- 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
- WTW (Dallas, TX)
- …PPO, Indemnity and Managed Care + Must demonstrate a high level of claims administration knowledge, including experience with medical , dental, mental health and ... **Description** As a Lead Auditor you will apply your audit , project management and client management skills to lead client audits. You will serve as the team leader… more
- Cardinal Health (Austin, TX)
- … medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles ... detection and correction of documentation, coding, and billing errors and/or medical necessity of services billed. Particular areas of focus include: evaluation… more
- Wells Fargo (Irving, TX)
- **About this role:** Wells Fargo is seeking an Innovation and Analytics Audit Manager, Vice President as part of our Chief Operating Office (COO) / Shared Services ... Operations (SSO) Audit Innovation & Analytics team. The Audit ...properties, corporate security), enterprise complaints and remediation, fraud and claims management, control executive, regulatory & policy affairs, and… more
- Conduent (Dallas, TX)
- … Auditor CPhT** **Do you have a CPhT certification?** **Would you like to audit pharmacy claims for accuracy?** **About the Role** Conduent Payment Integrity ... behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety...and pharmacy practices. + Responding to pharmacy calls regarding audit results and dealing with clients periodically to report… more
- Molina Healthcare (Houston, TX)
- …Data Validation) team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of chart retrieval chase ... lists by helping identify and validate source data required for medical record collection. This is an ideal opportunity for an early-career analyst with a strong… more
- Providence (TX)
- **Description** ** Claims Manager** **_Remote. Candidates residing in AK, WA, MT, OR, CA or TX are encouraged to apply._** The Claims Manager is responsible for ... day-to-day oversight of general and professional liability claims in accordance with the System's claims ...- they're invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused,… more
- Sedgwick (Austin, TX)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements, and ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead I Workers Comp (Calif Exp) **PRIMARY...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Sedgwick (Austin, TX)
- …management reports and takes appropriate action. + Performs quality review on claims in compliance with audit requirements, service contract requirements and ... a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Claims Team Lead, General Liability **PRIMARY PURPOSE** : To supervise a team of… more
- Amazon (TX)
- …program around the world across all of its various use cases. Amazon's Last Mile Claims team is seeking a talented claims professional to support our rapidly ... auto program. You will lead strategy on complex bodily injury auto claims , handling pre-litigation disputes and resolving litigated claims with cross-functional… more