- Elevance Health (Houston, TX)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to ... prevention and control. + Review and conducts analysis of claims and medical records prior to payment. + Researches...training of new associates. **Minimum Requirements:** + Requires an Associate Degree in Nursing and/or current certification as a… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …creating event-driven architectures + AWS Certified Solution Architect - Associate or higher **Bonus Qualifications/Experience** + AWS Certified Solutions Architect ... basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match,… more
- Allied Universal (Houston, TX)
- Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and Investigation Services ... **No office to** **report** **to!** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, including… more
- Humana (Austin, TX)
- …achieving operational and compliance key performance indicators. In addition, the associate will participate in cross functional teams and support analyzing business ... an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and… more
- Humana (Austin, TX)
- …responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- US Physical Therapy (Houston, TX)
- …expanding Houston team. Your role will be critical in our billing and claims department, and you will be asked to facilitate procedural requirements, including data ... elements, insurance verification, authorization for services, and collections for all...authorizations and verify coverage. + Follow up on unpaid claims and denials. + Maintain accurate and up-to-date patient… more
- Omni Hotels (Houston, TX)
- …ensures accurate documented enrollment for all eligible associates. + Monitor unemployment insurance claims and actively work to reduce claim liability through ... for the Human Resources Department. + Participates in planning and execution of associate events planned by the Human Resources Department. + Develop associate … more
- Humana (Austin, TX)
- …first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data Management Professional work assignments are varied ... Qualifications** + 1 - 5 years or more of claims processing experience + Minimum of 1 year experience...other related fields + X12 experience + Prior health insurance industry experience + Working knowledge of Microsoft SQL… more
- Humana (Austin, TX)
- …in Texas and other states. This is accomplished by analysis and adjudication of claims , appeals, and potential quality of care issues. The Dental Director - Texas ... with review policies, procedures, and performance standards. o Review dental claims consistent with current ADA CDT terminology and current professional standards… more
- Evolent (Austin, TX)
- …require technical experts to find the most valuable defects. The IQA reports to a associate director or a manager. One or many IQAs may be engaged in any testing ... - Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in… more