health care coding or management certification. 2+ years in claims auditing, QA, or recovery ... Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review experience. Knowledge in coding: DRG, ICD-10, HCPCS codes is… more
- WestRock Company (Houston, TX)
- …Health & Safety KPI\u2019s for the plant and provide monthly reports to Management * Manage Workers Compensation claims , working on recommendations for claim ... facility. How you will impact Smurfit Westrock: * Work closely with plant management and local safety personnel to address Environmental, Health & Safety issues and… more
- Sysco (Houston, TX)
- …administration and control of all maintenance related repair warranty claims (including Fleet, Material Handling Equipment) across different Sysco maintenance ... third-party suppliers. The role also includes directing investigations into potential warranty claims to seek possible credits from the manufacturer. The role also… more
- AON (Houston, TX)
- …creatively. Position is multi-faceted centered on client services, broking, account management , analytics, QA/QC and financial responsibilities. This is a hybrid ... responsibilities touch on invoicing, routine reconciliations and transactions, collateral management and reporting, monitoring loss sensitive programs including complex… more
- Aston Carter (Mckinney, TX)
- …categorized by Independent Sales Representatives. This role involves resolving pricing claims and deductions by validating customer debit memos against system ... working with QC, Shipping, and Sales teams to address claims and arrange returns when necessary, and issuing credit/debit...and debit memos. + Extremely organized with excellent time management skills. + Strong team player who assists team… more
- WTW (Houston, TX)
- **Description** As a Medical Claim Lead Auditor, you will apply your audit, project management and client management skills to lead client audits. You will serve ... administrators. You will review discrepancy issues identified by field auditors, re-adjudicate claims , resolve open issues, and draft the final report. You will… more