- Elevance Health (Grand Prairie, TX)
- …and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and ... in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies,… more
- Allied Universal (San Antonio, TX)
- …Law Associate (FCLA) + Fraud Claim Law Specialist (FCLS) + Certified Protection Professional (CPP) + Associate in Claims (AIC) + Chartered Property Casualty ... Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services....consulting projects, and other assignments as directed + Produce professional and expert reports, memos, and letters that are… more
- Evolent (Austin, TX)
- …administration, epidemiology, public health, biology) + At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider, ... or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and… more
- Zurich NA (Dallas, TX)
- Senior Professional Liability Underwriter 125023 Zurich is seeking an experienced Construction Professional Liability Underwriter, (Mid-Level II or Sr Level III) ... role will be filled at either the Mid-Level Construction Professional Liability Underwriter (Level II), or Sr. Construction Property...and 6 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Zurich NA (Houston, TX)
- AVP, Construction Professional Liability Underwriter 125133 Zurich North America is hiring an AVP, Construction Professional Liability Underwriter, (AVP Level IV ... role will be filled at either the AVP, Construction Professional Liability Underwriter or VP, Construction Professional ...and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Humana (Austin, TX)
- …determining objectives and approaches to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from ... and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of… more
- Elevance Health (Grand Prairie, TX)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- Humana (Austin, TX)
- …community and help us put health first** The Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of ... improvements of encounter submission processes. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions… more
- Humana (Austin, TX)
- …community and help us put health first The Encounter Data Management Professional will conduct research and analysis to execute accurate, timely, and completeness ... of DSNP encounter submissions. Encounter Data Management Professional will have comprehensive knowledge of processes, policies and...Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of… more
- Humana (Austin, TX)
- …determining objectives and approaches to assignments. The Senior Encounter Data Management Professional ensures data integrity for claims errors. The Senior ... and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of… more