- Humana (Austin, TX)
- …Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Humana (Austin, TX)
- …Director (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.… more
- Actalent (Houston, TX)
- Job Title: Remote Appeals Technician Job Description: As a Remote Pharmacy Technician, you will play a crucial role in managing coverage determination requests and ... * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and… more
- Elevance Health (Grand Prairie, TX)
- …for system edits. + Coordinates research and responds to system inquiries and appeals . + Conducts research of claims systems and system edits to identify ... and long term disability benefits, 401(k) +match, stock purchase plan, life insurance , wellness programs and financial education resources, to name a few. Elevance… more
- Insight Global (Irving, TX)
- …pharmacy services. This role focuses on patient outreach, medication refills, insurance coordination, and appeals , ensuring seamless communication and support ... Conduct refill calls and manage prescription workflows Coordinate with insurance companies to obtain claims and run tests Draft...to obtain claims and run tests Draft and submit appeals for denied claims Perform patient outreach via phone… more
- Cardinal Health (Austin, TX)
- …queue as assigned in the appropriate system. + Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate ... right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They will work within the scope of… more
- Houston Methodist (Houston, TX)
- …required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee environment. ... in dealing with patients and insurance companies. + Understanding of insurance contractual agreements, payer policies, guidelines and appeals process. +… more
- US Anesthesia Partners (Austin, TX)
- … companies for status on outstanding claims. + Process and follow up on appeals to insurance companies. + Refiles claims as needed. + Works correspondence ... adjustments. + Understanding of Medical terminology. + Advanced knowledge of insurance processing, guidelines, laws, and EOBs. + Knowledge of managed care,… more
- Select Medical (Dallas, TX)
- … insurance approvals and authorizations, as well as facilitating appeals for patients + Demonstrates positive referrer satisfaction and account retention. ... experience in a related position preferred. + Experience with insurance approvals, prior authorizations, and the appeals ...with insurance approvals, prior authorizations, and the appeals process. + Experience in workers' compensation is a… more
- NTT DATA North America (Plano, TX)
- …Manager to join our team. NTT DATA is seeking to hire a **Medicare Appeals Clinical Leader** to lead service delivery engagements and improve end-to-end delivery of ... Medicare Appeals . Desire experience specifically for processes for clinical ...eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health… more