- WALGREENS (Austin, TX)
- …pharmacy errors and the Continuous Quality Improvement Program. * Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. * Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational… more
- NTT DATA North America (Plano, TX)
- …inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims processing to join our team in Plano, Texas (US-TX), United ... these roles you will be responsible for: Review and process insurance claims . Validate Member, Provider and other Claim's information. Determine accurate payment… more
- Molina Healthcare (TX)
- …or legal requests. * Assists with reducing rework by identifying and remediating claims processing issues. * Locates and interprets claims -related regulatory ... claims using standard principles and applicable state-specific regulations to identify claims processing errors. * Applies claims processing … more
- Elevance Health (Grand Prairie, TX)
- …I :** Requires a HS diploma or GED and a minimum of 3 years of claims processing experience; or any combination of education and experience which would provide ... ** Claims Auditor I, II and Senior** **Location :**...or GED and a minimum of 5 years of claims processing experience including a minimum of...a minimum of 5 years of claims processing experience including a minimum of 1 year related… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Claims Analyst is responsible for claims processing , research and adjudication to correctly apply benefit determination and pricing for ... Rx-drug claims (CMS 1500 and UB04), in accordance with claims processing guidelines. **ESSENTIAL FUNCTIONS OF THE ROLE** Processes and adjusts professional… more
- Molina Healthcare (TX)
- …Department of Health and Human Services (DSHS) and Medicare billing guidelines, Molina claims processing policies and procedures, and other resources to validate ... application. * Follows department processing policies and procedures including, claims processing (claim reversals and adjustments), claim recovery (refund… more
- NTT DATA North America (Plano, TX)
- …DATA and for the people who work here. NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client. **NOTE** : This is a US ... fee schedule **Requirements:** + 3 year(s) hands-on experience in **Healthcare Claims Processing ** + **In-depth, hands-on, practiced experience processing… more
- NTT DATA North America (Plano, TX)
- …methodology/ fee schedule/ Required Skills for this role include: + 2 years of healthcare claims processing (full cycle: Pay, Pend, Deny) + 2 years using a ... new software tools + High school diploma or GED. Preference + Experience processing claims in Amisys or Xcelys is a plus. + Ability to communicate (oral/written)… more
- Highmark Health (Austin, TX)
- …the department. + Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special ... is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various… more
- Molina Healthcare (Dallas, TX)
- …with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. ... JOB DESCRIPTION Job Summary Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching,… more
