- Deloitte (Houston, TX)
- …and contribute to the formulation and critique of damages theories, claims , or conclusions. + Help prepare client presentations, reports, and deliverables ... on projects including accounting and fraud investigations, false claims act cases, and complex business litigation. + Demonstrate adaptability, attention to detail,… more
- Baylor Scott & White Health (Plano, TX)
- …patient registration procedures and documentation. + Knowledge of medical insurance claims procedures and documentation. Needs to have thorough understanding of the ... and maintaining patient records. + Ability to examine unpaid third-party claims and delinquent accounts to establish appropriate follow-up actions to ensure… more
- Evolent (Austin, TX)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Adecco US, Inc. (Irving, TX)
- …access and reimbursement barriers. + Manage benefit investigations, prior authorizations, claims escalations, and appeals. + Deliver payer insights and education on ... insurance, and specialty pharmacy. + Experience with prior authorizations, claims processing, and appeals. + Strong communication, presentation, and organizational… more
- Adecco US, Inc. (Irving, TX)
- …focused on supporting specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer ... high-impact reimbursement cases by overseeing benefit investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient access. 3.… more
- Centene Corporation (Austin, TX)
- …tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity ... with claims payment, utilization management, provider/vendor contracts, risk adjustment for...color, religion, sex, sexual orientation, gender identity, national origin, disability , veteran status, or other characteristic protected by applicable… more
- Centene Corporation (Mcallen, TX)
- …+ Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform ... care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management… more
- CVS Health (Austin, TX)
- …strong organizational and decision-making skills. + Provide technical expertise in claims adjudication, business rules, network structures, and testing support. + ... of network programs and procedures, including retail pharmacy operations and claims adjudication + Intermediate to advance Microsoft Access database experience +… more
- Sedgwick (Austin, TX)
- …but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Kemper (Houston, TX)
- …collaborating with peers in the sales organization, State Product Managers, Claims , Agency Support and Licensing, Marketing, and Customer Service/Underwriting. + The ... Bilingual English/Spanish a plus. + Working knowledge of insurance operations: underwriting, claims , marketing, and product. + Must have and maintain an acceptable… more