- Molina Healthcare (Houston, TX)
- …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- CVS Health (Irving, TX)
- …operations - especially where healthcare intersects with global partnerships, claims processing , third-party relationships and government affiliated entities. ... Government, Business Compliance Office (BCO), Legal, Network Team and Claims Processing Team to standardize due diligence process for international third-party… more
- Highmark Health (Austin, TX)
- …**EXPERIENCE** **Required** + 5 years of relevant, progressive experience in health insurance claims + 3 years of prior experience processing 1st dollar health ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Mass Markets (Dallas, TX)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... to support inbound customer service, technical support, and back-office processing representatives for commercial and public sector support positions. In… more
- Mass Markets (Killeen, TX)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... service representatives to support inbound customer service, help desk, and back-office processing for commercial and public sector support positions. In this role,… more
- Mass Markets (Dallas, TX)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... support inbound customer service, help desk, technical support, and back-office processing representatives for commercial and public sector positions. In this role,… more
- Health Care Service Corporation (Richardson, TX)
- …abilities and sound decision-making. *Knowledge of contracts, applications and products; claims processing systems. *Knowledge and experience in provider ... providers; and acting as liaison with providers through education, training, claims assistance and ongoing provider service. Required Job Qualifications: *Bachelor… more
- Actalent (Dallas, TX)
- …care (call center, appeals, or claims ) + Experience in health claims processing , coordination of benefits, and eligibility + Familiarity with Medicaid ... disputes, grievances, and complaints. + Use internal systems to determine outcomes of claims appeals and grievances. + Review medical records and billing details to… more
- Highmark Health (Austin, TX)
- …+ High school diploma or GED + Experience in pharmacy prescription claims processing /submission/payment. **Preferred** + Associate degree + Pharmacy technician ... completely in the appropriate systems. + Monitor member medication adherence through claims data analysis and other available resources. + Identify and resolve… more
- Molina Healthcare (TX)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
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