- Houston Methodist (Houston, TX)
- …and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of complex claims ... **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with revenue integrity teams to review provider services and provide effective education and feedback. Coordinates… more
- Molina Healthcare (TX)
- …as the professional scope of a Payment Integrity Clinician. This includes assessing medical documentation, itemized bills, and claims data to ensure appropriate ... tracking cost containment initiatives through comprehensive clinical and financial analysis of claims data, medical documentation, and itemized bills. + Leads… more
- USAA (San Antonio, TX)
- …multi-tasking, and problem-solving skills. + Proficient knowledge of human anatomy and medical terminology associated with bodily injury claims . + Ability to ... and framework, responsible to adjust attorney-involved, moderately complex bodily injury claims , and UM claims to include confirming coverage, determining… more
- Houston Methodist (Houston, TX)
- …Office (CBO). This includes, but is not limited to, resolution of charge review (where applicable) and claim edits, payor rejections, unresolved or no response ... insurance claims and processing of financial correspondence. The Insurance Biller...one of the nation's leading health systems and academic medical centers. Houston Methodist consists of eight hospitals: Houston… more
- TEKsystems (Dallas, TX)
- …Health claim submission software and Salesforce. * Work with all payers to ensure medical claims are being processed timely and paid accurately. * Analyze and ... Description Primary responsibilities will include submitting claims , posting payments, working payor rejections and denials, and completing follow ups to ensure… more
- Sedgwick (Irving, TX)
- …eligibility review ; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Informs claimants of documentation required to ... claims status either by phone, written correspondence and/or claims system. + Reviews medical information to determine if the claimant meets the requirements… more
- Sedgwick (Irving, TX)
- …eligibility review ; and to ensure the ongoing processing of claims . **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** * Informs claimants of documentation required to ... claims status either by phone, written correspondence and/or claims system. * Reviews medical information to determine if the claimant meets the requirements… more
- Rexel USA (Dallas, TX)
- …and implementing programs and processes to control the cost of insurance and claims . What You'll Do + Provide best practices in workers compensation management ... + Daily Management of third-party administrator for all RHUSA workers compensation claims + Liaise with National Safety Manager on Workers Compensation claims… more
- Rush Enterprises (New Braunfels, TX)
- …claims required. + Perform regular audits of individual claim files and review workers' compensation claims . + Efficiently manage caseload ratios by balancing ... Oversee and manage complex workers compensation claim process, including reporting, medical coordination, lost time and return-to-work program. + Provide strategic… more
- Fun Town RV (Amarillo, TX)
- …reimbursements and maintaining compliance with warranty standards. Warranty Claim Processing: + Review , prepare, and submit warranty claims to manufacturers for ... Administrator is responsible for managing all aspects of warranty claims in the dealership. This role ensures that warranty...a competitive salary and benefits package including: + Major Medical , Dental, Vision + Life Insurance + Paid Vacation… more