- Elevance Health (Grand Prairie, TX)
- …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 ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- NTT America, Inc. (Houston, TX)
- …people who work here. NTT DATA, Inc. currently seeks a "TEMP BPO Senior Specialist **"** to join our team. **Client's business problem to solve?** Our client ... per the requirement and according to defined business rules of new claims processing platform. + Evaluation of Configuration Requirement and Formulation of… more
- Banner Health (TX)
- …coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple ... and progressively responsible coding experience required. Requires Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Professional… more
- Highmark Health (Austin, TX)
- …work will directly impact millions of lives. As our Lead Graph Intelligence specialist , you will be the spearhead of cutting-edge research projects. This means ... leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , and clinical data to uncover hidden patterns, propagate insights… more
- Adecco US, Inc. (Irving, TX)
- …access and reimbursement barriers. + Manage benefit investigations, prior authorizations, claims escalations, and appeals. + Deliver payer insights and education on ... insurance, and specialty pharmacy. + Experience with prior authorizations, claims processing, and appeals. + Strong communication, presentation, and organizational… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance with ... processes. + Reviews, assesses and analyzes medical records, coding, billing, claims , reimbursements and workflow processes to ensure accuracy, completeness, and… 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 ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
- Mass Markets (TX)
- …partner in the industry. We are seeking a Licensed Life and Health Insurance Specialist who will play a vital role in educating and guiding customers to select ... and retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and up-to-date… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …direct oversight of daily coding operations while also performing coding specialist functions. **Requisition ID:** 41973BR **Travel Required:** Up to 25% ... Provide direct oversight, training and guidance to assigned multi-specialty coding specialist teams. Coach, develop and make recommendations to the director… more
- Molina Healthcare (Fort Worth, TX)
- …activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors + Maintains professional and technical ... Association** + Certified Professional Coder (CPC) + Certified Coding Specialist (CCS) **Preferred Education** Bachelor's Degree in related field **Preferred… more