- Humana (Austin, TX)
- …to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from the data exchange between Humana and its ... to make an impact** **Required Qualifications** **5+ years of medical claims processing/auditing or encounter data management experience** **Demonstrated deep dive… 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
- Molina Healthcare (Fort Worth, TX)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- Sedgwick (Bedford, TX)
- …Automotive Customer Case Coordinators. We help auto customers through the manufacturing claims process. **_We offer benefits on day one:_** + **_401K_** + ... required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Alight (TX)
- …Be Alight. Learn more at careers.alight.com **About the Role** The Health Navigation Claims Specialist position exists to work on behalf of our customers to resolve ... special review + Assisting in reviewing medical, dental, vision, and pharmacy related claims for accuracy to ensure customers are receiving proper benefit coverage +… more
- AECOM (Dallas, TX)
- …+ Work with management and staff to resolve pre-litigation disputes and potential claims + Manage various types of litigation matters and claims utilizing ... experience at an engineering, architecture or construction company + Claims /litigation handling, including management of outside counsel, relating to architecture,… more
- Elevance Health (Houston, 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...be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with… more
- UTMB Health (Galveston, TX)
- …programs, clinical issues, device and equipment, incident management, and claims /lawsuits. **Job Duties:** + Administrative liaison for Risk Management issues. ... risk management programs for device and equipment, incident management and claims /lawsuits. + Keeps lines of communication open with directors, managers, physicians,… 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 ... to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues...be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with… more
- CDM Smith (Fort Worth, TX)
- …and maintaining a project risk register. Claim management: Early support for claims and disputes on the project. Identify contractual requirements to maintain and ... prosecute claims , and assist project team in managing to those...motor vehicle record as well as drug testing. **Additional Compensation :** All bonuses at CDM Smith are discretionary and… more