- Kelsey-Seybold Clinic (Pearland, TX)
- …meet work standards and performance measures for this position **Job Title: Claims Processing Specialist ** **Location: Pearland Administrative Office** ... laws and regulations governing Medicare billing practices, medical billing systems, and claims processing . Preferred: IDX/EPIC, PC skills, and understanding of… more
- Sedgwick (Houston, TX)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Senior Claims Specialist , Professional Liability (A&E, D&O) **ESSENTIAL FUNCTIONS and ... RESPONSIBILITIES** + Analyzes and processes complex or technically difficult liability claims by investigating and gathering information to determine the exposure on… more
- Molina Healthcare (Houston, TX)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
- Molina Healthcare (Houston, TX)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... years operational managed care experience (call center, appeals or claims environment). + Health claims processing...center, appeals or claims environment). + Health claims processing background, including coordination of benefits,… more
- Molina Healthcare (Houston, TX)
- …Provider Network Operations, Hospital or Physician Billing, or similar. + Claims processing background including coordination of benefits, subrogation, and/or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- Republic Finance, LLC (Baytown, TX)
- …in the financial services industry for you, apply today! As a Sr. Consumer Loan Specialist , you will be a key team member in the branch. Your primary responsibility ... explaining the loan process, answering questions regarding loan products and loan processing . Take ownership of customer concerns and works with management to… more
- Valero (Houston, TX)
- …and updates a log on each employee out on long-term leave. * Completes processing of all duties involved in employment, termination, transfer, and promotion of all ... the department, such as open enrollment. * Numbers, prepares, and completes processing of all Personnel Activity Requests. * Prepares and distributes annual Vacation… more
- Molina Healthcare (Houston, TX)
- …applicants. * Completes data corrections in the credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems ... to determine provider status, as necessary. * Completes follow-up for provider files on 'watch' status, as necessary, following department guidelines and production goals. * Reviews and processes daily alerts for federal/state and license sanctions and… more
- Catholic Health Initiatives (Pasadena, TX)
- **Responsibilities** Responsible for the timely processing of all patient charges assuring maximum revenue capture; reconciliation of all patient charges & ... coordinating with Patient Financial Services to expedite resolutions to facilitate claims reimbursement. In addition plays an important role in patient satisfaction… more
- Molina Healthcare (Houston, TX)
- …years of experience working in the group health business preferred, particularly within claims processing or operations. + A demonstrated working knowledge of ... + Experience with UNET, Comet, Macess/CSP, or other similar claims processing systems. + Demonstrated ability to...+ AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional… more
- Actalent (Houston, TX)
- …team. In this role, you will be responsible for handling insurance claims , processing prior authorizations, and making coverage determinations. You'll work ... Remote Pharmacy Technician - Insurance & Coverage Determination Specialist Location: Remote (US Based) Job Type: Full-Time...Key Responsibilities + Process and follow up on insurance claims and prior authorizations + Evaluate and make coverage… more