- Humana (Austin, TX)
- …on beneficiary needs; assists with beneficiary related issues which may include claims inquiries, enrollment issues, travel attestations, access to care, wait lists, ... + Bilingual a plus. + Experience working in a remote /work at home setting. **Additional Information** **Work Days/Hours** :...8:00 am - 4:00 pm EST. **Work Style** : Remote **Work at Home/ Remote Requirements** To ensure… more
- Humana (Austin, TX)
- …appeals experience + Prior experience interpreting Member Benefits and Medical Claims + Previous experience processing medical authorizations + Bilingual (English ... + Prior experience with Medicare + Experience with the Claims Administration System (CAS) + Knowledge of medical terminology...to keep you informed. Travel: While this is a remote position, occasional travel to Humana's offices for training… more
- Banner Health (TX)
- …individual needs, with continued support throughout your career here! This is a fully remote position and available if you live in the **following states only: AK, ... coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple… more
- Robert Half Legal (Richardson, TX)
- …you. Responsibilities: * Manage and oversee legal cases assigned by the Claims Department, ensuring timely and effective handling. * Develop comprehensive case ... memorandums. * Prepare and deliver regular status reports to claims handlers, ensuring updates occur at least every 60...* Ability to work in-office with occasional opportunities for remote work. * Willingness and ability to travel as… more
- BrightSpring Health Services (San Angelo, TX)
- …personnel costs, consultant services, etc + 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...disability, behavioral/mental health support, in-home pharmacy solutions, telecare and remote support, supported employment and training programs, and day… more
- Sedgwick (Austin, TX)
- …career making an impact on the health and lives of others, and a remote work environment. + Enjoy flexibility and autonomy in your daily work, your location, ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Centene Corporation (Austin, TX)
- …tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity ... with claims payment, utilization management, provider/vendor contracts, risk adjustment for...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Centene Corporation (Mcallen, TX)
- …+ Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics + Perform ... care or medical group experience, provider relations, quality improvement, claims , contracting utilization management, or clinical operations. Project management… more
- Sedgwick (Austin, TX)
- …career making an impact on the health and lives of others, and a remote work environment that allows face to face interaction with injured workers and medical ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Zelis (Plano, TX)
- …team to refine into user stories with acceptance criteria, including creating test cases/ claims with expected pricing outcomes . + Perform analysis of various data ... understanding of public and private healthcare payment systems, medical claims , standard claim coding, claim editing, contracting, preferred-provider organizations,… more