- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information...contracts and coordination of benefits related to coverage, clinical appeals , and denials to include knowledge of… more
- Molina Healthcare (San Antonio, TX)
- …subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Marketplace benefits and services including reviewing and resolving member appeals and complaints, then communicating resolution to members or... appeals and denials . * Customer service experience. * Strong organizational and… more
- Molina Healthcare (Fort Worth, TX)
- …subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... Responsible for the comprehensive research and resolution of the appeals , dispute, grievances, and/or complaints from Molina members, providers... appeals and denials . + Strong verbal and written communication skills To… more
- Molina Healthcare (Houston, TX)
- …Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and requests for appeals into information system and prepares ... systems and other available resources. * Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. * Requests and obtains… more
- Molina Healthcare (Houston, TX)
- …subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines for ... years of managed care experience in a call center, appeals , and/or claims environment, or equivalent combination of relevant... appeals and denials . * Customer service experience. * Strong organizational and… more
- Houston Methodist (Houston, TX)
- …This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the ... At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect...queues for complex payers and resolve accounts. + Manages denials and appeals efforts. Creates and submits… more
- HCA Healthcare (Plano, TX)
- …We want your knowledge and expertise! **Job Summary and Qualifications** The Clinical Denials Coding Review Specialist is responsible for applying correct coding ... Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have an exciting opportunity for… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …coding staff on documentation and coding guidelines. + Reviewing medical coding claim denials for correction and appeals within the AthenaIDX and Enterprise Task ... **43114BR** **Extended Job Title:** Coding Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Review medical record provider… more
- KPH Healthcare Services, Inc. (Longview, TX)
- **Overview** The Revenue Cycle Management Specialist - Collections responsibility is to ensure timely collection of outstanding balances. **Responsibilities** + ... complex or uncollectible accounts to management for further action. + Submit appeals /claim corrections as needed within timely filing limits. + Utilize billing… 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. + ... prioritizes getting the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and...Processes denials & rejections for re-submission (billing) in accordance with… more