- Houston Methodist (Houston, TX)
- …responsible for resolving all outstanding third party primary and secondary insurance claims for professional services. This position performs collections activities ... on simple and complex denials and on outstanding insurance balances in the professional fee environment. This role...including claims resubmission to payors. + Creates and submits appeals when necessary. Engages the coding follow-up team for… more
- Humana (Austin, TX)
- …include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The ... other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
- Humana (Austin, TX)
- …include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The ... other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
- Centene Corporation (Austin, TX)
- …optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and ... medical necessity appeals . + Participates in provider network development and new...work in the areas of Health Administration, Health Financing, Insurance , and/or Personnel Management is advantageous. Experience treating or… more
- The City of Houston (Houston, TX)
- …plan. Benefits include: + Medical + Dental + Vision + Wellness + Supplemental Insurance + Life insurance + Long-term disability + Retirement pension + 457 ... an acceptable answer). 09 What city in the world appeals most to you, either to live in or...to live in or to visit? What about it appeals to you? What lessons do you think Houston… more
- HCA Healthcare (Live Oak, TX)
- …plans (accident, critical illness, hospital indemnity), auto and home insurance , identity theft protection, legal counseling, long-term care coverage, moving ... assistance, pet insurance and more. + Free counseling services and resources...analysis of managed care issues. Offers clinical support for appeals and denials process, discharge planning, case management, and… more
- Elevance Health (Grand Prairie, TX)
- …and consultant to other areas of the company; particularly the Medical Review and Appeals areas + May be required to represent the company to external entities ... a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any… more
- Executive Office for US Attorneys and the Office of the US… (Houston, TX)
- …represents the US Attorney's Office in criminal matters in the United States Court of Appeals for the Fifth Circuit. As an AUSA in the Appellate Division, you will ... matters, and sentencing issues. You will be assigned to work on appeals and post-conviction matters arising from offenses targeted by the Department's Border… more
- Methodist Health System (Dallas, TX)
- …and maintain an efficient flow of patients from patient registration, insurance verification, initial contact and surgeon consultation through the surgical pathway ... to complete insurance and program criteria, and medical clearances to be...schedules 1 week post op appointment. * Handle all appeals and denials in conjunction with patient's care. *… more
- Intermountain Health (Austin, TX)
- …for the accurate and timely submission of claims follow up, reconsideration and appeals , response to denials, and re-bills of insurance claims, and all ... for performing a variety of complex duties, including working outstanding insurance claims follow-up for no response, unresolved from payors, and/or claim… more