• Medical Director - Florida

    Humana (Austin, TX)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
    Humana (10/03/25)
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  • Revenue Cycle Specialist / Biller and Coder

    System One (Frisco, TX)
    … Administration, Business, or related field (preferred). + Minimum 3 years of medical billing and coding experience; neurology or specialty practice preferred. + ... key part in maintaining the clinic's financial health by managing billing, coding , and reimbursement processes. If you're passionate about accuracy, compliance, and… more
    System One (10/09/25)
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  • Investigator II

    Elevance Health (Grand Prairie, TX)
    …for the identification, investigation and development of cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on ... fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible...Impact:** + Responsible for identifying and developing enterprise-wide specific healthcare investigations that may impact more than one company… more
    Elevance Health (09/30/25)
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  • Investigator Senior

    Elevance Health (Grand Prairie, TX)
    …Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent ... identification, investigation and development of complex cases against perpetrators of healthcare fraud in order to recover corporate and client funds paid on… more
    Elevance Health (10/07/25)
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  • Performance Quality Analyst II

    Elevance Health (Grand Prairie, TX)
    …complex audits. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding , member and provider inquiries, ... billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector), including a minimum of 1 year related experience… more
    Elevance Health (10/10/25)
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  • Provider Services Representative I

    Methodist Health System (Dallas, TX)
    …interpersonal interactions with physicians and office staffs. * Must demonstrate understanding of medical claims billing and coding practices. * Ability to ... physicians and office personnel on the health plan contracts, fee schedules, claims processes, and regulatory requirements. * Serves as liaison between MHS… more
    Methodist Health System (09/28/25)
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  • Provider Reimburse Admin Sr

    Elevance Health (Grand Prairie, TX)
    …by law._ The Provider Reimburse Admin Sr ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... of education and experience, which would provide an equivalent background. + RN; Medical billing and coding certification strongly preferred. Please be advised… more
    Elevance Health (09/30/25)
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  • Patient Account Representative

    US Physical Therapy (Houston, TX)
    … billing and collections + Knowledge of medical billing and coding , insurance regulations, and healthcare reimbursement policies + Strong attention to ... Your role will be critical in our billing and claims department, and you will be asked to facilitate...information. + Provide excellent customer service to patients and healthcare providers. + Collaborate with other departments to improve… more
    US Physical Therapy (10/04/25)
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  • Provider Appeals & Grievances Specialist (remote)

    Cognizant (Austin, TX)
    …**Qualifications/Skills Needed:** 1-2 years of Appeals and Grievance 1 yr. medical claims processing experience (Must be with a healthcare plan, not on ... Service with managed care plans or directly with CMS Billing and Coding - Medical Insurance Knowledge of Member/Provider Appeals and Grievances, processes,… more
    Cognizant (10/07/25)
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  • Field Reimbursement Director (Remote USA)

    Danaher Corporation (Houston, TX)
    …/ customer facing role responsible for delivering compliant payer coverage, coding and reimbursement information regarding Cepheid on market diagnostics. This role ... will have the opportunity to: + Provide education to internal colleagues, healthcare providers, lab professionals, office staff and financial decision makers on… more
    Danaher Corporation (10/02/25)
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