- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …and implementing procedures to ensure that the business units quality management and compliance program are effective and efficient in identifying, detecting, ... Systems and Risks will be reported periodically to Senior Management through the Management Review process to...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Prime Therapeutics (Austin, TX)
- …including such items as assurance of Service Level Agreement performance in Care Management Centers and Shared Services, assurance of claims accuracy payment/ ... cost solutions that meet the desired outcomes of the customer; general management of the account, including P&L responsibility; and accountability for contract… more
- Zurich NA (Addison, TX)
- …Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate ... and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- NTT DATA North America (Plano, TX)
- …Texas (US-TX), United States (US). Roles and Responsibilities: * Process Adjudication claims and resolve for payment and Denials * Knowledge in handling ... authorization, COB, duplicate, pricing and corrected claims process * Knowledge of healthcare insurance policy concepts including in network, out of network… 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 ... + Maintains accuracy and quality standards as established by audit management . + Identifies potential documentation and coding errors by recognizing aberrant… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …Clerk/Coder to assign procedure, and diagnosis codes for insurance billing, review claims data, research, and correspond with insurance companies to obtain accurate ... reimbursement for healthcare claims . This person will also be responsible for analyzing,...regulations, policies, procedures, etc. + Ability to apply time management practices to prioritize, schedule and complete work effectively… more
- Carrington (Plano, TX)
- …completes the Set-up bankruptcy filings process, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of Final Cures, Post-Petition ... processes for the set-up bankruptcy filings, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of Final Cures, Post-Petition… more
- Sedgwick (Irving, TX)
- …and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices. **ARE YOU ... and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Establishes FMLA claims ; tracks and codes documentation in accordance with internal workflow… more
- Zurich NA (Houston, TX)
- …Diploma or equivalent and 10 or more years of experience in the claims or underwriting support areaOR + Zurich approved Apprenticeship program including an associate ... and 8 or more years of experience in the Claims or Underwriting Support area. + Knowledge of Microsoft...property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. We… more
- Molina Healthcare (Fort Worth, TX)
- …you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners ... toward durable fixes, and convert disciplined CTM management into Stars gains, audit readiness, and measurable member-experience improvements. You'll begin as a… more