- Sedgwick (Austin, TX)
- …vehicle tear down + Determine repair time allotments and required labor operations + Makes accurate repair/replace decisions + Assess and applies pre-existing ... with information regarding their vehicle's cost of repair estimate and explains claims /repair process + Maintains accurate vehicle's cost of repair estimate and… more
- CDM Smith (San Antonio, TX)
- …Smith is seeking a Forensic Accounting Specialist with expertise in disaster fraud claims . This role is critical in evaluating and analyzing financial data related ... to disaster-related claims , including property damage, business interruption, and other loss...of the disaster on the applicant's assets, inventory, and operations . * Expert Testimony and Litigation Support: In cases… more
- Evolent (Austin, TX)
- …into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant ... findings. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate raw unadjudicated claims data.… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …activities, including patient transport, Special Mode Travel, mileage reimbursement claims , transportation contracts, 911 ambulance claims , inter-facility ... including patient transport, Special Mode Travel (SMT), mileage reimbursement claims , transportation contracts, 911 ambulance claims , inter-facility transfers,… more
- Molina Healthcare (Fort Worth, TX)
- …CMS timelines. 2. Workflow Integration - Embed CTM insights into downstream operations -Stars, appeals & grievances, enrollment, claims -so each team addresses ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- TEKsystems (Addison, TX)
- …Job Description: This position involves accurately coding anesthesiology procedures, submitting claims , and ensuring compliance with coding and billing regulations * ... * Apply appropriate modifiers for precise coding. * Generate and submit claims promptly. * Verify patient insurance information and resolve discrepancies. * Address… more
- Omnicell (Fort Worth, TX)
- …forms and documentation. . Communicate any issues that may arise, including claims disputes. . Oversee development and communication of customer reports. . Partner ... the design of necessary accounting protocols for submission of payment and claims posting activities. . Quickly and accurately answer customer questions; route… more
- Baylor Scott & White Health (Dallas, TX)
- …and civil litigation matters. Reporting to the system Vice President overseeing claims for Baylor Scott & White Health (BSWH). The Director-Assistant General Counsel ... on legal, regulatory, and risk management matters. Applies understanding of daily operations of BSWH acute care hospitals, clinics, and affiliates. + Manages and… more
- Prime Therapeutics (Austin, TX)
- …Solution Strategist for our NEW JUDI program. If you have experience with PBM/health claims , love working in a fast-paced environment within a group that has a ... **Responsibilities** + Oversee one strategic initiative in partnership with Operations and/or IT + Collaborate with cross-functional stakeholders to advance… more
- Molina Healthcare (TX)
- …with Customer/Member services, Provider Services, Sales, Enrollment, UM, Case Management, Claims , and other departments within Molina Medicare and Medicaid regarding ... A&G operations and dependencies. * Responsible for the A&G department...experience **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, including… more