- 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 ... the Medicaid and Medicare programs as well as Marketplace + Understanding of claim billing codes, medical terminology, anatomy, and health care delivery systems… more
- Intermountain Health (Austin, TX)
- …Integrity Analyst II is responsible for appropriate charge capture, assigned account, claim edits and/or charge edits for an assigned service line. This position ... + Audits and evaluates system automation by comparing the charge/ claim data to the clinical record. Leverages other system...certification through AAPC, AHIMA or HFMA, or other specialty medical coding group. + Experience in a role requiring… more
- Compass Group, North America (Longview, TX)
- …position._** **Job Summary** The **Safety Director** will be responsible for reducing claims and lost time injuries by providing safety and workers compensation ... and control programs. + Provides training to managers to follow safe work practices and maintain a safe working...annual reports. + Monitors and reports on workers' compensation claim trends and develop strategies that address injury management.… more
- Walgreens (Kemp, TX)
- …medical providers and conducts or participates in 3rd party audits. + Follow -up with medical providers' offices to clarify prescribed medications, dosages, ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Fresenius Medical Center (Irving, TX)
- …communication with all. + Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner. ... project specifications and review methodologies. Analyses will include review of claims data, analysis of medication utilization for global contracts and analysis… 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
- Intermountain Health (Austin, TX)
- …**Essential Functions** + Oversees the day-to-day revenue cycle functions including claims processing, denials, payments, customer service, and follow up ... Process + Communication + Insurance Processing and Issues + Medical Terminology + Claims Processing + Collaboration...personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe… more
- CenterWell (Austin, TX)
- …+ Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations. + Medication adherence outreach, auditing, ... + Assist clinical pharmacists in troubleshooting prescription third party claim rejections by accessing and understanding formulary restrictions, plan limitations,… 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 ... communicate accurate information to customers, vendors, and third parties to resolve claims and invoice disparities + Work independently with customers and vendors… more
- Sumitomo Pharma (Austin, TX)
- …(https://c212.net/c/link/?t=0&l=en&o=4190475-1&h=3440496098&u=https%3A%2F%2Fwww.us.sumitomo-pharma.com%2F&a=https%3A%2F%2Fwww.us.sumitomo-pharma.com+) or follow us ... company's new and established programs. This position reports to the Chief Medical Officer. **Job Duties and Responsibilities** + Strategic thought partner including… more