- Adecco US, Inc. (Austin, TX)
- …service or provider calls as needed. . Coordinates UM processes with Medical Directors, UM Nurses, hospitals, physicians and other various departments. . ... for providing clerical support to clinical staff for their medical necessity review process. . Correspondence UM Coordinator is.... Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are… more
- Swedish Health Services (TX)
- …but not limited to commercial, Blue Cross, Blue Shield, Aetna, Uniform Medical , United Healthcare, HMOs, PPOs, and other payers. Contact insurance payers by ... either phone or online inquiry regarding unpaid hospital claims . Review remaining balances on account after insurances have...best people, we must empower them. **Required Qualifications:** + Medical terminology and medical coding training in… more
- CVS Health (Austin, TX)
- …Senior Claim Benefit Specialist reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. They will act as ... customer service inquiries and problems. **Key Responsibilities** + Reviews pre-specified claims or claims that exceed specialist adjudication authority or… more
- Adecco US, Inc. (San Antonio, TX)
- …patients and providers + Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are NCB or medically ... request, researches and provides requested information + Works with claims department to redirect claims related appeal...screening + 401(k) Plan + Skills Training + Excellent medical , dental, and vision benefits Benefit offerings include … more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product ... Work closely with, market access, Finance, Commercial operations, and medical teams to ensure seamless execution of brand strategies...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- CVS Health (Austin, TX)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- Adecco US, Inc. (San Antonio, TX)
- …patients and providers . Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are NCB or medically ... request, researches and provides requested information . Works with claims department to redirect claims related appeal...2+ years of related experience . Sound knowledge of medical terminology . Proficient software computer skills **Why work… more
- 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 ... filing system. + Assist with case management of open claims through to closure; notify safety director of safety...your family: + 401(k) Plan + Competitive Pay + ** Medical , Dental, Vision Insurance** + Term Life, AD&D Insurance,… more
- CVS Health (Austin, TX)
- …Provide excellent customer services for high volume inbound provider calls for the Claims Inquiry/ Claims Research Medicaid team. Extensive claims research on ... and issues. + Assist in compiling claim data for audits. Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating… more
- Otsuka America Pharmaceutical Inc. (Abilene, 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