- Insight Global (San Antonio, TX)
- …assigned MRO for technical matters, delivery schedules, invoice discrepancies, warranty claims , and disposition of airline-owned materials. * Maintains and applies ... and accurate records of discrepancies to support requests for procedural changes and claims for charge adjustments. * Maintains a thorough working knowledge of the… more
- Humana (Austin, TX)
- …closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid ... APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience utilizing Microsoft Excel (eg performing basic… more
- Insight Global (Irving, TX)
- …refill calls and manage prescription workflows Coordinate with insurance companies to obtain claims and run tests Draft and submit appeals for denied claims ... and expression, marital status, national origin, ancestry, genetic factors, age, disability , protected veteran status, military or uniformed service member status,… more
- Allied Universal (Edinburg, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services is ... **report** **to!** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation,… more
- Humana (Austin, TX)
- …clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key ... or managed care working experience + Experience working with medical, pharmacy, lab claims + Experience working with big data and using PySpark, Spark R or… more
- Humana (Austin, TX)
- …**Required Qualifications** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, ... Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience in a… more
- Mass Markets (TX)
- …to resolve issues when needed + Accurately document and process customer claims in appropriate systems + Utilize knowledge base and training to accurately ... Savings:Secure your future with retirement savings programs, where available. + Disability Insurance:Short-term disability coverage is available to help protect… more
- Mass Markets (TX)
- …plan environment). + Proficiency with computers is essential. + Proficiency in claims management systems, contact center platforms, and MS Office products. + Strong ... Savings:Secure your future with retirement savings programs, where available. + Disability Insurance:Short-term disability coverage is available to help protect… more
- Mass Markets (Killeen, TX)
- …+ Utilize internal systems and tools to manage customer accounts and process claims + Accurately document customer interactions and resolutions in CRM systems + ... Savings:Secure your future with retirement savings programs, where available. + Disability Insurance:Short-term disability coverage is available to help protect… more
- Zelis (Plano, TX)
- …team to refine into user stories with acceptance criteria, including creating test cases/ claims with expected pricing outcomes . + Perform analysis of various data ... understanding of public and private healthcare payment systems, medical claims , standard claim coding, claim editing, contracting, preferred-provider organizations,… more