- Mass Markets (Killeen, TX)
- …trusted partner in the industry. We are seeking a detail-oriented and analyticalOn-SiteClaims Adjudication Specialist to join our team! If you have strong ... of experience in one or more of the following: call center, claims adjudication , insurance adjusting, or technical customer service (preferably in a high-volume… more
- CVS Health (Austin, TX)
- …inquiries and problems. Additional Responsibilities - Reviews pre-specified claims or claims that exceed specialist adjudication authority or processing ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Allied Solutions (Plano, TX)
- …Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the ... Position Summary; This position is responsible for the initial setup and investigation of claims prior to the assignment of the claim to a licensed adjuster. This… more
- CVS Health (Austin, TX)
- …to assist in the claim adjudication process. Routes and triages complex claims to Senior Claim Benefits Specialist . Proofs claim or referral submission to ... or CST time zone** **Pay $18.00 per hour** Reviews and adjudicates routine claims in accordance with claim processing guidelines. Critical success factors - Ability… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …and entering the completed referral into the electronic medical record system for claims adjudication to ensure services are validated. Description of Duties + ... Position Information Posting NumberSRGV8223 Working TitlePRIOR AUTHORIZATION AND REFERRAL SPECIALIST (UT Health RGV Cancer and Surgery Center) Number of Vacancies1… more
- TEKsystems (Addison, TX)
- Description - Review and analyze denied claims , payment discrepancies, and reimbursement issues to identify the root causes. - Initiate and manage the appeals and ... arbitration process for denied or underpaid claims , ensuring timely and accurate submissions. - Prepare compelling...Skills & Qualifications - Proven experience as an Appeals Specialist , AR, denial, NSA experiece or in a… more
- CVS Health (Austin, TX)
- …demographic transaction updates in provider system applications in support of claim adjudication and Provider directory. - Performs intake triage and responds to ... into applicable systems. **Required Qualifications** - 1-3 years' of Medicaid claims experience. - 1-3 years' Network background. **Preferred Qualifications** - 1+… more