- UIC Government Services and the Bowhead Family of Companies (San Antonio, TX)
- …audits and time analysis by pulling patient notes from medical records and/or medical records for physicians to conduct peer review audits of medical ... **Overview** MEDICAL CLERK - (BAMC-2025-23675): Bowhead seeksMedical Clerks to...characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- Methodist Health System (Dallas, TX)
- …or medical reimbursement Proven experience in managing no response claims , denied claims , and billing correspondence. Knowledgeable with payors; Managed ... a particular emphasis on addressing and resolving no response claims , rejected or denied claims , and managing...12 hospitals (through ownership and affiliation) with nationally recognized medical services, such as a Level I Trauma Center,… more
- HCA Healthcare (Houston, TX)
- …provides satisfaction and personal growth, we encourage you to apply for our Medical Collections Specialist opening. We promptly review all applications. Highly ... **Introduction** Do you have the career opportunities as a Medical Collections Specialist you want with your current employer?...work to correct them + You will monitor insurance claims and contact insurance companies to resolve claims… more
- Centene Corporation (Austin, TX)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. + Supports effective implementation… more
- Elevance Health (Grand Prairie, TX)
- …+ Serves as a resource and consultant to other areas of the company; particularly the Medical Review and Appeals areas + May be required to represent the company ... fee for service and assisting nurses as needed with review of claims . Works with other Medicare...claims . Works with other Medicare Administrative Contractor (MAC) Medical Directors for developing collaborative policies. May participate in… more
- Houston Methodist (Houston, TX)
- …and initiate calls to ensure prompt authorization approvals and secure payment of medical claims for both hospital billing and physician billing. + Consistently ... is documented clearly, so that various departments involved in resolution can review the account. Follow established customer service guidelines and strive to meet… more
- Humana (Austin, TX)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... to operationalize this knowledge in their daily work. The Medical Director's work includes computer based review ...The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, … more
- Sedgwick (Austin, TX)
- …you have just started your career, you are a leader in the industry, or a claims management expert looking for a new challenge, this is your chance to showcase your ... of clients across the globe, handling complex cases and claims + Collaborate with a talented and supportive team...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
- Humana (Austin, TX)
- …Prior experience in provider education + Strong knowledge of medical record review + Understanding of billing, claims submission, and related processes + ... Coding Educator is responsible for reviewing and analyzing internal data and medical records, as well as coordinating educational sessions with providers to enhance… more
- Molina Healthcare (Austin, TX)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... Public Health, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. +… more