- Mass Markets (TX)
- …partner in the industry. We are seeking a detail-oriented and analytical Quality Assurance Specialist to join our team. This role is critical in ensuring the highest ... forms to score calls based on communication skills, adherence to scripts, and problem resolution . + Analyze call data to identify trends and areas for improvement. +… more
- Molina Healthcare (Fort Worth, TX)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... areas of responsibility (eg, Provider Services/Provider Inquiry Research & Resolution , Provider Contracting/Provider Relationship Management). + Provides timely, accurate… more
- Molina Healthcare (Austin, TX)
- …for reviewing and resolving member & provider complaints and communicating resolution to members (or authorized) representatives in accordance with the standards ... to state and federal and Molina Healthcare guidelines. + Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research. +… more
- Methodist Health System (Dallas, TX)
- …as a proactive point of contact for benefit vendors, ensuring timely resolution of inquiries related to eligibility file reconciliation. + Provide exceptional ... maintaining organized employee files. + Proactively manage and process FMLA/LOA claims across the organization, ensuring compliance with Methodist policies and… more
- MTC (Rosharon, TX)
- …of available insurance benefits, procedures, etc. Coordinate with insurance company regarding claims , resolution of problem cases, etc. 6. Provide follow-up ... hour** **Schedule** - Full Time, Monday - Friday **Benefit package includes:** + Medical , vision, and prescription drug benefits + Dental benefits + Life insurance +… more
- Highmark Health (Austin, TX)
- …relationships hold the key to uncovering society's most complex challenges? Do you see medical records not just as disparate facts, but as a vast, dynamic network of ... work will directly impact millions of lives. As our Lead Graph Intelligence specialist , you will be the spearhead of cutting-edge research projects. This means… more
- Highmark Health (Austin, TX)
- …cases of the change or problems and takes appropriate steps to effect resolution . (10%) + Reviews and interprets medical information, classifies that information ... related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding,… more