- Guidehouse (San Antonio, TX)
- …**:** None **Clearance Required** **:** None **What You Will Do** **:** The ** Insurance Patient Account Representative ** is an extension of a client's business ... **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS 1500… more
- Humana (Austin, TX)
- …community and help us put health first** Job Description Summary The Pharmacy Claims Representative assists local pharmacies with claims adjudication to ... up and maintaining hospice/facility/pharmacy relationships under the direction of the Pharmacy Claims Team Leaders & the Pharmacy Claims (Support Services)… more
- Providence (TX)
- …caregivers regarding Centers for Medicare and Medicaid Services (CMS) Medicare Secondary Payer reporting, applicable laws, insurance regulations, and other ... claim payments and write-offs and serve as our mandatory reporting authorized representative + Facilitate monthly claims files internal audits including monthly… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …the supervision of the Business Services Supervisor, the Claim Edit Follow-Up Representative is responsible for processing the electronic claims edits, "front ... years' experience in a healthcare business office setting, preferably in electronic claims billing, or insurance follow up. **License(s)** Required: N/A… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …or health plan insurance environment. Knowledge of health Care and insurance and the ability to Interpret/Apply Medicare Prescription Drug Benefits, Medical ... to administrative issues related to health plan operations including claims resolution, premium billing, medical benefit interpretation, organization and coverage… more
- Cardinal Health (Austin, TX)
- …the right things done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of ... from AR & Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Houston Methodist (Houston, TX)
- …is responsible for resolving all outstanding third party primary and secondary insurance claims for professional services. This position performs collections ... productivity goals. **FINANCE ESSENTIAL FUNCTIONS** + Expedites and maximizes payment of insurance medical claims by contacting third party payors and patients.… more
- Cardinal Health (Austin, TX)
- …+ Acts as a subject matter expert in claims processing. + Processes claims : investigates insurance claims ; properly resolves by follow-up & disposition. ... account receivables performance and client satisfaction. + Resolves complex insurance claims , including appeals and denials, to...or third party policy. + Updates patient files for insurance information, Medicare status, and other changes… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …Representatives handle member and provider calls for self-funded, fully insured and Medicare Commercial plans. **Job Title: Managed Care Representative II** ... to health plan operations including benefit interpretation for providers, claims resolution, referral inquiries, general plan benefits, Kelsey-Seybold Clinic… more
- Specialty Rx, Inc. (Austin, TX)
- …by the Billing Supervisor + Research and establish patient eligibility coverage with insurance providers (state and private) + Determine and process insurance ... daily report + Maintain and update patient billing and insurance information in the system + Submit prior authorizations... updates + Interact with client facilities staff, PDP ( Medicare ), CMS, NJM and NYM, if necessary + Follow… more