- Kelsey-Seybold Clinic (Houston, TX)
- …tasks including development and coaching and other duties as assigned. **Job Title: Supervisor , Managed Care Claims ** **Location: Pearland Administrative ... **Responsibilities** Responsible for the supervision of Commercial claims adjudication. Essential job functions include ensure that...years of working experience in a Managed Care environment as Senior Analyst, Coordinator, OR Supervisor… more
- Apex Health Solutions (Houston, TX)
- …by assisting in alternative care placements incompliance to the applicable managed care plan or certified workers' compensation network benefit coverage ... Duties and Responsibilities: Serves as a resource to the Claims Department in determining the medical necessity of ...One (1) to two (2) years' experience in a Managed Care environment performing preauthorization, concurrent review… more
- Houston Methodist (Houston, TX)
- …reimbursement policies and procedures + Understands payor environment such as managed care , independent physician associations (IPAs), and third-party ... for resolving all outstanding third party primary and secondary insurance claims for professional services. This position performs collections activities on simple… more
- Actalent (Houston, TX)
- …applications for analysis, information retrieval, and data entry necessary for claims adjudication. Use reasoning skills to identify missing information and make ... license of the state they currently reside in. + Understanding of managed pharmacy benefit concepts including formulas, prior authorizations, edits, and claim… more