- Elevance Health (Houston, 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
- Elevance Health (Houston, 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
- Wells Fargo (Irving, TX)
- …Lines & Loans businesses. **In this role, you will:** + Manage moderately complex claims and litigation + Provide legal advice and representation of the Company in ... moderate risk litigation, negotiations, settlement discussions, and claims related legal issues + Review and analyze moderately complex challenges that require an… more
- Zurich NA (Houston, TX)
- …Diploma or Equivalent and 6 or more years of experience in the Claims or Underwriting Support area + Zurich Certified Insurance Apprenticeship program including an ... and 4 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of line/s...color, religion, sex, sexual orientation, gender identity, national origin, disability , or protected veteran status. Zurich does not accept… more
- The City of Houston (Houston, TX)
- …& casualty insurance experience + Insurance Adjusters License and property insurance claims experience + Fluent in Microsoft Office Software, including Excel and ... an individual's sex, race, color, ethnicity, national origin, age, religion, disability , sexual orientation, genetic information, veteran status, gender identity, or… more
- 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
- 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
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …and accreditation standards. + Monitor and update policies to align with evolving regulations. Claims & Revenue Cycle Support + Review claims data to ensure ... coding and documentation meet payer requirements. + Resolve denied claims through research and collaboration with providers and payers. + Utilize specialized… more
- Hensel Phelps (El Paso, TX)
- …to aid in the management of the schedule and implement controls to avoid claims . + Analyze delivery impacts, time extensions, claims , etc. using schedule ... fragments. + Interact with scheduling consultant in schedule reviews, claims analysis, etc. Perform monthly cash flow projections and analysis. + Perform workforce… more
- Amazon (TX)
- …needs via 1Life's tasking system to provide the best customer service. Investigating claims through insurance to ensure they were processed according to the patient ... from One Medical patients (customers) regarding their medical bills, insurance claims , and payment inquiries. Daily activities include reviewing patient accounts,… more