- Highmark Health (Austin, TX)
- …through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a resource for technical staff. + ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of… more
- SCI Shared Resources, LLC (Houston, TX)
- …and annual ACA review for benefits eligibility + Reviews 2nd level benefits appeals and provide recommended resolution to Benefits Manager in accordance with company ... of benefit services. + Develops and maintains relationships with vendors, insurance carriers, third-party administrators who provide direct benefits customer support… more
- Baylor Scott & White Health (Dallas, TX)
- …+ Confirm applicable coverage. Maintain compliance with ERISA plan document, insurance policies, and procedure manuals. Take recorded statements. Establish reserve ... + Responsibility for the preparation of summaries and files for denials, appeals , medical advice, subrogation, and litigation. + Collection of documents and… more
- Evolent (Austin, TX)
- …of the request and provides clinical rationale for standard and expedited appeals . . Utilizes medical/clinical review guidelines and parameters to assure consistency ... package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on… more
- Elevance Health (Corpus Christi, TX)
- …+ Assists and participates in appeal or fair hearings, member grievances, appeals , and state audits. **Minimum Requirements:** + Requires BA/BS degree and a ... 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
- Evolent (Austin, TX)
- …of best practices. + Provides clinical rationale for standard and expedited appeals . + Discusses determinations (peer to peer phone calls) with requesting physicians ... package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on… more
- Capgemini (El Paso, TX)
- …software systems to create Prescription cases and determine coverage, determination and appeals process + Good written and verbal communication skills + The ability ... Full time regular employees are eligible for paid time off, medical/dental/vision insurance , 401(k), and any other benefits to eligible employees. Note: No amount… more
- UTMB Health (Galveston, TX)
- …guidelines. + Responsible for timely and accurate account resolution, including payer appeals for all denials and underpayments. + Collaborates and communicates with ... changes. Establishes policy to ensure compliance with all federal regulations and insurance company requirements related to the revenue cycle for UTMB facilities. +… more
- CBRE (Dallas, TX)
- …be solved, and scope of the project, such as, mortgage financing, insurance replacement cost calculation, estate valuation, tax appeals , equitable distribution, ... corporate employee relocation, investment, or sale. + Determine valuation method by selecting approach and techniques for valuing property, ie, cost, direct sales comparison, and income capitalization; identifying property characteristics and attributes. +… more
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