- Elevance Health (Rockwall, TX)
- …care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. **How you will make an impact:** + Responsible ... evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long...+ May also assist in problem solving with providers, claims or service issues. + Directs and/or supervises the… more
- Elevance Health (Grand Prairie, TX)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... an Impact:** + Uses analytic tools to: track both health risks and compliance, as well as supporting the...term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name… more
- Elevance Health (Grand Prairie, TX)
- …**Be Part of an Extraordinary Team** A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new ... management. + Respond to and resolve issues related to member/provider complaints, claims processing issues and appeals. **Minimum requirements:** + PharmD from an… more
- Elevance Health (Grand Prairie, TX)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... project lead. + Uses analytic tools to track both health risks and compliance, as well as supporting the...term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name… more
- Elevance Health (Houston, TX)
- …coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. **How you ... + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Covenant Health (Lubbock, TX)
- …benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance , disability ... of Covenant. This individual addresses claim edits, files all claims on either a UB-04 (RHC) or 1500 (835/837...Experience in computer applications. **Preferred qualifications:** + 1 year Health care business office experience or related field. +… more
- Highmark Health (Austin, TX)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY:** This job...position is responsible for educating members about how their insurance benefits work, the financial impact of healthcare choices,… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Senior Payment Integrity Professional uses technology and data mining, detects anomalies ... in data to identify and collect overpayment of claims . Contributes to the investigations of fraud waste and our financial recovery. The Senior Payment Integrity… more
- Baylor Scott & White Health (Temple, TX)
- …financial clearance functions, including but not limited to, verifying insurance eligibility and benefits, ensuring authorizations and providing price estimates. ... interviews to obtain demographic and financial data for registration, insurance verification, pre-certification and billing. Records accurate patient demographic… more