- Lincoln Financial (Austin, TX)
- …reviews for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. ... You will analyze and manage a caseload of appeals claims . You will review, investigate, and...+ Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims… more
- Covenant Health (Lubbock, TX)
- **Description** ** Claims Appeals Representative** **Works collaboratively with Case Management (CM) Leadership, Case Managers (CM), Complex Discharge Planners ... 3 or more years of experience in managed care claims / reimbursement setting or experience working in another other...401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life insurance , disability … more
- Elevance Health (Houston, TX)
- **Manager II Grievance/ Appeals ** **- Claims Support** **Office Locations:** _The selected candidate must reside within a reasonable commuting distance of the ... an accommodation is granted as required by law._ The **Manager II Grievance/ Appeals ** responsible for management oversight of grievances and appeals departmental… more
- Molina Healthcare (Fort Worth, TX)
- …the likelihood of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, ... Experience in the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific… more
- Humana (Austin, TX)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on ... + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc. +… more
- Guidehouse (Lewisville, TX)
- …home._** **Essential Job Functions** + Hospital Claims + Account Review + Appeals & Denials + Medicare/Medicaid + Insurance Follow-up + Customer Service + ... year's medical provider experience working with UB04, appeals & denials. + Hospital or EOB claims...creating a diverse and supportive workplace. Benefits include: + Medical , Rx, Dental & Vision Insurance +… more
- Houston Methodist (Houston, TX)
- …impacting AR collections. **FINANCE ESSENTIAL FUNCTIONS** + Expedites and maximizes payment of insurance medical claims by contacting third party payers and ... responsible for resolving all outstanding third-party primary and secondary insurance claims for professional services. This Specialist...resolution. Engages the coding follow up team for any medical necessity or coding related appeals . +… more
- Caris Life Sciences (Irving, TX)
- …and Commercial insurance companies. This included following up on claims statuses, researching rejections and denials, handling medical records request ... insurance denials and take appropriate action. + Check claims status via phone or poral. + Submit Medical Records upon request and follow up on submission. +… more
- R1 RCM (TX)
- …Denials Consultant, you will represent healthcare providers in their disputes with medical insurance carriers and managed care organizations at all stages ... experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines...contractual provisions and applicable state and federal laws, writing appeals and letters to insurance companies to… more
- Houston Methodist (Houston, TX)
- …follow-up productivity goals. **FINANCE ESSENTIAL FUNCTIONS** + Expedites and maximizes payment of insurance medical claims by contacting third party payors ... is responsible for resolving all outstanding third party primary and secondary insurance claims for professional services. This position performs collections… more