- Guardian Life (Plano, TX)
- …are compliant with applicable state regulations. You will ensure that claims , referrals, appeals, and grievances meet state specific regulations, timeframes, and ... **Responsibilities** + Review & ensure that determination and processing of claims , referralsand appeals meet state regulations, time frames& definitions. +… more
- Towne Park (San Antonio, TX)
- …the policy guidelines. **Benefits:** Employees are eligible to enroll in medical , dental, and vision insurance, accident insurance, critical illness insurance, ... the ability to positively move the metrics for forecasting, productivity, claims , customer service, and turnover. Manages payroll and ensures that controls… more
- Fresenius Medical Center (Irving, TX)
- …project specifications and review methodologies. Analyses will include review of claims data, analysis of medication utilization for global contracts and analysis ... 200,000.00 Benefit Overview: This position offers a comprehensive benefits package including medical , dental, and vision insurance, a 401(k) with company match, paid… more
- North Star Diagnostic Imaging (Plano, TX)
- …charges; controlling credit extended to patients; filing, collecting, and expediting third-party claims . + Helps patients in distress by responding to emergencies. + ... Protects patients' rights by maintaining confidentiality of personal and financial information. + Maintains operations by following policies and procedures; reporting needed changes. + Contributes to team effort by accomplishing related results as needed.… more
- CVS Health (Austin, TX)
- …heart, each and every day. The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure ... compliance with coding practices through a comprehensive record review for medical , behavioral, transportation and other healthcare providers. The CPC must have the… more
- Molina Healthcare (Dallas, TX)
- …to law enforcement or for payment recovery. **KNOWLEDGE/SKILLS/ABILITIES** + Reviews post pay claims with corresponding medical records to determine accuracy of ... for investigating and resolving instances of healthcare fraud and abuse by medical providers. This position uses information from a tip, member benefits, and… more
- Datavant (Austin, TX)
- …Radiology Cardiology Injection and Infusion services Orthopedics Post-operative pain blocks Medical necessity documentation Claim edits and revenue codes ... Radiology Cardiology Injection and Infusion services Orthopedics Post-operative pain blocks Medical necessity documentation Claim edits and revenue codes… more
- The City of Houston (Houston, TX)
- …status changes, bona fide offers of employment, statutory employer forms, medical questionnaires, and payroll time codes. + Collaborates with department partners ... with the following skillset(s): Previous experience adjusting workers' compensation claims and/or previous experience in Risk Management, including but not… more
- DriveTime (Fort Worth, TX)
- …all inbound calls in a timely manner + Handle customer complaint claims resulting from repossession activity through customer calls, research, and appropriate vendor ... information to customers, vendors, and third parties to resolve claims and invoice disparities + Work independently with customers...notice._ **So What About the Perks? Perks matter** + ** Medical , dental, and vision, oh my!** DriveTime Family of… more
- AON (Houston, TX)
- …monitoring loss sensitive programs including complex reconciliations involving claims and premium data, tracking/documenting historical information from previous ... by the client. + Monitor, summarize and report on claims . + Undertake various duties as assigned by unit...plan; consideration for long-term incentive awards at Aon's discretion; medical , dental and vision insurance, various types of leaves… more