- Elevance Health (Grand Prairie, TX)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- Adecco US, Inc. (Irving, TX)
- …access and reimbursement barriers. + Manage benefit investigations, prior authorizations, claims escalations, and appeals. + Deliver payer insights and education on ... Medicare and commercial insurance coverage. + Collaborate with physician offices, specialty pharmacies,..., and specialty pharmacy. + Experience with prior authorizations, claims processing, and appeals. + Strong communication, presentation, and… more
- Highmark Health (Austin, TX)
- …work will directly impact millions of lives. As our Lead Graph Intelligence specialist , you will be the spearhead of cutting-edge research projects. This means ... leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , and clinical data to uncover hidden patterns, propagate insights… more
- Molina Healthcare (San Antonio, TX)
- …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... with the Chief Medical Officer for Administrative Law Judge pre-hearings, State Insurance Commission, and Meet and Confers. + Represents Molina and presents cases… more
- Molina Healthcare (Fort Worth, TX)
- …activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors + Maintains professional and technical ... and written communication skills + Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) + Ability to establish and… more
- Hensel Phelps (El Paso, TX)
- …construction projects. + Associate Safety Professional (ASP) or Safety Management Specialist (SMS) designation preferred. + Valid Driver's License. + Strong ... Duties:** + Effectively communicate with various stakeholders including project owners, insurance carrier, Hensel Phelps leadership, staff, craft and trade partners.… more
- AIG (Dallas, TX)
- …the way we help customers to manage risk. Join us as Product Wording Specialist to play your part in that transformation. It's an opportunity to grow your ... and align with underwriting intent. + Work with Underwriting, Claims and Legal in drafting new policy forms and...Degree from a four-year college or university. #LI-NH1 #productwording # insurance At AIG, we value in-person collaboration as a… more
- Morley (Houston, TX)
- …**_Questions Before You Apply?_** Live chat with a Morley Talent Acquisition (TA) Specialist ( careers.morleycompanies.com | chat hours: M-F 7 am - 4 pm Central ... coverage, including free annual physicals + Dental and vision insurance + Paid time off + Associate wellness program...Patient advocacy: Free 24/7 help with benefit questions and claims issues + Family, financial and estate guidance (will)… more
- The Hartford (San Antonio, TX)
- Sr Ability Analyst - C409ANAbility Specialist - C409BN We're determined to make a difference and are proud to be an insurance company that goes well beyond ... to meaningful work at The Hartford. The Senior Ability Analyst primarily investigates claims to make timely, accurate and customer focused initial and ongoing Long… more
- CenterWell (Vernon, TX)
- …+ Complete End of Period claim workflow as part of Billing Specialist responsibilities. This includes confirming all orders are signed appropriately and coordinating ... team at the branch to ensure other billing requirements are satisfied to release claims timely. + Adhere to and participate in Agency's mandatory HIPAA / Privacy… more