- HCA Healthcare (Live Oak, TX)
- …pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, discharge planning, case management, and utilization ... case managers and hospital staff in the reduction of payer denials and in the denial and appeals process, as requested by the Case Management Department and… more
- Cardinal Health (Austin, TX)
- …in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials , to ensure timely and accurate reimbursement. + ... Processes denials & rejections for re-submission (billing) in accordance with...changes that may need to be made. + Processes denials & rejections for re-submission (billing) in accordance with… more
- Guidehouse (Lewisville, TX)
- …and three days from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service ... + Billing + UB-04 & CMS 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a ... with clinical and other Humana parties. The Grievances & Appeals Representative 3 performs advanced administrative/operational/customer support duties that require… more
- Molina Healthcare (Austin, TX)
- …by the Centers for Medicare and Medicaid. **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into information system and prepares documentation ... systems and other available resources. + Assures timeliness and appropriateness of appeals according to state and federal and Molina Healthcare guidelines. +… more
- Methodist Health System (Dallas, TX)
- …patient of surgery date and schedules 1 week post op appointment. * Handle all appeals and denials in conjunction with patient's care. * Participate in patient ... education seminars or meet the doctor events with other members of practice staff, educating interested parties about the surgery program. * Prepare physical space for seminars/events. * Assist other staff members to deliver the highest quality of patient care… more
- UTMB Health (Galveston, TX)
- …guidelines. + Responsible for timely and accurate account resolution, including payer appeals for all denials and underpayments. + Collaborates and communicates ... with all levels of leadership throughout the Enterprise on denials trends and opportunities for maximizing reimbursement. + Responsible for the coordination and… more
- Texas A&M University System (San Antonio, TX)
- …with applicants and their 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… more
- Houston Methodist (Houston, TX)
- …services. This position performs collections activities on simple and complex denials and on outstanding insurance balances in the professional fee environment. ... Identifies denial trends and notifies supervisor and/or manager to prevent future denials and further delay in payments. Collaborates with internal CBO departments… more
- NTT America, Inc. (Plano, TX)
- …Manager to join our team. NTT DATA is seeking to hire a **Medicare Appeals Clinical Leader** to lead service delivery engagements and improve end-to-end delivery of ... Medicare Appeals . Desire experience specifically for processes for clinical ...interpret medical records, documenting recommendations to uphold or overturn denials + Excellent analytical and problem-solving skills + Strong… more