- PharmaCord (Austin, TX)
- …PharmaCord Lynk system, maintaining detailed records of reimbursement activities, including claims status, payments, and appeals . Generate reports and analysis ... includes completing benefit investigations, tracking prior authorizations / denial appeals , and assisting patients or other callers/stakeholders through resolution… more
- Lincoln Financial (Austin, TX)
- …for this opportunity. **Requisition #:** 74565 **The Role at a Glance** As an Appeals Specialist you will be responsible for being a product subject matter ... multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and...lieu of Bachelor's) + 1 - 3+ Years of Short -Term and/or Long-Term Disability. (Required) + Ability to communicate… more
- Cognizant (Austin, TX)
- **Provider Appeals & Grievances Specialist ** (remote) This is a remote position open to any qualified applicant that lives in the United States. **Summary:** We ... are seeking a dedicated Provider Appeals & Grievance Specialist with 1 to...and state Medicaid policies. **Qualifications/Skills Needed:** 1-2 years of Appeals and Grievance 1 yr. medical claims … more
- Actalent (Dallas, TX)
- …disputes, grievances, and complaints. + Use internal systems to determine outcomes of claims appeals and grievances. + Review medical records and billing details ... Job Title: Specialist , Appeals & GrievancesJob Summary: Responsible...Experience: Minimum 2 years in managed care (call center, appeals , or claims ) + Experience in health… more
- Cognizant (Austin, TX)
- …assigned accounts. . Maintain working knowledge of applicable health insurers' internal claims , appeals , and retro-authorization as well as timely filing ... with Medicare, Medicaid, and third-party guidelines. . Effectively document and log claims / appeals information on relevant tracking systems . Utilize critical… more
- Ascension Health (Austin, TX)
- …agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes. + Composes ... wellness plans Retirement benefits including employer match plans Long-term & short -term disability Employee assistance programs (EAP) Parental leave & adoption… more
- CVS Health (TX)
- …handle customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication ... day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject… more
- Keurig Dr Pepper (Frisco, TX)
- …+ Provide direct support to employee's needing assistance on maneuvering complex leave claims ie: Leave denials and appeals process, guidance on return to ... to be 100% onsite. The **Associate HR Operations Leave Specialist ** is part of the myHR team, a world-class,...administration process, including but not limited to FMLA, ADA, Short -term disability, long-term disability, and personal leaves +… more
- Cardinal Health (Austin, TX)
- …skills and prioritizes getting the right things done. **The Accounts Receivable Specialist is responsible for processing insurance claims and billing. They ... the appropriate system. + Manages and resolves complex insurance claims , including appeals and denials, to ensure...day with myFlexPay + Flexible spending accounts (FSAs) + Short - and long-term disability coverage + Work-Life resources +… more
