- Sedgwick (Houston, TX)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Bill Review Analyst | Professional Liability | Remote **PRIMARY PURPOSE** : The Bill ... Review Analyst plays a critical role in supporting the...Participates in the ongoing refinement of billing guidelines and review procedures to reflect evolving legal and industry standards.… more
- Molina Healthcare (Houston, TX)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
- Molina Healthcare (San Antonio, TX)
- …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member ... services review assessment processes. Responsible for verifying that services are...years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of… more
- Molina Healthcare (Austin, TX)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying ... 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant education… more
- Cornerstone Caregiving (Waco, TX)
- P&L Review Analyst for Waco, TX Finance & Accounting...Summary We are seeking a detail-oriented and analytical P&L Review Analyst to oversee the review and ... analysis of Profit & Loss (P&L) statements. This role is responsible for ensuring financial accuracy, identifying trends, and providing actionable insights to support business decisions. The ideal candidate will have strong financial acumen, excellent… more
- Molina Healthcare (Austin, TX)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary ... health care experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Medical Center Hospital (Odessa, TX)
- + Position Summary: The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital ... Utilization Review Program and makes appropriate referrals to designated Physician Advisors. + Qualifications: A. Education: Holds a current Texas license as a Registered Nurse OR a current Texas Licensed Vocational Nurse. B. Training and Experience: Three… more
- HCA Healthcare (Corpus Christi, TX)
- …PPEC chair with interview of physicians/department chairs. Assist in external peer review process. Create and report as appropriate to leadership council and peer ... review committee. Update and maintain log regarding physician concerns....our RN Coord Quality PI PRN opening. We promptly review all applications. Highly qualified candidates will be contacted… more
- Consolidated Electrical Distributors (Irving, TX)
- Summary Job title: Remote Position - Quality Control\Plan Review Specialist Job ID: null Department: Greentech Design Services Location: null-null Description ... Renewables' Design Services Team is looking for a Quality Control\Plan Review Specialist to complete locally code-compliant plan-sets conforming to customer… more
- Molina Healthcare (Fort Worth, TX)
- **Job Description** **Job Summary** Provides support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. ... on the claims transactional system and COB tracking database. + Review of claims identified for overpayment recovery. **Job Qualifications** **REQUIRED… more