- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …with Sales and Marketing on sample allocation and planning. + Support audit readiness and compliance reviews. **Operational Efficiency & Field Partnership** + ... with states and local laws. **Company benefits** : Comprehensive medical , dental, vision, prescription drug coverage, company provided basic...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- City of College Station (College Station, TX)
- …dependent verifications, earnings and deductions administration; billing/invoicing; claims reviews; system administration, vendor audits and reconciliations, ... to ensure reasonable responses to employee concerns, resolution of issues related to claims or service disruptions, and to confirm accuracy in the application of… more
- Molina Healthcare (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
- Mass Markets (Killeen, TX)
- …work at one of our locations. We offer bonuses opportunities, comprehensive medical , dental and vision benefits, paid vacation and holidays, and contests incentives. ... are administered fairly and consistently throughout the area of responsibility + Perform audit and compliance functions as requested on items such as audit … more
- Houston Methodist (Houston, TX)
- …with Clinical Research Billing Compliance. + Provides oversight and performs detailed claims analysis and medical record review as necessary, including the ... clinical trial protocols, study budgets, coverage analyses, etc. - Performs detailed claims testing and medical review. - Reviews Medicare Coverage Analysis… more
- Humana (Austin, TX)
- …operational goals, including regulatory compliance requirements + Promotes and builds an " Audit Ready Every Day" culture + Further simplifies and improves processes ... efficiencies + Collaborates with upstream business partners such as Claims , Clinical Guidance, and the Provider Network to identify...starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits +… more
- Elevance Health (Houston, TX)
- …the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How ... in a timely manner to ensure prompt resolution. + Tracks and trends audit results, providing feedback effectively and professionally to management. + Identifies and… more
- New Jersey Resources (Houston, TX)
- …changes to address deficiencies, improve programs and ensure company maintains an audit -ready status at all times. * Develop and maintain excellent working ... and subsequent response analysis reviews. * Assist in managing Workers' Compensation Claims , Return to Work programs, accident reports, claims and lead… more
- Walgreens (Dallas, TX)
- …issues and prevent payment rejections. Follows- up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Walgreens (Houston, TX)
- …issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more