- 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 ... prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses...Bachelors degree strongly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Elevance Health (Grand Prairie, TX)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues...CEMC and CEDC encouraged. Please be advised that Elevance Health only accepts resumes for compensation from agencies that… more
- Elevance Health (Grand Prairie, TX)
- …by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to ... with fraud and abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities… more
- Kemper (Dallas, TX)
- …Litigation Adjuster will investigate, evaluate and handle to conclusion attorney represented injury claims , complex injury claims , and litigated claims . The ... Responsibilities:** + Successfully handle any complex coverage or liability claims investigation. + Evaluate complex injury claims ...enjoy great benefits:** * Qualify for your choice of health and dental plans within your first month. *… more
- Cardinal Health (Austin, TX)
- …data to insurance providers + Researching and appealing denied and rejected claims + Preparing, reviewing, and transmitting claims using billing software ... and paper claim processing + Following up on unpaid claims within standard billing cycle time frame + Calling...- $31.20 per hour **Bonus eligible:** No **Benefits:** Cardinal Health offers a wide variety of benefits and programs… more
- TEKsystems (West Lake Hills, TX)
- …data scientists, and legal consultants to shape the future of medical claims review and healthcare resource optimization. Job Responsibilities: * Analyze healthcare ... * Collaborate on the design of predictive tools for claims review and risk stratification. * Prepare reports and...internal teams. Qualifications + Master's or PhD in Economics, Health Economics, Public Policy, or related field. + Experience… more
- Baylor Scott & White Health (Plano, 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...patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM… more
- CVS Health (Austin, TX)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive … more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …benefits, updating account information, correcting edits, performing follow up on unpaid claims , billing or re-billing claims to appropriate payer source and ... and navigation of insurance provider portals for verification of eligibility, benefits, claims status and appeals. **Campus:** HSC - El Paso **Department:** MPIP… more
- Travelers Insurance Company (Houston, TX)
- …reserving, negotiating and resolving assigned serious and complex General Liability claims . Provides quality claim handling throughout the claim life cycle (customer ... You Do?** CLAIM HANDLING: + Directly handle assigned severe claims when Travelers has coverage of $2 million or...litigation experience. **What Is in It for You?** + ** Health Insurance** : Employees and their eligible family members… more