- TEKsystems (Plano, TX)
- …tasks, including inpatient and outpatient services. Qualifications: + Proven experience in medical billing, preferably in behavioral health . + Familiarity with ... ensuring timely resolution and follow-up. + Process approximately 15-40 claims per day, depending on volume. + Support collections...for this temporary role may include the following: * Medical , dental & vision * Critical Illness, Accident, and… more
- Humana (Austin, TX)
- …us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Qualifications** + Medical utilization management experience + Working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Elevance Health (Grand Prairie, TX)
- …requirements. + Develop and analyze business performance reports (eg, for claims data, provider data, utilization data) and provides notations of performance ... Microsoft Excel experience. + Facets systems knowledge considered a plus. + Claims and/or Encounters experience preferred. + Experience with Medicaid data preferred.… more
- Humana (Austin, TX)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Centene Corporation (Austin, TX)
- …per year Centene offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a...of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving… more
- Baylor Scott & White Health (Plano, TX)
- …tactful. + Knowledge of patient registration procedures and documentation. + Knowledge of medical insurance claims procedures and documentation. Needs to ... **About Us** Here at Baylor Scott & White Health we promote the well-being of all individuals,...duties associated with patient relations, check-in or check-out, scheduling, insurance verification and answering phones. + Serves as a… more
- Sedgwick (Austin, TX)
- …and relatively complex National Account. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Examines insurance policies, claims , and other records to determine ... insurance coverage. + Administers and reconciles complex catastrophic claims for property. + Interviews, telephones, or corresponds with claimant(s) and witnesses… more
- Sedgwick (Houston, TX)
- …work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims ; documents decision rationale; and completes medical review of ... disability. + Provides clear and appropriate follow-up recommendations for ongoing medical management of claims ; ensures appropriate recommendations are made… more
- Highmark Health (Austin, TX)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** Are you...to uncovering society's most complex challenges? Do you see medical records not just as disparate facts, but as… more
- BrightSpring Health Services (Denton, TX)
- …personnel costs, consultant services + Monitors worker's compensation and unemployment claims for assigned service site(s). Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas...Other duties as assigned Qualifications + BA/BS in Business, Health Care Administration, or Social Services. High school diploma… more