- Texas A&M University System (San Antonio, TX)
- …parents to resolve extenuating circumstances, complaints, and appeals of admissions denials . + Completes reports on programs/projects. + Proposes, organizes, plans ... and coordinates events including accommodations, itineraries, meals, speakers, and records. + Coordinates major office programs. + Serves on office committees. Required Education and Experience: + Bachelor's degree in applicable field or higher in related… more
- Houston Methodist (Houston, TX)
- …and federal agencies. Collaborates with the appropriate resources to mitigate denials . + Collaborates with department leadership and revenue cycle partners regarding ... any claim issues or concern that may require clinical review during the pre-bill, audit, or appeal process. **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Expands own knowledge and serves as an instructor in continuing education or formal program and expert… more
- NTT DATA North America (Plano, TX)
- …and Responsibilities: * Process Adjudication claims and resolve for payment and Denials * Knowledge in handling authorization, COB, duplicate, pricing and corrected ... claims process * Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations * Ensuring accurate and timely completion… more
- HCA Healthcare (San Antonio, TX)
- …Updates required systems with authorization, pcp referrals, eligibility information and denials . 2. Consistently meets deadlines and turn around times to ensure ... that verifications, authorizations and pcp referrals are managed correctly and timely to support clinic operations. 3. Submits clinical information to insurance providers and case managers to obtain authorization. Works collaboratively with outside providers… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …appropriate notification of issues that may result in service delays or denials . Handle add-ons, reschedules, and cancellations appropriately and as per department ... protocol. + Perform administrative tasks as needed/assigned (including but not limited to): answer phones, receive/deliver messages, triage calls, and scan documents. + Maintain the reception and waiting areas for assigned ambulatory clinic. + Ensure the… more
- SAS Shoemakers (San Antonio, TX)
- …through detailed review, analysis, and follow-up on all pertinent customer accounts, denials , and rejections + Oversees investigation of credit risk for new and ... existing customers and advises on course of action for credit + Designs and implements processes to improve cash flow and reduce receivable aging + Creates and implements strategies to increase the number of successful collections on outstanding accounts +… more
- Actalent (Texas City, TX)
- …in pharmacy operations, appeals, managed care, claims processing, and handling denials . + Strong data entry and customer service capabilities. + Proficient ... in computer systems and applications. + Ability to work independently in a remote environment. Additional Skills & Qualifications + National Pharmacy Technician Certification (CPhT) preferred; required for certain supervisory roles. + Prior experience with… more
- BrightSpring Health Services (Grand Prairie, TX)
- …basic mathematical calculations (eg, converting milligrams) + May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale ... (POS) + Maintains current knowledge of Medicaid claim regulations and processes + May produce reports and keep management informed of unpaid claims and claims pending follow-up + Provides excellent customer service to external and internal customers in… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …solutions in order to optimize charge capture, lag, coding accuracy, and initial denials . + Approve departmental purchases and purchasing policies in the absence of ... the department administrator while ensuring alignment with the TTUHSC El Paso and TTUS requirements. + Assist the Department Administrator in preparing financial and administrative reports. + Assists in interpreting and analyzing financial statements; analyses… more
- Houston Methodist (Sugar Land, TX)
- …Provides appropriate notification of issues that may result in service delays or denials . + Role models healthy communication such as mitigation of conflict, leading ... problem-solving and resolution efforts. Serves as a preceptor, mentor and resource to less experienced staff. Recommends initiatives to improve department scores for employee engagement. **SERVICE ESSENTIAL FUNCTIONS** + Ensures high quality service is… more