- Ascension Health (Austin, TX)
- …and resolving health-care claim payment appeals and communicating resolution /determination in accordance with the standards and requirements established ... by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to state Medicaid guidelines. +… more
- Truist (Arlington, TX)
- …track all unresolved issues accurately, to ensure timely follow up and resolution . Servicing specialists act as client advocates to track client complaints and ... executing on the Truist Purpose, Mission and Values. 2. Investigate and provide resolution to clients' requests to Care Center, branches and other lines of business,… more
- Centene Corporation (Austin, TX)
- …- Friday; 10:30 am 7:00 pm EST.** **Position Purpose:** The Pharmacy Resolution Specialist receives and responds to calls from members, provider/physician's ... inbound and outbound calls with members and provider offices to provide resolution to claims (ie: additional information requests and medication determination… more
- Centene Corporation (Austin, TX)
- …Friday; 2:00 pm - 10:30 pm EST, schedule.** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and handles more ... inbound and outbound calls with members and provider offices to provide resolution to claims (ie: additional information requests and medication determination… more
- HCA Healthcare (Houston, TX)
- …UT, VA). Do you want to join an organization that invests in you as a Medical Insurance Claims Follow-up Specialist ? At Parallon, you come first. HCA ... of our team. **Job Summary and Qualifications** As an ** Medical Insurance Claims Follow-up Specialist **...issues and thereby affect payment and/or bringing them to resolution . **What you will do in this role:** +… more
- Houston Methodist (Houston, TX)
- …AR collections. **FINANCE ESSENTIAL FUNCTIONS** + Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients. This ... is responsible for resolving all outstanding third-party primary and secondary insurance claims for professional services. This Specialist is required to perform… more
- Travelers Insurance Company (Houston, TX)
- …or their legal representatives. + Recognizes and implements alternate means of resolution . + Manages litigated claims . Develops litigation plan with staff ... and resolving assigned General Liability Bodily Injury and Property Damage claims . Provides quality claim handling throughout the claim life cycle (customer… more
- Insight Global (Irving, TX)
- … is responsible for managing the end-to-end lifecycle of workers' compensation claims -from initial incident reporting through resolution and closure. This role ... Claims Management Oversee all phases of workers' compensation claims including intake, investigation, documentation, and resolution . Ensure timely… more
- Travelers Insurance Company (Richardson, TX)
- …employs creative resolution strategies. + Promptly and properly disposition all claims within delegated authority. + Negotiates disposition of claims with ... or their legal representatives. + Recognizes and implements alternate means of resolution . + Manages litigated claims . Develops litigation plan with staff… more
- Molina Healthcare (Fort Worth, TX)
- …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working environment is ... clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains… more