- Elevance Health (Houston, TX)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...and medical records prior to payment. + Researches new healthcare related questions as necessary to aid in investigations.… more
- Baylor Scott & White Health (Plano, TX)
- …individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core ... patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM...risk. **Key Success Factors** + Bachelor's Degree in a healthcare field and four years of clinical experience. Or,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- **Company Overview:** Otsuka is a global healthcare company driven by our purpose "to defy limitation, so that others can too." Patients are at the center of our ... purpose as we seek to discover and deliver innovative healthcare solutions. Otsuka is a leader in the CNS...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Methodist Health System (Dallas, TX)
- …physicians and office staffs. * Must demonstrate understanding of medical claims billing and coding practices. * Ability to analyze problems/issues/questions and ... physicians and office personnel on the health plan contracts, fee schedules, claims processes, and regulatory requirements. * Serves as liaison between MHS… more
- Carrington (Plano, TX)
- …completes the Set-up bankruptcy filings process, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of Final Cures, Post-Petition ... the set-up bankruptcy filings, Motion for Reliefs, Proof of Claims , Transfer of Claims , Reaffirmations, Notice of...more visit: www.carringtonmortgage.com . **What We Offer:** + Comprehensive healthcare plans for you and your family. Plus, a… more
- AbbVie (Austin, TX)
- …+ Researches, determines, and implements action necessary to resolve inquiries and claims from customers. + Exercises sounds judgement and discretion in making all ... routine decisions to ensure that all claims are handled accurately and to the satisfaction of...experience. + SAP and FIS GETPAID experience preferred. + Healthcare or Pharmaceutical experience preferred. Additional Information Applicable only… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …benefits, updating account information, correcting edits, performing follow up on unpaid claims , billing or re-billing claims to appropriate payer source and ... Review and process correspondence by mail or via the HealthCare Link portal. + Submit Form A adjustment request...of insurance provider portals for verification of eligibility, benefits, claims status and appeals. **Campus:** HSC - El Paso… 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
- Prime Therapeutics (Austin, TX)
- …in Microsoft Word, Excel, Project, PowerPoint, and Visio **Preferred Qualifications** + Rx Claims system proficiency + Previous PBM or healthcare experience + ... experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to… more
- Catholic Health Initiatives (Houston, TX)
- …requirements. Reports are produced for Revenue Cycle functions such claims submission, insurance follow‐up, cash management, credits/refunds, charge/payment posting, ... 10. Maintain department standard of productivity metrics related to claims processed, claims rejected, claims ...or similar experience with 3 years of experience in healthcare financial and revenue cycle analysis. Experience in Financial… more