• CSC Customer Service Specialist - Evenings

    Baylor Scott & White Health (Dallas, TX)
    …weekend shifts required_ We are currently hiring for **multiple** Customer Service Specialist roles and will be conducting **onsite** interviews from October 13 to ... vary based upon position type and/or level._ **Job Summary** The Customer Service Specialist acts as a business analyst in a complex office, examining and resolving… more
    Baylor Scott & White Health (11/21/25)
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  • Medication Therapy Management Specialist

    Prime Therapeutics (Austin, TX)
    …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
    Prime Therapeutics (10/31/25)
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  • Specialist , Appeals & Grievances - Remote…

    Molina Healthcare (Dallas, TX)
    …accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST will require to work 1 ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
    Molina Healthcare (11/23/25)
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  • Specialist , Appeals & Grievances

    Molina Healthcare (Houston, TX)
    …accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for the comprehensive ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
    Molina Healthcare (11/21/25)
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  • Coding Specialist

    Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
    **43114BR** **Extended Job Title:** Coding Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Review medical record provider ... Paso **Preferred Qualifications:** + Extensive knowledge of HIPAA, Medicare and Medicaid guidelines and regulations evaluation and management coding guidelines in an… more
    Texas Tech University Health Sciences Center - El Paso (11/26/25)
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  • Specialist , Quality Interventions/QI…

    Molina Healthcare (Dallas, TX)
    …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to one or ... **Preferred Experience** 1 year of experience in Medicare and in Medicaid . **Preferred License, Certification, Association** + Certified Professional in Health… more
    Molina Healthcare (11/21/25)
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  • Research & Resolution Specialist

    Aveanna Healthcare (Dallas, TX)
    Research & Resolution Specialist ApplyRefer a FriendBack Job Details Requisition #: 208950 Location: Dallas, TX 75254 Category: Medical Billing/Collections Salary: ... a signed agreement with Aveanna. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant… more
    Aveanna Healthcare (11/08/25)
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  • Insurance Authorization Specialist

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Insurance Authorization Specialist position is responsible for obtaining and managing insurance authorizations for medical services and ... focus and application of positive language principles + Knowledge of Medicare, Medicaid , and managed care reimbursement methodologies + Ability to manage multiple… more
    Houston Methodist (11/06/25)
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  • Utilization Review Specialist Nurse (RN)…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... local and national coverage determinations + Comprehensive knowledge of Medicare, Medicaid , and Managed Care requirements + Comprehensive knowledge of community… more
    Houston Methodist (11/02/25)
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  • Intake Specialist

    KPH Healthcare Services, Inc. (Longview, TX)
    **Overview** **Scope of Responsibilities:** The Intake Specialist is an experienced individual who is able to assist and manage the referral intake process. **Job ... any changes that possibly may occur within the Insurance Payor, Medicare, or Medicaid + Responsible for completing all mandatory and regulatory training programs +… more
    KPH Healthcare Services, Inc. (10/23/25)
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