• Clinical Risk Manager

    Baylor Scott & White Health (Round Rock, TX)
    …type and/or level **Location** This position will support two hospitals; Baylor Scott & White Medical Center - Round Rock and Baylor Scott & White Medical Center ... patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM...care and responds within the CMS-designated time frame. Provides follow -up communication when the complaint is resolved. + Is… more
    Baylor Scott & White Health (08/28/25)
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  • Oncology Accounts Receivable Specialist

    Urology Clinics of North Texas (Mesquite, TX)
    …business. Responsibilities: + Prioritize tasking and utilize tasking for daily work + Follow up on all oncology claims from billing through final resolution ... Qualifications Education/Experience: + High school diploma or equivalent + Urology/Oncology and medical terminology + Knowledge of insurance plans, claims and… more
    Urology Clinics of North Texas (09/27/25)
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  • Clinical Provider Auditor II

    Elevance Health (Grand Prairie, TX)
    …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... abuse. **How you will make an impact:** + Examines claims for compliance with relevant billing and processing guidelines...to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in… more
    Elevance Health (10/05/25)
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  • Neuroscience Specialist

    Otsuka America Pharmaceutical Inc. (Amarillo, TX)
    …innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health. In ... the respective Area Business Lead, coordinating with cross-functional colleagues in Medical (MSLs), Market Access (HSAMs), and Patient Support (PELs) under… more
    Otsuka America Pharmaceutical Inc. (07/19/25)
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  • Senior Denials Mgmt Specialist

    Houston Methodist (Sugar Land, TX)
    …+ Communicates to interprofessional staff and customers, information on, and the need to follow , payor criteria for the use of medical resources and services, ... decisions and is accountable for reviewing denials for level of care, medical necessity, and as appropriate, DRG recoupments/downgrades, and denials for no… more
    Houston Methodist (07/31/25)
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  • Risk Manager RN Full-time

    Texas Health Resources (Fort Worth, TX)
    …tools), and RCA (root cause analysis) + Utilize investigative skills - investigations, follow trends and process improvement **What You Will Do** * Utilizes the ... safety/risk exposures affecting the quality of care and outcomes. * Makes medical staff quality review referrals as appropriate. * Utilizes statistical and other… more
    Texas Health Resources (10/02/25)
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  • Executive Director of R&D Global Quality (Remote)

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …(PV) operations. + **Audit Management:** Oversee the planning, execution, and follow -up of internal and external audits to ensure compliance with regulatory ... years of experience in a FDA regulated pharmaceutical and/or medical device industry environment + Strong knowledge of current...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
    Otsuka America Pharmaceutical Inc. (08/14/25)
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  • Inbound Helpdesk Representative ($15/hr.)

    Mass Markets (Dallas, TX)
    …technology to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, ... with other departments to resolve issues as applicable + Follow the processes of the Client program and perform...cars! + Health Benefits:Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 60 days of… more
    Mass Markets (10/03/25)
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  • Republican Political Representative (Full-Time…

    Mass Markets (TX)
    …technology to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, ... with other departments to resolve issues as applicable + Follow the processes of the Client program and perform...cars! + Health Benefits:Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 60 days of… more
    Mass Markets (08/21/25)
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  • Cable Sales Representative (Full-Time)

    Mass Markets (Killeen, TX)
    …technology to complete account management tasks + Accurately document and process customer claims in appropriate systems + Follow all required scripts, policies, ... with other departments to resolve issues as applicable + Follow the processes of the Client program and perform...cars! + Health Benefits:Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 60 days of… more
    Mass Markets (07/29/25)
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