- Guidehouse (Lewisville, TX)
- …Works all denials taking necessary actions to obtain account resolution + Submits appeals , as appropriate, for all non-clinical denials + Monitors all denials for ... and / or plan changes as appropriate to ensure the integrity of the insurance master is maintained + Updates patient accounts with corrected demographic or … more
- Humana (Austin, TX)
- …other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. + ... review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + Experience with national guidelines such as MCG(R) or InterQual… more
- Southland Industries (Carrollton, TX)
- …and potential career paths with one of the country's largest MEP building systems firms appeals to you and you're ready for the next big step in your career, then ... upon performance, profitability, and achievement + **Medical, Dental, Vision Insurance - 100% Paid for Employee** + Term Life,...- 100% Paid for Employee** + Term Life, AD&D Insurance , and Voluntary Life Insurance + Disability… more
- Southland Industries (Houston, TX)
- …and potential career paths with one of the country's largest MEP building systems firms appeals to you and you're ready for the next big step in your career, then ... + 401(k) Plan + Competitive Pay + **Medical, Dental, Vision Insurance ** + Term Life, AD&D Insurance , and Voluntary Life Insurance + Disability Income… more
- Southland Industries (Houston, TX)
- …and potential career paths with one of the country's largest MEP building systems firms appeals to you and you're ready for the next big step in your career, then ... + 401(k) Plan + Competitive Pay + **Medical, Dental, Vision Insurance ** + Term Life, AD&D Insurance , and Voluntary Life Insurance + Disability Income… more
- HCA Healthcare (Arlington, 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...Hoc quality review process + Submits and reviews coding appeals as appropriate **What qualifications you will need:** +… more
- Texas A&M University System (Corpus Christi, TX)
- …Portal and intake of appeal materials, serve as point of contact for appeals . Research student/academic cases as assigned by the Associate Vice President- University ... University is an engaging and rewarding place to work. INSURANCE : (https://assets.system.tamus.edu/files/benefits/website/BenefitsGuide.pdf) + Medical + $0 - $30 per… more
- Elevance Health (Grand Prairie, TX)
- …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 ... or segment health management is a plus. + Knowledge of the health insurance industry and the National Accounts segment is preferred. For candidates working in… more
- Cardinal Health (Austin, TX)
- …reviewing the physician's daily schedule and obtaining verification of patients' insurance benefits for their scheduled visits. They will also obtain authorization ... necessary & must be knowledgeable of a variety of Insurance Plans and Policie **Responsibilities** + Submit authorizations for...to not delay patient care. + Complete any pre-service appeals to obtain paying approval based on medical necessity.… more
- Highmark Health (Austin, TX)
- …medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and ... + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry **LICENSES...this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described… more