- 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
- Cardinal Health (Austin, TX)
- …Practice Operations Management oversees the business and administrative operations of a medical practice. The Revenue Cycle Management team focuses on a series of ... distributing, and managing all billable services for reimbursement to the medical facility. This role works directly with insurance companies, healthcare providers,… more
- Elevance Health (Grand Prairie, TX)
- …Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent ... in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies,… more
- Covenant Health (Lubbock, TX)
- …of claim billed and collected on behalf of Covenant. This individual addresses claim edits, files all claims on either a UB-04 (RHC) or 1500 (835/837 ... file formats) and completes follow -up on outstanding accounts. In addition, this individual identifies...valued - they're invaluable. Join our team at Covenant Medical Group and thrive in our culture of patient-focused,… more
- Schlumberger (Houston, TX)
- …on those strategies including appropriate correspondence, record keeping, meetings and pro-actively follow up to a suitable conclusion. + Take lead on all ... but not limited to contract compliance, change management and claim mitigation strategies. + Analyzing the basis and extent...+ Analyzing the basis and extent of change Tracking claims and monitoring progress through the claims … more
- Elevance Health (Plano, TX)
- …period of time. + Inputs appropriate progress/billing note (test claim , real claim OOP, payment plan). + Adjudicate real claims daily and ensure credit ... and incentive bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits, 401(k) +match,… more
- Elevance Health (Grand Prairie, TX)
- …in order to recover corporate and client funds paid on fraudulent Medicaid claims . **How You Will Make an Impact:** + Responsible for identifying and developing ... more than one company health plan, line of business and/or state + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and… more
- Elevance Health (Houston, TX)
- …the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How ... audits. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment &… more
- Elevance Health (Grand Prairie, TX)
- …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... into effective and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS… more
- Southland Industries (Carrollton, TX)
- …to Brandt's/Southland safety department, with heavy emphasis on workers compensation claims management. **What you'll do:** + Provide administrative support to group ... supervisor's first report of injury. Set-up and maintain w/c claim filing system. + Assist with case management of...filing system. + Assist with case management of open claims through to closure; notify safety director of safety… more