- USAA (San Antonio, TX)
- …based on thorough analysis of claim and applicable program rules in Automobile, Medical Pay, or Personal Injury Protection (PIP) claims . Recognizes and documents ... to pass required exams to serve as a panelist in arbitrations for Automobile, Medical Pay, or Personal Injury Protection (PIP) claims within 90 days (which… more
- Bank of America (Addison, TX)
- …**Position Summary:** + Technology architecture and design of the Claims Technology capabilities. + Stability, resiliency, performance, and disaster recovery ... strategy/plans/testing of the Claims platform. + Alignment of technology strategy to enterprise...+ Design and development best practices as well as review processes to ensure consistency. Establishing quantitative metrics to… more
- Sedgwick (Austin, TX)
- …maker and sets time bound expected completion date per Client Guidelines + Review and assess the validity of all supplement request + Proactively provides customers ... with information regarding their vehicle's cost of repair estimate and explains claims /repair process + Maintains accurate vehicle's cost of repair estimate and… more
- HCA Healthcare (Austin, TX)
- …This position is incentive eligible. **Job Summary and Qualifications** HCA Graduate Medical Education is one of the nation's largest providers of residency and ... HCA GME is building a leading network of innovative, patient-centered graduate medical education programs. We believe graduate medical education is much… more
- Stantec (Plano, TX)
- …System selection to be based on Project/Client needs as well as proactive Claims /Risk mitigation. + Oversee and approve development and management of the Project ... Development and maintenance of the Project Risk Register, based on review of contract conditions, project-specific delivery requirements, client characteristics, and… more
- Elevance Health (Grand Prairie, TX)
- …experience preferred. + Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing ... the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims...you will make an impact:** + Analyzes and audits claims by integrating medical chart coding principles,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …with, and/or be a critical partner to Early Phase & Translational Medical , Clinical Development, Value and Real-World Evidence, Regulatory, Medical Affairs, ... on study concepts and study protocols in governance meeting and review processes + Prepare reports and presentations summarizing findings, recommendations and… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …negligence claims ). + Ensure all aspects of the University's medical , podiatric, and allied-health clinical practices meet applicable regulatory requirements. + ... management, transactional, academic (student/trainee), and litigation-related issues associated with medical , podiatric, or allied-health practices and education. Description of… more
- Sedgwick (Austin, TX)
- …new business plan with goals and objectives for assigned locations/offices; provides expert medical and product support to Sedgwick claims and clinical staff. ... and high quality delivery of case management and utilization review services to clients for multiple business lines; and...education and experience required to include five (5) years medical case management, two (2) years clinical experience, two… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide ... territory plans through partnerships with internal and external stakeholders + Review and educate offices on payer policies, including prior authorization… more