- Highmark Health (Austin, TX)
- …the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code submission, analysis of the ... effective Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a review of...+ Ability to visualize, articulate and solve complex problems representative of a broad range of service and claim… more
- Stantec (Plano, TX)
- …stock purchase program, life and accidental death & dismemberment (AD&D) insurance , short-term/long-term disability plans, emergency travel benefits, tuition ... System selection to be based on Project/Client needs as well as proactive Claims /Risk mitigation. - Oversee and approve development and management of the Project… more
- Healthpeak Properties, Inc. (Dallas, TX)
- …technical capability of portfolio increases through vendor partnerships and training + Manage insurance claims on behalf of the owner + Collaborate with facility ... identify capital needs + Provide project management oversight and act as owner's representative to ensure capital is deployed as effectively as possible + Provide… more
- Highmark Health (Austin, TX)
- …medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior ... of benefit billing practices through paid clams review. + Participate as pharmacy representative in onsite member appeals and grievances sessions. + Serve as a… more
- Medtronic (TX)
- …Clinical Expert + Translates complex technical messaging, dispels competitive claims , resolves complex technical issues, and maintains customer relationships through ... objectives with little guidance **Additional Job Requirements** + Frequent required travel to customer sites, hospitals, and offsite meetings. While performing the… more
- Towne Park (Dallas, TX)
- …**Benefits:** Employees are eligible to enroll in medical, dental, and vision insurance , accident insurance , critical illness insurance , hospital indemnity ... and telemedicine benefits. Employees are provided company-paid basic life and AD&D insurance as well as short-term and long-term disability. Employees are also able… more
- Houston Methodist (The Woodlands, TX)
- …and verifying eligibility for care. This position supports timely, accurate claims submission and may perform registration and/or other revenue cycle functions. ... when performing functions such as charge entry, registration, scheduling, insurance verification/coordination, or obtaining authorizations or referrals to ensure… more
- HUB International (El Paso, TX)
- **About Us:** HUB is a global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee ... with generating benchmarking reports (annually, quarterly or monthly) + Manages claims and coverage issue resolution for clients' employees when elevated from… more
- Gilead Sciences, Inc. (Houston, TX)
- …and Drug Administration's implementing regulations, the Federal Anti-Kickback Statute, the False Claims Act, PhRMA, Corporate Code of Business Conduct and the Office ... 4+ Years with MS/MA + Ability to engage in travel as may be reasonably required, including regular ...each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable… more
- Guidehouse (San Antonio, TX)
- …finance or customer service. + Working knowledge can be of the following: insurance claims , billing, coding, follow-up, finance, accounting or customer service ... **Job Family** **:** Patient Account Representative ** Travel Required** **:** Up to...healthcare patient relations call center + Patient Access or insurance verification call center management + Bilingual Spanish \#IndeedSponsored… more