- Elevance Health (Grand Prairie, TX)
- …healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, ... and claim systems for review of facility, professional and pharmacy claims . + Responsible for identifying and developing enterprise-wide specific healthcare… more
- Baylor Scott & White Health (Plano, TX)
- …risk exposure. **LOCATION** This position will support two hospitals; Baylor Scott & White Medical Center - Lake Pointe and Baylor Scott & White Medical Center ... investigation of the event will be delegated to Corporate claims manager for further review. The CRM will participate,...adverse event reports. + Regularly reports to executive and medical staff managers related to CRM trending data and… more
- CVS Health (Austin, TX)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...review. A candidate must become subject matter experts in claims , plan documents, eligibility, coverages, and quirks of multiple… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …prior authorizations and referrals and entering the completed referral into the electronic medical record system for claims adjudication to ensure services are ... appropriate departmental staff in a timely manner. + Communicates effectively with health plans, payor representatives, and network and claims department staff… more
- HCA Healthcare (Houston, TX)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Medical Collections Specialist with HCA Healthcare you can be a part of an ... Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Sedgwick (Austin, TX)
- …Applies jurisdictional and medical knowledge to properly assess the indemnity, medical and expense exposure of assigned claims and appropriately interprets ... PURPOSE** **:** To manage claim caseload of basic to highly complex claims within granted authority level including related financial implications, along with… more
- Mass Markets (TX)
- …cars! + Health Benefits: Full-time employees are eligible for comprehensive medical , dental, and vision coverage after 90 days of employment, and all employees ... as a trusted partner in the industry. We are seeking an onsite licensed health insurance specialist who will play a vital role in educating and guiding customers… more
- Sedgwick (Austin, TX)
- …**PRIMARY PURPOSE** **:** To handle complex or high exposure claim issues; to provide medical knowledge of the health care system and health care ... issues; to independently investigate, analyze and evaluate medical malpractice claims for self-insured and commercially insured clients; to provide information… more
- Robert Half Accountemps (Dallas, TX)
- Description We are seeking a detail-oriented Medical Biller well-versed in eClinicalWorks (ECW) to join a dynamic healthcare team. The ideal candidate will possess a ... strong foundation in medical billing processes, demonstrate proficiency in ECW, and have...resolution of billing issues, helping to maintain the financial health of the organization. Core Responsibilities: + Insurance Claim… more
- Robert Half Accountemps (Dallas, TX)
- Description We are looking for a skilled Medical Billing Specialist to join our team in Dallas, Texas. This Contract-to-Permanent position offers an excellent ... The ideal candidate is detail-oriented and has a strong background in medical billing and coding, ensuring accuracy and timeliness in all billing operations.… more