- Molina Healthcare (Houston, TX)
- …**Job Summary** Responsible for reviewing Medicaid, Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, billing guidelines, ... and provider compliance. Interacts with health plans and vendors regarding recovery outstanding overpayments. **Job Duties** + Prepares written provider overpayment… more
- Waste Connections (The Woodlands, TX)
- …Legal** **Qualifications:** **Minimum of 5 years prior experience in Liability Claims Administration** ** Claims Recovery experience** **Experience working ... evaluations and claim resolution strategy** **Assist field locations in administration of liability claims , subrogation recovery of claims and small property… more
- Waste Connections (The Woodlands, TX)
- … Claims Counsel in the Legal Department in The Woodlands, Texas. This specialist in insurance law and claims management will provide a wide range ... Join Waste Connections, and Connect with Your Future! **Job Title** Claims Counsel **Employee Type** Employee **Requisition Primary Location** The Woodlands, Texas… more
- CDM Smith (Houston, TX)
- …40509BR **Business Unit:** FSU **Job Description:** The Disaster Program Delivery Specialist : * Collects, coordinates and/or reviews applicant data to determine ... gather information from applicants, and understands each applicants' projects and recovery priorities. * Supports the communication process with the applicant about… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... ESSENTIAL FUNCTIONS** + Analyzes data from various sources (medical records, claims data, payer medical policies, etc.), determines the causes for denials… more
- ENFRA (Houston, TX)
- …OR OUR HOUSTON OFFICE 25% travel to projects The Senior Project Controls Specialist is responsible for providing oversight of project Planning & Scheduling, Progress ... mitigation is a key responsibility of this position. The Senior Project Controls Specialist may be required to provide guidance to junior personnel. As such, they… more
- Elevance Health (Houston, TX)
- …at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing. + Requires at least one of ... auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all...Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. +… more
- Molina Healthcare (Houston, TX)
- …(specialty and ancillary) contracts highly desirable. **STATE SPECIFIC REQUIREMENTS** : Certified Recovery Peer Specialist certification required in the state of ... for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems… more