- Elevance Health (Houston, TX)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- Elevance Health (Grand Prairie, TX)
- …with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately… more
- Cognizant (Austin, TX)
- …satisfaction. **Responsibilities:** Reviewing available Appeals & Grievances for the pending claims to verify due process was followed. Determine if the appeal ... or Grievance is legitimate. A strong understanding of Claims , Appeals and Medical Benefits. Referring suspicious or complicated Claims to investigators.… more
- TEKsystems (Houston, TX)
- …just picking up the phone to communicate and solve problems - determine why claims are denied - determine where to send appeals - determine whether a claim ... follow up, root cause analysis, EHR, EMR, EPIC, Cerner, medical billing, claims audit, appeals process, appeals letter, denials, insurance follow ups Top Skills… more
- Southern Glazer's Wine and Spirits (Dallas, TX)
- …Shelf Benefits, including comprehensive medical and prescription drug coverage, dental and vision plans, tax-saving Flexible Spending Accounts, disability coverage, ... withdrawals + Electronic imaging + Research shortage and miss-shipped claims + Process/enter orders and pick-ups + Handle calls...address and make the necessary corrections + Handle delivery claims and logs (shortage claims , miss ships,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life, accidental death ... 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
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life, accidental death ... 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
- DriveTime (Fort Worth, TX)
- …and resolve any vendor invoice escalations + Handle customer complaint claims due to repossession activity through customer calls, research and communication ... to problem solve and identify root cause of alleged claims to ensure satisfactory resolution withing SLAs + Work...**So What About the Perks? Perks matter** + **Medical, dental , and vision, oh my!** DriveTime Family of Brands… 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
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …a minimum of 5 business days. **Company benefits:** Comprehensive medical, dental , vision, prescription drug coverage, company provided basic life, accidental death ... 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