• Clinical Appeals Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and...+ Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager… more
    Molina Healthcare (08/15/25)
    - Related Jobs
  • Senior Quality Specialist

    CVS Health (Austin, TX)
    …measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical ... both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from standard practices to… more
    CVS Health (09/02/25)
    - Related Jobs
  • Inpatient Coding Denials Specialist

    HCA Healthcare (El Paso, TX)
    …to join an organization that invests in you as an Inpatient Coding Denials Specialist ? At Parallon, you come first. HCA Healthcare has committed up to $300 million ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...We are looking for a dedicated Inpatient Coding Denials Specialist like you to be a part of our… more
    HCA Healthcare (07/26/25)
    - Related Jobs
  • Desk Review Specialist

    Kemper (Mcallen, TX)
    …can be highly motivating and productive. **Position Summary:** As Desk Review Specialist , you will be reviewing incoming auto damage demands from other carriers ... utilized within Industry Standards. + Examine third-party Total Loss claims through photos, estimates, total loss valuations to ensure...they are in line with the facts of the claim and within Industry Standards. + Ensure adherence to… more
    Kemper (08/24/25)
    - Related Jobs
  • FEMA - Construction Specialist

    CDM Smith (Dallas, TX)
    …applicant-provided cost claims for reasonableness to report to FEMA regarding claim eligibility. Participates in and assists with the development of the final ... **Business Unit:** FSU **Job Description:** The FEMA Disaster Management Construction Specialist : * Schedules and conducts site inspections with applicants, performs… more
    CDM Smith (07/15/25)
    - Related Jobs
  • Billing Specialist

    HCA Healthcare (Mckinney, TX)
    …you to be a part of our team. **Job Summary and Qualifications** Billing Specialist PHY GENERAL SUMMARY OF DUTIES: Processes claims electronically to insurance ... an organization that invests in you as a(an) Billing Specialist ? At MSO - Comprehensive OB/GYN, you come first....colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
    HCA Healthcare (07/30/25)
    - Related Jobs
  • Financial Operations Recovery Specialist

    Elevance Health (Houston, TX)
    **Financial Operations Recovery Specialist Lead** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration ... is granted as required by law. The **Financial Operations Recovery Specialist Lead** is responsible for the discovery, validation, recovery, and adjustments… more
    Elevance Health (08/27/25)
    - Related Jobs
  • Accounts Receivable Specialist II

    Cardinal Health (Austin, TX)
    …and transmitting claims using billing software including electronic and paper claim processing + Following up on unpaid claims within standard billing ... prioritizes getting the right things done. **_Responsibilities_** + Submitting medical documentation/billing data to insurance providers + Researching and appealing… more
    Cardinal Health (08/27/25)
    - Related Jobs
  • Safety Specialist

    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
    Southland Industries (08/17/25)
    - Related Jobs
  • Collections Specialist

    Robert Half Accountemps (Fort Worth, TX)
    Description We are looking for a skilled Credit & Collections Specialist to join our team in Ft. Worth, Texas. This Contract-to-Permanent position offers an ... calls related to billing inquiries and provide thorough resolutions. * Administer claims and track payment statuses using accounting and CRM software. * Collaborate… more
    Robert Half Accountemps (08/08/25)
    - Related Jobs