- Adecco US, Inc. (San Antonio, TX)
- …patients and providers + Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are NCB or medically ... to the UM policy + Receives appeal requests from health plans and/ or QIO, logs request, researches and...request, researches and provides requested information + Works with claims department to redirect claims related appeal… more
- AUI Partners (TX)
- …and tool inspections. + Investigate accidents, incidents, and worker compensation claims , ensuring timely and effective resolution. + Coordinate and conduct safety ... assigned objectives. + Assist the Safety Supervisor/Safety Team on Worker Compensation claims and other claims involving the public, vehicles, utilities and… more
- Houston Methodist (Houston, TX)
- …for resolving all outstanding third party primary and secondary insurance claims for professional services. This position performs collections activities on simple ... and applicable department's revenue cycle operations. + Ensures protection of private health and personal information. Adheres to all Health Insurance… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …inspection ready, resources are provided on site and/or remotely during health authority inspections, observational findings are responded to appropriately and ... fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive… more
- Prime Therapeutics (Austin, TX)
- …Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of ... data + Develop financial pricing models to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive savings and/or meet… more
- Walmart (Sherman, TX)
- …area in accordance with company policies and procedures by properly handling claims and returns; utilizing equipment to perform a variety of merchandising functions ... fulfillment process when necessary by processing information for third-party insurance claims ; rescanning illegible images; alerting patients to inventory that is… more
- TEKsystems (Dallas, TX)
- …to determine next steps. 2. Rebilling & Appeals Submission + Focus on claims ready for appeal-already vetted and prioritized. + Write appeal letters, make calls ... + Determine reasons for denials and appropriate appeal pathways. + Escalate claims when necessary and recommend strategic actions. + Collaborate with analysts to… more
- The City of Houston (Houston, TX)
- …& casualty insurance experience + Insurance Adjusters License and property insurance claims experience + Fluent in Microsoft Office Software, including Excel and ... city offers a competitive benefits program, including competitively priced health coverage and a defined contribution pension plan. Benefits...07 Do you have experience with handling Property Insurance Claims ? + Yes + No 08 If you answered… more
- TEKsystems (Houston, TX)
- …just picking up the phone to communicate and solve problems - determine why claims are denied - determine where to send appeals - determine whether a claim ... follow up, root cause analysis, EHR, EMR, EPIC, Cerner, medical billing, claims audit, appeals process, appeals letter, denials, insurance follow ups Top Skills… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... to communicate about a legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo, Gmail, Hotmail, etc, and not… more