- Elevance Health (Grand Prairie, TX)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new...Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4… more
- Amentum (Austin, TX)
- …global insurance programs (property, casualty, cyber, D&O, aerospace, marine, professional , etc.), including annual renewals, broker engagement, and carrier ... appropriate insurance coverage and risk mitigation strategies. + Lead complex claims management, including litigation strategy and resolution in coordination with… more
- Molina Healthcare (San Antonio, TX)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other...Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified Professional in… more
- Mass Markets (El Paso, TX)
- …and provide accurate solutions. + Use internal systems to manage accounts, process claims , and update records. + Follow scripts and procedures to ensure compliance ... place for you. Apply today! PHYSICAL REQUIREMENTS This job operates in a professional office environment. While performing the duties of this job, the employee will… more
- Sedgwick (Bedford, TX)
- …Are you looking for an impactful job that offers an opportunity to develop a professional career? + A stable and consistent work environment in an office + A ... benefits package to take care of your mental, physical, financial and professional needs **PRIMARY PURPOSE OF THE ROLE:** To supervise Specialized Services… more
- Allied Universal (Dallas, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... Time Off** **!** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation,… more
- Kemper (San Antonio, TX)
- …believe a high-performing culture, valuable opportunities for personal development and professional challenge, and a healthy work-life balance can be highly ... sales partners along with other internal partnerships like product, marketing, and professional development. + Coordinates and delivers new and on-going training on… more
- UNUM (Austin, TX)
- …Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to… more
- Houston Methodist (Katy, TX)
- …**FINANCE ESSENTIAL FUNCTIONS** + Follows up on assigned delinquent insurance claims . Ensures maximization of collection dollars from insurance companies in ... and application of positive language principles + Extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers… more
- Mass Markets (Killeen, TX)
- …using internal systems and team collaboration + Document customer interactions and claims accurately + Follow scripts, policies, and compliance procedures + Handle ... place for you. Apply today! PHYSICAL REQUIREMENTS This job operates in a professional office environment. While performing the duties of this job, the employee will… more