- Guidehouse (Lewisville, TX)
- …denials for trends and issues and reports findings to supervisor + Bills or re-bills claims as necessary + Ensures the client follows all state and federal rules and ... reflects our commitment to creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance + Personal and Family Sick Time &… more
- Command Investigations (Laredo, TX)
- …hire. Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, Auto, or ... include Microsoft Word and Microsoft Outlook (email) Full-Time benefits Include: + Medical , dental and vision insurance + 401K + Extensive performance bonus program… more
- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims ... FUNCTIONS** + Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes… more
- 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 ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Provider Auditor II** is responsible for… more
- Sedgwick (Irving, TX)
- …time frames, and claims status either by phone, written correspondence and/or claims system. + Reviews medical information to determine if the claimant meets ... Galleria Officentre Southfield MI 48034 **PRIMARY PURPOSE** **:** To process claims and determine accommodation options following written guidelines and procedures… more
- Sedgwick (Irving, TX)
- …time frames, and claims status either by phone, written correspondence and/or claims system. * Reviews medical information to determine if the claimant meets ... 12650 Ingenuity Dr Orlando FL 32826 **PRIMARY PURPOSE:** To process claims and determine accommodation options following written guidelines and procedures pursuant… more
- Jet Health (Granbury, TX)
- …be considered for this role. This position coordinates systems and procedures with medical records, data entry, claims review, and personnel functions to ensure ... billing department as requested. + Oversees, evaluates and analyzes medical records, data entry and claims review...and analyzes medical records, data entry and claims review by reviewing patient charts for compliance and… more
- Conduent (El Paso, TX)
- …extended periods + Strong attention to detail and organizational skills + Prior knowledge of medical , hospital, or dental claims is a plus, but not required + ... expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran… more
- Elevance Health (Grand Prairie, TX)
- …fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Clinical Fraud Investigator II** is responsible for… more
- Intermountain Health (Austin, TX)
- …and applicable regulations. **Skills** + Pharmacy + Pharmacy Benefits Management (PBM) + Medical Prescriptions + Pharmacy Claims + Customer Service + Problem ... Resolution + Phone Calls (Inbound/Outbound) + Oral Communication + Written Communication + Group Problem Solving + Medicare Part D + Medicaid + Mentorship/Coaching + Decision Making + Microsoft Excel **Minimum Qualifications:** + Pharm D. degree or Masters… more