- Elevance Health (Grand Prairie, TX)
- …week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office ... abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines...prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses… more
- Elevance Health (Grand Prairie, TX)
- …week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office ... in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies,… more
- Stantec (Plano, TX)
- …System selection to be based on Project/Client needs as well as proactive Claims /Risk mitigation. - Oversee and approve development and management of the Project ... written communications, including Change notifications, Change Requests, responses to Claims notifications, etc. within the timeframes required by the Contract… more
- Adecco US, Inc. (Austin, TX)
- …various departments. . Correspondence UM Coordinator is responsible for providing clerical support to clinical staff for their medical necessity review process. . ... . Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are...request, researches and provides requested information . Works with claims department to redirect claims related appeal… more
- Molina Healthcare (TX)
- …across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice, ... + Develop and maintain policies, workflows, and escalation protocols to support efficient and compliant subrogation operations across Medicaid, Medicare, and… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …including governmental and private payors; accreditation-related issues; false claims ; tax; anti-trust; tissue or organ transplantation; collections; risk ... and management of potentially compensable events and malpractice or negligence claims ). + Ensure all aspects of the University's medical, podiatric, and… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …of this position is to lead the clinical development activities in support of domestic and international clinical development initiatives. The Senior Director, GCD ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Norstella (Austin, TX)
- …integrating diverse data sources, including laboratory data, electronic medical records (EMR), claims data, and social determinants of health (SDoH) data, to drive ... innovative analytical solutions and insights that support our strategic objectives. **Responsibilities:** + Lead the design, development, and execution of innovative… more
- AECOM (Dallas, TX)
- …construction process and ensure the timely completion of all construction phase support services in accordance with the written project and construction documents + ... issues to minimize client exposure + Proactively work to avoid claims and resolve claims expeditiously to minimize client exposure + Utilize the DFW approved… more
- Mass Markets (Killeen, TX)
- …CENTER JOB OPENINGS We are looking for bilingual call center representatives to support inbound customer service, help desk, technical support , and back-office ... processing representatives for commercial and public sector support positions. In this role, you will handle inbound...account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts,… more