- IQVIA (Houston, TX)
- **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our...or equivalent + Experience in claim processing required + Medical Billing Certification required + Coding Certification… more
- Elevance Health (Grand Prairie, TX)
- …would provide an equivalent background. **Preferred Skills, Capabilities and Experiences:** + Medical Coding experience highly preferred. + Clinical Code editing ... **Manager Rating/ Claims System Analyst** **Location:** This role enables associates...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Molina Healthcare (Fort Worth, TX)
- …or equivalent combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working ... to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of...within the core processing system (QNXT). * Conducts focal healthcare Medical claim audits on samples of… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …companies and healthcare professionals to resolve issues resulting from denied claims + Adhere to coding policies and procedures consistent with the ... research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing,… more
- Molina Healthcare (San Antonio, TX)
- …will work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding . **Job Summary** Utilizing clinical knowledge ... refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. **JOB QUALIFICATIONS** Graduate from an...two years of experience in Claims Auditing, Medical Necessity Review and Coding experience +… more
- Molina Healthcare (TX)
- …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Molina Healthcare (Dallas, TX)
- …different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- HCA Healthcare (San Antonio, TX)
- …or healthcare license/certification required. + Minimum 1 year directly related Healthcare experience or coding experience required. + Knowledge of CPT/HCPCS ... of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Molina Healthcare (San Antonio, TX)
- …to health care fraud, waste, and abuse. Duties include performing accurate and reliable medical review audits that may also include coding and billing reviews. ... with various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims ) to gather documentation… more
- CVS Health (TX)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... and is ideal for a data professional with strong coding skills in SQL and Python who can transform...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more