- WTW (Dallas, TX)
- …the posted locations. **Qualifications** **Qualifications** + 5+ years' experience in health claims adjudication gained preferably in a consulting environment ... and/or in a major insurance claims administrator or health plan environment + Solid understanding of health and welfare plan design and all areas of … more
- Ascension Health (Austin, TX)
- …**Additional Preferences** Additional Preference: + Three (3) years of experience in health -care claims adjudication required. + Expertise in the Facets platform ... Must reside in Austin, Texas **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
- Elevance Health (Grand Prairie, TX)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health ... by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to… more
- Molina Healthcare (Fort Worth, TX)
- …+ Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including ... to ensure that internal and/or regulatory timelines are met. + Research claims appeals and grievances using support systems to determine appeal and grievance… more
- R1 RCM (Austin, TX)
- …in the health insurance industry (Commercial Insurances, Medicare, Medicaid); health claims billing and/or Third-Party contracts, minimum of two years ... solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines… more
- Humana (Austin, TX)
- …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... as a focus on collaborative business relationships, value based care, population health , or disease or care management. Medical Directors support Humana values, and… more
- Humana (Austin, TX)
- …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. **Preferred… more
- Baylor Scott & White Health (Dallas, TX)
- **About Us** Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest ... to time off benefits At Baylor Scott & White Health , your well-being is our top priority. Note: Benefits...and/or level **Job Summary** + Under the Safe Choice Claims Manager, the Safe Choice Claims Specialist… more
- Highmark Health (Austin, TX)
- …errors and/or performing quality control review and final adjudication of paper/electronic claims . Determines whether to return, deny or pay claims following ... and inquiries to determine corrective action including adjusting claims as necessary and takes the corrective action steps...with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as… more
- Elevance Health (Houston, TX)
- ** Claims Auditor I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... for employment, unless an accommodation is granted as required by law._ The ** Claims Auditor** **I** is responsible for pre and post payment and adjudication audits… more