- The Hunton Group (Houston, TX)
- …TX 77087, USA | HS | Full Time | Our comprehensive benefits package includes medical , dental and vision coverage after 60 days; a 401(k) plan, PTO, life insurance ... you will oversee the full warranty lifecycle-identification, validation, documentation, claim submission, and recovery-while ensuring compliance with company, OEM,… more
- Highmark Health (Austin, TX)
- …and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level ... the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the … more
- Sedgwick (Irving, TX)
- …naturally empathic and solution-focused. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Makes claim determinations to approve non-complex disability claims or makes ... your 2+ years' experience in a office setting or medical experience and grow with us! + A stable...professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability… more
- Sedgwick (Irving, TX)
- …time frames, and claims status either by phone, written correspondence and/or claims system. + Reviews medical information to determine if the claimant meets ... and/or client requirements for a qualifying condition. + Makes claim determinations to approve non-complex ADA claims ...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Molina Healthcare (Dallas, TX)
- …and prepares written response to incoming provider reconsideration requests related to claims payment, requests for claim adjustments, and/or requests from ... JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to… more
- Highmark Health (Austin, TX)
- …requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and ... and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. **ESSENTIAL RESPONSIBILITIES** +… more
- UNUM (Austin, TX)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- Elevance Health (Grand Prairie, TX)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... -expense spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the… more
- Sedgwick (Austin, TX)
- …**:** To supervise the activities of the adjuster department; to assign caseload of claims to adjusters and to ensure customer satisfaction of claims services ... + Develops standards, programs, processes, and initiatives to assure quality claim files and results. + Resolves complaints and problems which have… more
- Fresenius Medical Center (Plano, TX)
- …coding. + Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses ... and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses… more