• Associate Director, Promotion Compliance Strategic…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …being asked to pay or offered money for equipment fees or some other application processing fee, even if claimed you will be reimbursed, this is not Otsuka. These ... claims are fraudulent and you are strongly advised to...Otsuka Pharmaceutical Development & Commercialization, Inc., and Otsuka Precision Health , Inc. ("Otsuka") does not accept unsolicited assistance from… more
    Otsuka America Pharmaceutical Inc. (04/17/25)
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  • Dallas Energy Customer Care Representative…

    Mass Markets (Dallas, TX)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, and procedures… more
    Mass Markets (04/16/25)
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  • Customer Service Representative (Full-Time)

    Mass Markets (Killeen, TX)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... to resolve issues when needed + Accurately document and process customer claims in appropriate systems + Utilize knowledge base and training to accurately… more
    Mass Markets (03/29/25)
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  • Sales Specialist

    Mass Markets (TX)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... plan environment). + Proficiency with computers is essential. + Proficiency in claims management systems, contact center platforms, and MS Office products. + Strong… more
    Mass Markets (03/08/25)
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  • Member Services Representative II -Kspa

    Kelsey-Seybold Clinic (Pearland, TX)
    …Skills** Required: Strong knowledge of HMOPOS and TPA Plan Design and Claims Processing Member Service Representatives must build and maintain productive ... into practice software applications to respond to administrative issues related to health plan operations including claims resolution, premium billing, medical… more
    Kelsey-Seybold Clinic (05/10/25)
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  • Appeals Licensed Practical Nurse

    Evolent (Austin, TX)
    … plan. * Research requests for post-determination review and categorizes each for processing based on the applicable health plan policies and procedures. * ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...physicians and other clinicians who review the appeal, the claims department to review provider post-service claims more
    Evolent (05/16/25)
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  • Managed Care Representative II

    Kelsey-Seybold Clinic (Pearland, TX)
    …Preferred: N/A **Special Skills** Required: Strong knowledge of HMOPlan Design and Claims Processing Managed Care Representatives must build and maintain ... health plan operations including benefit interpretation for providers, claims resolution, referral inquiries, general plan benefits, Kelsey-Seybold Clinic… more
    Kelsey-Seybold Clinic (05/10/25)
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  • Senior Software Engineer- COBOL coding

    Humana (Austin, TX)
    …team at Humana is essential in delivering core services through effective claims processing and management solutions. This position involves coding software ... part of our caring community and help us put health first** **Requires a strong foundation in COBOL mainframe...offers a variety of benefits to promote the best health and well-being of our employees and their families.… more
    Humana (05/16/25)
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  • System Engineer II

    NASCO (Austin, TX)
    …you will tackle moderate to complex technical challenges, enhancing data management and claims processing systems for NASCO and its partners. Collaborating with ... and performance + Researches and resolves production issues so claims can be paid accurately and timely + Explores...and Abilities:** + General to working experience knowledge of Health Care industry + Proven experience displaying knowledge and… more
    NASCO (05/06/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Austin, TX)
    …of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience ... part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst...IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the… more
    Humana (05/10/25)
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