- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical ... as appropriate, DRG recoupments/downgrades, and denials for no authorization. The Senior Denials Management Specialist position communicates clinical information… more
- The Hartford (San Antonio, TX)
- …too. Join our team as we help shape the future. The Construction Account Specialist (CAS) or Senior Construction Account Specialist (SCAS) provides Risk ... Hygienist (CIH), Associate in Risk Management (ARM), Construction Risk and Insurance Specialist (CRIS), or Construction Health and Safety Specialist (CHST) is… more
- CVS Health (Austin, TX)
- …do it all with heart, each and every day. **Position Summary** The ** Senior Accounts Receivable Specialist ** prepares accounting and financial records and ... in accounting system. + Enter and process monthly fee claims for ancillary product offerings via claim ...every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our… more
- Centene Corporation (Austin, TX)
- …a Monday - Friday; 2:00 pm - 10:30 pm EST, schedule.** **Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and ... Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Applicants for… more
- Citizens (Irving, TX)
- …challenges? Citizens Bank is seeking a Single Point of Contact (SPOC) Relationship Specialist to serve as the primary liaison for borrowers throughout the default, ... customer's needs and provide suitable repayment solutions. + Extensive Training: Benefit from cutting-edge tools, including advanced AI simulations, to prepare for… more
- Molina Healthcare (Fort Worth, TX)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... and FQHC/RHC reports. + Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER,… more
- CVS Health (Austin, TX)
- …measuring and monitoring the quality and effectiveness of work processes in claim processing and customer service that impact customer satisfaction, medical cost ... both routine and non-routine business support tasks for the Sr Quality Specialist area under limited supervision, referring deviations from standard practices to… more
- CVS Health (Austin, TX)
- …- Distributes work assignment daily to junior staff. - Trains and mentors claim benefit specialists.- Makes outbound calls to obtain required information for ... handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication… more
- Mass Markets (TX)
- …passion for building strategic partnerships and driving revenue? We're seeking a Senior Business Development Executive to lead new client acquisition, manage key ... + Client Acquisition & Relationship Building Identify, qualify, and engage senior business leaders through outbound calls, emails, social media, and networking.… more
- Prime Therapeutics (Austin, TX)
- …+ MISCELLANEOUS DUTIES: + Provide backup support to team members (SIU Coordinator and Senior SIU Specialist ) in the performance of job duties as assigned. + ... drives every decision we make. **Job Posting Title** SIU Specialist - Pharmacy Tech - Remote in the California...Experience Level 2+ years + Required Fraud Investigations and Claims experience Must be eligible to work in the… more
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