- Molina Healthcare (Fort Worth, TX)
- …of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other ... for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Sedgwick (Irving, TX)
- …**_caring counts-and so do you._** **We're not just a global leader in claims management; we're a team driven by empathy, expertise, and impact. Right now, ... the go-to guide for individuals navigating the challenges of disability claims . Your role blends technical expertise with human connection-you'll interpret medical… more
- Travelers Insurance Company (Richardson, TX)
- …Claim Counsel team conducts thorough investigation, analysis, evaluation, and disposition of claims and claim litigation to achieve superior customer service and to ... (REMOVE WHEN POSTING) Commercial Surety: Travelers' Commercial Surety Team handles claims on non-construction surety bonds; mitigates exposures on commercial surety… more
- Elevance Health (Houston, TX)
- …Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case ... and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- GuideOne Insurance (Dallas, TX)
- …you will be responsible for the full adjustment of first party commercial lines claims . In this role, you will be primarily accountable for overseeing large loss ... claims within the non-profit, church, education centers and niche...Medical, dental and vision plans to meet your unique healthcare needs + Wellness incentives + Generous time off… more
- Sedgwick (Houston, TX)
- …Review Analyst plays a critical role in supporting the medical malpractice claims team by ensuring legal invoice accuracy, compliance, and defensibility. This ... billing guidelines, industry standards, and customary legal practices specific to healthcare litigation. The Analyst contributes to cost containment efforts and… more
- Ascension Health (Austin, TX)
- …in the patient account record of all billing activities. Maintain documentation of claims processed as part of the daily claims reconciliation process. + ... in the patient account record of all billing activities. Maintain documentation of claims processed as part of the daily claims reconciliation process. +… more
- Caris Life Sciences (Irving, TX)
- …cancer. We're pushing the frontiers of medicine and leading a revolution in healthcare -driven by innovation, compassion, and purpose. **Join us in our mission to ... The Accounts Receivable Associate is responsible for reviewing outstanding denied claims with Medicare, Medicaid and Commercial insurance companies. This role… more
- Public Consulting Group (Austin, TX)
- …through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- Moore County Hospital District (Dumas, TX)
- Moore County Hospital District (MCHD), located in Dumas, Texas, is a leading healthcare provider dedicated to serving Moore County and the surrounding areas. Our ... over 15,000 nursing homes evaluated. MCHD is proud to provide comprehensive healthcare services to residents across six counties, ensuring accessible and exceptional… more