- Kemper (Dallas, TX)
- …office and will work closely with and report directly to the Director of Claims , Arbitration and Subrogation. The Senior Manager will assist the leadership team ... to our stakeholders that delivers on our promises._ Kemper is seeking a Senior Manager for our Arbitration and Subrogation Department. The selected candidate will… 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 ... At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for...Conducts risk-based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about ... 340+ senior focused primary care centers in 15 states. The...that supports the PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across… more
- Providence (TX)
- **Description** ** Senior Claims Manager - Employment Practice Liability \*Remote * Candidates residing in Alaska, Washington, Montana, Oregon, California, Texas ... or New Mexico are encouraged to apply.** The Senior Claims Manager- Employment Practice Liability ("EPL")...- they're invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused,… 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)
- …with other documentation and coding and billing standards; communication of audit results to physicians, physician leadership, senior leadership, management, ... medical terminology; E/M rules, teaching physician guidelines, and/or medical necessity defense reviews; healthcare compliance audit methodology, principles… 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 ... You will lead strategy on complex bodily injury auto claims , handling pre-litigation disputes and resolving litigated claims...a successful candidate will support and report to a Senior Risk Manager and be enthusiastic about driving change,… 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
- CRC Insurance Services, Inc. (TX)
- …5. Train claims staff on new policies or procedures. 6. Oversee and audit claims process ensuring proper documentation was created in the system and/or ... order to provide account loss ratios and claims history to senior management....of CRC Group offering the position. CRC Group offers medical , dental, vision, life insurance, disability, accidental death and… more
- Ascension Health (Austin, TX)
- …requirements established by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to ... that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes....of care, including more than 140 hospitals and 40 senior living communities in 19 states. Our Mission, Vision… more