- Otsuka America Pharmaceutical Inc. (Austin, TX)
- Otsuka America Pharmaceutical Inc. is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health worldwide." ... its evolved customer engagement model, a Hospital Specialist engages healthcare providers (HCPs) using in-person, virtual, and digital tools,...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- The City of Houston (Houston, TX)
- …with the following skillset(s): Previous experience adjusting workers' compensation claims and/or previous experience in Risk Management, including but not ... Plan + Paid Prenatal, Parental and Infant Wellness Leaves + Healthcare Flexible Spending Account For plan details, visit http://www.houstontx.gov/hr/benefits.html 01… more
- Cognizant (Austin, TX)
- …need to have to be considered:** + **Experience** : 2-3 years in healthcare revenue cycle. + **Education** : HS Diploma. Associate or bachelor's degree preferred. ... **Technical Skills** : Proficiency in Excel, payer portals, and claims clearinghouses. + **Accounts Receivables** : AR follow up...office **These will help you stand out** + **Examine Claims ** : Analyze denied and underpaid claims … more
- DriveTime (Fort Worth, TX)
- …all inbound calls in a timely manner + Handle customer complaint claims resulting from repossession activity through customer calls, research, and appropriate vendor ... communicate accurate information to customers, vendors, and third parties to resolve claims and invoice disparities + Work independently with customers and vendors… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis, and medical record reviews of complex claims and ... FUNCTIONS** + Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes… more
- Oracle (Austin, TX)
- …solve by applying company policies and procedures. Work closely with US healthcare payers, Oracle teams, and third-party service providers to develop engagement ... resolve complex customer issues by designing and implementing solutions. The US healthcare industry is a complex system comprising providers, payers (health plans… more
- Humana (Austin, TX)
- …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS + ... and with a team **Preferred Qualifications** + BS in healthcare or business-related field + Knowledge of internal Medical...field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + CAS claims processing… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …factors influencing US market access, including reimbursement trends, payer concerns and healthcare policy + Strong understanding of the US payer environment, payer ... market dynamics, payer marketing principles and how healthcare players make decisions across private & public channels...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- 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 ... understanding of healthcare terminology, techniques,...including, but not limited to: medical/surgical physician and institutional claims and encounters, clinical data, prescription drug data, membership… more
- Prime Therapeutics (Austin, TX)
- …and/or prescriber fraud, waste and abuse (FWA). This position conducts claims data mining, fraud analysis and auditing/monitoring activities and proactively ... compliance with federal, state and local laws pertaining to investigations and fair claims handling practices; evaluate risk to determine how best to proceed with… more