- Deloitte (Dallas, TX)
- …pricing studies + Implement competitive vendor search and selection initiatives + Review of health plan renewals including assisting in rate negotiation, and ... medical and pharmacy + Prepare financial projections and rate development + Review health plan performance, including reviewing policy year settlements and premium… more
- Methodist Health System (Dallas, TX)
- …maintaining organized employee files. + Proactively manage and process FMLA/LOA claims across the organization, ensuring compliance with Methodist policies and ... federal regulations, regularly updating the payroll team, and maintaining accurate records in Workday HCM. + Perform post/pre-tax and dependent audits (ages 19-26) for all benefit plans each month to ensure accuracy and compliance. + Prepare and transmit COBRA… more
- Valero (Houston, TX)
- …Hourly Employees Monthly Reports. * Responds in writing to unemployment claims , provides employment verifications, and completes mortgage application forms. * Issues ... card at all times while working at the refinery. Please review eligibility criteria athttps://www.tsa.gov/for-industry/twic. Position level and salary will be… more
- Kemper (Dallas, TX)
- …to our stakeholders that delivers on our promises._ **Position Summary:** Our Claims Litigation Specialist will investigate, evaluate and handle to conclusion ... all assigned litigated claims . The Litigation Specialist will have advanced...FL, and Henderson, NV **Position Responsibilities:** + Ability to review loss facts, including legal pleadings and new suits… more
- Elevance Health (Houston, TX)
- …is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and ... issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines… more
- Elevance Health (Grand Prairie, TX)
- …clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will ... make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims and ... **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with revenue integrity teams to review provider services and provide effective education and feedback. Coordinates… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …to ensure compliance with federal/state laws and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure ... processes. + Reviews, assesses and analyzes medical records, coding, billing, claims , reimbursements and workflow processes to ensure accuracy, completeness, and… more
- TEKsystems (Dallas, TX)
- Medical Biller - Healthcare Claims Specialist Location: Hybrid in Dallas, TX (In-office Tues-Thurs, Remote Mon/Fri) Employment Type: Contract-to-Hire Expected ... identifying root causes and recommending prevention strategies. + Route uncollectible claims to appropriate queues (Financial Patient Responsibility Review or… more
- Banner Health (TX)
- …accurate coding based on documentation for positive outcomes. 5. Performs ongoing audits/ review of inpatient and/or outpatient medical records to assure the use of ... coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple… more