- Highmark Health (Austin, TX)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... governmental agencies. These studies and projects may involve all aspects of the health insurance business and care management processes and may be confidential in… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …verifying benefits, updating account information, correcting edits, performing follow-up on unpaid claims , billing or re billing claims to appropriate payer ... and process by mail or via the Healthcare Link portal correspondence and paper claims . + Process weekly TX Medicaid Self pay eligibility GERDS. + Other duties as… more
- Sedgwick (Austin, TX)
- …evaluates, negotiates, and resolves recreational marine or personal watercraft claims internationally, regardless of complexity and quantum. **ESSENTIAL FUNCTIONS ... and RESPONSIBILITIES** + Investigates recreational marine or personal watercraft claims thoroughly using technical expertise and complex analysis. + Examines… more
- Highmark Health (Austin, TX)
- **Company :** Highmark Health **Job Description :** The Graduate Intern - Data Analytics will work closely with Senior Data Scientists to support Highmark's Fraud, ... Daily responsibilities will involve the in-depth analysis of complex healthcare claims data utilizing advanced analytical techniques to detect anomalous provider… more
- Elevance Health (Grand Prairie, TX)
- …development and implementation of medical expense management initiatives for assigned Carelon Health business unit. **How you will make an impact:** + Oversees the ... of new and innovative initiatives specific to the Carelon Health , enterprise or one or more health ...human capital resources, and partners with care management, network, claims & operational teams, IT, and business partners. +… 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 ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
- Health Care Service Corporation (Richardson, TX)
- …impact for our customers and members. At the largest customer-owned and not-for-profit health insurer and fourth largest health insurer overall in the United ... (or thematic units) within AI Solutions, with topics that include Claims and Payment Integrity, Member Engagement, Utilization Management, Document Intelligence,… more
- Health Care Service Corporation (Richardson, TX)
- …business analysis, process improvement,** project management, business operations or relevant health care industry experience * 3 years of experience leading with ... + . Provider Credentialing - sCRED application + . Claims Intake process + . Claims Adjudication...* Agile tool such as Jira/Rally * SQL * Health insurance or healthcare industry experience with emphasis on… more
- The Hartford (San Antonio, TX)
- Team Leader Claims - CH08AE We're determined to make a...world? What else can we do to destigmatize mental health in the workplace? Can we make our communities ... our team as we help shape the future. The Claims Team Leader will manage and direct claim investigation,...and execution of the investigation, disposition and settlement of claims , in compliance with corporate claim standards and procedures,… more
- Mass Markets (TX)
- …a globally expanding, industry-leading organization. We are seeking aLicensed Life and Health Insurance Specialistwho will play a vital role in educating and guiding ... and retention. + Respond to customer inquiries regarding coverage, benefits, claims , and other insurance-related questions. + Maintain accurate and up-to-date… more