- IQVIA (Houston, TX)
- **Patient Support Medical Claims Processing Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of commercial ... a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to...+ High School Diploma or equivalent + Experience in claim processing required + Medical … more
- Kelsey-Seybold Clinic (Pearland, TX)
- …Must be familiar with laws and regulations governing Medicare billing practices, medical billing systems, and claims processing . Preferred: IDX/EPIC, ... Claim Edit Follow-Up Representative is responsible for processing the electronic claims edits, "front end...School diploma or GED Preferred: Additional training as a medical office assistant, medical claims … more
- CVS Health (Austin, TX)
- …enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims . You will be a key link in ... day. ** Claim Benefit Specialist** Reviews and adjudicates claims in accordance with claim processing...willingly to change, and a positive, willing attitude. Prior medical claim processing experience is… more
- CVS Health (Austin, TX)
- …information for claim or reconsideration. **Required Qualifications** + 2+ years of medical claim processing experience. + Previous experience in a ... multiple assignments competently, accurately and efficiently. **Preferred Qualifications** + Self funded medical claim processing experience. + DG system… more
- CVS Health (Austin, TX)
- …competently, accurately and efficiently. **Preferred Qualifications** - 18+ months of medical claim processing experience - Self-Funding experience ... or claims that exceed specialist adjudication authority or processing expertise. - Applies medical necessity guidelines, determines coverage, completes… more
- Sedgwick (Houston, TX)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Sedgwick (Austin, TX)
- …Liability (MEDMAL) **PRIMARY PURPOSE** : To analyze complex or technically difficult medical malpractice claims ; to provide resolution of highly complex nature ... and RESPONSIBILITIES** + Analyzes and processes complex or technically difficult medical malpractice claims by investigating and gathering information to… more
- Sedgwick (Dallas, TX)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... and provides report of investigation pertaining to new events, claims and legal actions. + Negotiates claim ...depositions, mediations, and trial monitoring as needed. + Communicates claim activity and processing with the client;… more
- Sedgwick (Irving, TX)
- … by investigating and gathering information to determine the exposure on the claim ; manages claims through well-developed action plans to an appropriate and ... including strategic vendor partnerships to reduce overall cost of claims for our clients. + Manages claim ...directions in a professional and timely manner. + Communicates claim activity and processing with the claimant… more
- Molina Healthcare (San Antonio, TX)
- …Contracted Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility ... from start to finish of the claim disputes to include intake, processing , decisioning,...a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal… more