- Datavant (Austin, TX)
- …timely and compliant claim processing.** **What You Will Do:** + Review medical records and assign precise codes to ensure accurate coding aligned with client ... to make a significant impact in the field of medical coding. You will provide essential consulting services and...service outcomes in both hospitals and alternative care settings. ** Claim edit experience is required; Must be proficient in… more
- CVS Health (Austin, TX)
- …implementing, and coordinating all case management activities with members to evaluate the medical needs of the member and to help facilitate the member's overall ... including co-morbid and multiple diagnoses that impact functionality. - Reviews prior claims to address potential impact on current case management plan. -… more
- Elevance Health (Grand Prairie, TX)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... network satisfaction. Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues. Supports large scale… more
- Elevance Health (Grand Prairie, TX)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... + Provides expert advice, analytic and consultative support to Medical Directors and management on cost of care issues....impact decision making tools + Recommends policy changes and claim 's system changes to pursue cost savings. + Reviews… more
- Evolent (Austin, TX)
- …and contracting. **What You'll Be Doing:** + Serve as the lead for medical cost and revenue projections for Performance Suite business + Partner with Performance ... and size impact of innovative care models + Oversee Medical Cost Action Planning work to identify, size, and...clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for… more
- Urology Clinics of North Texas (Mesquite, TX)
- …including office-administered medications and infusion services. + Strong knowledge of medical terminology, insurance plans, claims , and billing processes. + ... including office-administered medications and infusion services. + Strong knowledge of medical terminology, insurance plans, claims , and billing processes. +… more
- Select Medical (Lakeway, TX)
- …**Baylor Scott & White Institute for Rehabilitation - Lakeway** _2000 Medical Dr_ _Lakeway, TX_ **Human Resources Coordinator** **_Salary Range - $60K-80K/year_** ... coordinates any necessary investigations + Processes and maintains all worker's compensation claims in a timely manner and according with the company's Return to… more
- Molina Healthcare (Houston, TX)
- …fraud, abuse, and over utilization by providers and recipients. The position will review claims data, medical records, and billing data from all types of ... Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems + Understanding… more
- WestRock Company (Houston, TX)
- …* Manage Workers Compensation claims , working on recommendations for claim settlements, medical treatments and strategies (reducing company exposure/costs) * ... competencies, and potential. * Generous benefits including 401 K Matching, Medical , Dental, Vision all starting day one. Employee discounts, Tuition Reimbursement,… more
- Highmark Health (Austin, TX)
- …providers. + Advocate for the member by providing assistance with transferring medical records, making prompt appointments with AHN or other community providers and ... providing assistance with resolving claim or billing issues.Educate members about access to comprehensiveclinical care and demonstrate the quality of care and… more