- CVS Health (Austin, TX)
- …it all with heart, each and every day. **Position Summary** The Lead Director, Pharmacy Appeals will lead a team of 40+ colleagues in the management of ... (TATs) and with high accuracy while making sure the team is appropriately staffed and organized. In addition, you...other internal business units to resolve issues quickly. The Lead Director, Pharmacy Appeals is also responsible… more
- Elevance Health (Plano, TX)
- **Referral Specialist I/Patient Access (Pre & Prior Authorizations, Appeals , Insurance) - Paragon Infusion** **Location:** 3033 W President George Bush HWY., STE ... **Referral Specialist I** is responsible for providing support to a clinical team in order to facilitate the administrative components of clinical referrals. **How… more
- American Heart Association (Dallas, TX)
- …evolving landscape of direct response fundraising and strategies for the future. + Lead and manage a team of direct response fundraising professionals, providing ... communications team to develop compelling and persuasive fundraising messages, appeals , and creative assets for direct response campaigns. Collaborate with the… more
- Humana (Austin, TX)
- …and/or requested site of service should be authorized at the Initial and Appeals /Disputes level. All work occurs within a context of regulatory compliance, and work ... an overview of coding practices and clinical documentation, disputes processes, and appeals processes, and outpatient services and equipment, within their scope. The… more
- Humana (Austin, TX)
- …with other team members, other departments, Humana colleagues and the Lead Medical Director. After completion of mentored training, daily work is performed with ... an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, and outpatient services and equipment, within their scope.… more
- Elevance Health (Grand Prairie, TX)
- …report reopenings. + Under guided supervision, participate in completing more complex appeals related work: + Position papers + Jurisdictional Reviews + Maintaining ... by updating all logs, case files, tracking systems + Participate in all team meetings, staff meetings, and training sessions **Minimum Requirements:** + Requires a… more
- Integrative Emergency Services (Dallas, TX)
- …but not limited to change capture, coding, billing, collections, denials, and appeals . + Serve as a liaison between specialty services and other departments, ... with third party payors specific to specialty services, including underpayments, appeals , and contractual discrepancies. + Stays current on payor regulations… more
- HCA Healthcare (Conroe, TX)
- …for a Chief Medical Officer for our HCA Houston Healthcare Conroe team where excellence creates excellence. **Benefits** HCA Houston Healthcare Conroe, offers a ... and analysis of managed care issues. Offers clinical support for appeals and denials process, discharge planning, case management, and utilization review/management.… more
- Humana (Austin, TX)
- …an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and outpatient services and equipment, within their scope. The ... some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, and Humana colleagues. After completion of mentored… more
- Elevance Health (Houston, TX)
- …of covered treatments and genetic testing. + Participate in periodic physician team meetings. + Demonstrate and maintain knowledge of relevant policies and ... a subject matter expert. + Perform first level provider appeals as designated by the client for adverse determinations....is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more