- Cognizant (Austin, TX)
- …assigned accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals , and retro-authorization as well as timely filing ... with Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims / appeals information on relevant tracking systems . Utilize critical… more
- Centene Corporation (Austin, TX)
- …to optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex ... as to individuals and families served by the Health Insurance Marketplace. Looking for a compelling opportunity to move...cases and medical necessity appeals . + Participates in provider… more
- Centene Corporation (Austin, TX)
- …to optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex ... cases and medical necessity appeals . + Participates in provider...would improve utilization and health care quality. + Reviews claims involving complex, controversial, or unusual or new services… more
- Guardian Life (Plano, TX)
- …Texas are compliant with applicable state regulations. You will ensure that claims , referrals, appeals , and grievances meet state specific regulations, ... + Review & ensure that determination and processing of claims , referralsand appeals meet state regulations, time...is preferred + A thorough understanding of the dental insurance industry, claims management experience, and a… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …for proper account/claim adjudication. + Analyze and interpret patient account information; ensure claims will submit to insurance companies in a timely manner. ... **43131BR** **Extended Job Title:** Medical Billing Specialist **Org Level 1:** Texas Tech Unv Hlth Sci Ctr El Paso **Position Description:** Responsible for… 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 ... Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance , other healthcare providers, clinical group practice management. +… more
- Cardinal Health (Austin, TX)
- …billing queue as assigned in the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure timely and ... **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Urology Clinics of North Texas (Mesquite, TX)
- …including office-administered medications and infusion services. + Strong knowledge of medical terminology, insurance plans, claims , and billing ... to insurance carriers as needed. + Review insurance Explanation of Benefits (EOB) and initiate appeals...office-administered medications and infusion services. + Strong knowledge of medical terminology, insurance plans, claims ,… more
- HCA Healthcare (Plano, TX)
- …preferred, such as accounts receivable follow-up, insurance follow-up and appeals , insurance posting, professional medical /billing, medical ... as it relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims . This job requires regular outreach to payors and… more
- Molina Healthcare (Fort Worth, TX)
- …recoveries in a managed care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. ... and contractual guidelines. + Partner with provider relations, Health plans and appeals teams to address recurring dispute trends and recommend systemic solutions. +… more