- Health Care Service Corporation (Amarillo, TX)
- …Under Supervision, This Position Is Responsible For Processing Complex Claims Requiring Further Investigation, Including Coordination Of Benefits And Resolving ... Pended Claims . **Required Job Qualifications:** * High School diploma or...written and verbal communication skills. * Experience processing medical claims . **Preferred Job Qualifications:** * Referral preference given to… more
- AUI Partners (TX)
- As a Safety Technician you will play a pivotal role in ensuring a safe and healthy work environment by collaborating with project teams and implementing ... comprehensive safety programs. The Safety Technician will be responsible for conducting inspections, leading emergency response efforts, and fostering a culture of… more
- Elevance Health (Plano, TX)
- **Pharmacy Technician II - Paragon Specialty Pharmacy** **Pharmacy Location:** 3033 W President George Bush Hwy., STE 100, Plano TX 75075 **In Office Expectation:** ... ** Onsite ;** This role requires associates to work from the...our infusion centers, and the home setting. The **Pharmacy Technician II - Specialty** is responsible for assisting pharmacists… more
- Elevance Health (Houston, TX)
- …documentation purposes (eg, letter writing) on lower level auditors. + Identifies new claim types by identifying potential claims outside of the concept where ... Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case… more
- Highmark Health (Austin, TX)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... claims processing/submission/payment. **Preferred** + Associate degree + Pharmacy technician certification certificate + Experience working in a managed care… more
- Elevance Health (Grand Prairie, TX)
- …paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use ... of proprietary data and claim systems for review of... systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying and developing enterprise-wide… more
- Elevance Health (Grand Prairie, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and… more
- Elevance Health (Houston, TX)
- …and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims . **How you will make an impact:** + Analyzes and audits claims ... applicable state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5… more
- CVS Health (Austin, TX)
- …travel if a plan sponsor requests pharmacist attendance for an onsite visit/assessment/audit. The Pharmacy Program Manager role includes: -Collaborate with an ... expert" for all pharmacy/medication related needs. - Oversees pharmacy technician , who obtains answers/resolution for pharmacy benefit and precertification related… more