- Kelsey-Seybold Clinic (Pearland, TX)
- …meet work standards and performance measures for this position **Job Title: Claims Processing Specialist ** **Location: Pearland Administrative Office** ... laws and regulations governing Medicare billing practices, medical billing systems, and claims processing . Preferred: IDX/EPIC, PC skills, and understanding of… more
- CVS Health (Austin, TX)
- …+ Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. + Applies medical necessity guidelines, ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- Sedgwick (Austin, TX)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Specialist Sr - Commercial Coverage Specialist **PRIMARY PURPOSE** ... **:** To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature and/or severe injury claims ; to… more
- Molina Healthcare (Houston, TX)
- …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific positions only_ )… more
- Mass Markets (Killeen, TX)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... in the industry. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong critical thinking skills,… more
- CVS Health (Austin, TX)
- …Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity ... every day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a… more
- Allied Solutions (Plano, TX)
- …Loss, GAP, CPI and others as assigned. This position will involve the initial processing and investigation of 20-40 claims per day. This position ensures that ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...insurance/recovery claim experience as a Claim Processor or Claim Specialist with a minimum of 9 months to 2… more
- Cognizant (Austin, TX)
- … processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate ... * 1 year of Facets experience. * Experience in the analysis and processing of claims for payments, utilization review/quality assurance procedures. * Must… more
- Elevance Health (Houston, TX)
- …+ Requires a HS diploma or equivalent and minimum of 4 years claims processing and/or customer service experience; or any combination of education ... **Financial Operations Recovery Specialist Lead** **Location:** _Hybrid1:_ This role requires associates...higher level degree preferred. + Leadership experience in a claims processing environment preferred Please be advised… more
- UTMB Health (Galveston, TX)
- … 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 ... Patient Account Specialist - Revenue Cycle PB Billing & Denials **Galveston,... claims . Identifies billing issues affecting hospital and/or physicians claims… more
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