- Molina Healthcare (Austin, TX)
- …concisely, accurately and in accordance with regulatory requirements. * Researches claims processing guidelines, provider contracts, fee schedules and systems ... or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), subrogation… more
- Public Consulting Group (Austin, TX)
- …through claim issue research. Additional this position will assist in performing claims processing , medical record audits for all implemented agencies, and ... claim issue research. Additional this position will assist in performing claims processing , medical record audits for all implemented agencies, and assist with… more
- Texas Veterans Commission (Borger, TX)
- …of Veteran Affairs. . Knowledge of laws, rules, and regulations applicable to the processing of veterans' claims ; and of assessment techniques. . Fluent in ... Ability to interpret laws, rules, and regulations applicable to the processing of veterans' claims . . Ability to communicate effectively both orally and in… more
- Molina Healthcare (Austin, TX)
- …payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is ... experience **Required Experience** 5-7 years in SQL, Medicare, Networx, QNXT, claims processing and hospital claims payment method. **Preferred Education**… more
- UTMB Health (Galveston, TX)
- …Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or ... hospital claims . Identifies billing issues affecting hospital and/or physicians claims /accounts and takes necessary action to ensure timely and appropriate claim… more
- UTMB Health (Galveston, TX)
- …Account Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or ... hospital claims . Identifies billing issues affecting hospital and/or physicians claims /accounts and takes necessary action to ensure timely and appropriate claim… more
- Molina Healthcare (TX)
- …Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to ... updates/changes within a claims processing system. + Advanced experience validating and confirming information related to provider contracting, network… more
- Cardinal Health (Austin, TX)
- …as required, necessary, or appropriate. + Acts as a subject matter expert in claims processing . + Processes claims : investigates insurance claims ; ... administration customer and vendor pricing, rebates, billing (including drop-ships), processing chargebacks and vendor invoices and developing and negotiating… more
- DXC Technology (Plano, TX)
- …solutions across: + Policy administration (new business, underwriting, policy servicing) + Claims processing + Billing & payments + Customer experience platforms ... relationships with senior leaders across L&A customers, including Operations, IT, Claims , Actuarial, Distribution, Policy Admin, and Customer Experience. + Conduct… more
- Baylor Scott & White Health (Temple, TX)
- …pharmacy benefits, assist with understanding the prior authorization process, and resolve claims processing and eligibility issues while adhering to department ... THE ROLE** Helps members by phone or in writing to effectively resolve claims processing issues for all Health Plan products, utilizing pharmacy claims … more