- Alight (TX)
- …(https://careers.alight.com/us/en) . **THE ROLE** Are you interested in joining a collaborative Appeals team? As an Appeals Specialist , you'll review ... claims, ensuring each case is effectively tracked and managed through the appeals process. + Assess medical, financial, and non-medical information with the support… more
- Houston Methodist (Houston, TX)
- …Revenue Cycle experience** At Houston Methodist, the Accounts Receivable (AR) Appeals Denials Specialist position is responsible for reviewing accounts ... S Fry Katy, TX 77450** **Looking for candidates with the following:** + ** Appeals with hospital accounts** + **Epic experience is a plus** + **Government Advantage… more
- TEKsystems (Richardson, TX)
- …insurance, out of network Additional Skills & Qualifications: - Proven experience as an Appeals Specialist or in a similar role within a healthcare setting. - ... reimbursement issues to identify the root causes. - Initiate and manage the appeals and arbitration process for denied or underpaid claims, ensuring timely and… more
- Healthfirst (TX)
- …Termination, and Suspension of services. The end to end process requires the Specialist to independently: + Research issues + Reference and understand HFs internal ... + Work within a framework that measures productivity and quality for each Specialist against expectations + Prepare cases for Medical Director Review ensuring that… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding-specific clinical charges and denial ... management and appeals process in a collaborative environment with revenue cycle...Professional Coder (AAPC) **OR** + CCS - Certified Coding Specialist (AHIMA) **OR** + An approved Specialty Society Coding… more
- Elevance Health (Grand Prairie, TX)
- **Title: Plan to Plan Service Specialist I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of ... of our PulsePoint locations. The **Plan to Plan Service Specialist I** will be responsible for serving as a...internal business partners (sales, member experience, claims, medical review, appeals , etc.) and external contacts within the other Blues… more
- MD Anderson Cancer Center (Houston, TX)
- …employees and the public. **Summary** The primary purpose of the PBS Specialist position is to follow-up on claims within regulatory guidelines. The PBS ... Specialist must ensure that all claims have a follow-up...delay in payments. Makes recommendations for resolution 7. Pursues appeals when available. Initiates communication with coding team and… more
- Randstad US (Dallas, TX)
- medical collections and claims specialist . + dallas , texas + posted september 30, 2024 **job details** summary + $25 - $32 per hour + temporary + high school + ... healthcare, is seeking a skilled A/R Collections & Claims Specialist for a contract role. In this critical position,...Investigate and analyze denied claims, prepare and submit necessary appeals , and ensure all claims are fully paid in… more
- Jet Health (Fort Worth, TX)
- Revenue Cycle Specialist Fort Worth, TX (http://maps.google.com/maps?q=4100+International+Plaza+Fort+Worth+TX+USA+76109) Job Type Full-time Description TheRevenue ... Cycle Specialist (RCS)will be responsible for overseeing critical financial tasks...to prepare claims and follow-through with corrections, resubmission, or appeals to resolve balances. + Submit clean claims to… more
- TEKsystems (Austin, TX)
- Position Summary: The Revenue Cycle HEDIS Specialist will be responsible for building and maintaining collaborative and productive relationships within the ... Works closely with various vendor operations teams (Prior authorization, Claims and Appeals ) to oversee operations activity that directly impacts the revenue cycle… more
- AECOM (Dallas, TX)
- …perform the tasks listed above in the Project Overview. EHP Specialist positions may include Archaeologist, Architectural Historian, Biologist, Certified Floodplain ... Manager, Ecologist, Environmental Planner, Historic Architect, Horticulturalist, Water Quality Specialist , and Wetlands Specialist . The EHP Specialist will… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Coding Specialist position is responsible for applying correct coding conventions to patient charge encounters in a clinical ... the electronic health record. In addition, the Sr Coding Specialist position is responsible for reviewing, correcting and appealing...posting to the assigned work queues. + Investigates and appeals unpaid, denied and partially paid claims by third… more
- Methodist Health System (Dallas, TX)
- …**Your Job:** We are seeking an experienced Accounts Receivable II (AR II) Specialist specializing in Professional Billing for Family Practice to join our team in ... claims, denied claims, and correspondence. As an AR II Specialist , you will play a crucial role in optimizing...actions based on correspondence received, such as claim corrections, appeals , or adjustments. - Conduct thorough follow-up on aging… more
- Sevita (Austin, TX)
- …today, and experience a career well lived. **Program Administration Eligibility Specialist ** _Location: Austin, TX (in office)_ _Hourly Rate: $20/hr_ _Schedule: ... _Where Sevita is representative payee, assembles, completes, and submits applications, appeals , or other forms related to financial eligibility, partnering with… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- Summary Serve as Equal Employment Opportunity (EEO) Specialist in the Office of the Director and assist the EEO Manager in planning, development, implementation, ... is not a virtual position. Position Description/PD#: Equal Employment Specialist /PD03748O Relocation/Recruitment Incentives: Not authorized Permanent Change of Station… more
- BECU (TX)
- …can be found here . **IMPACT YOU'LL MAKE** **:** As a Leave & Absence Specialist at BECU, you'll play a crucial role in supporting our employees during significant ... **Manage Documentation:** Oversee documentation for state-specific leave programs, handling appeals and ensuring compliance and accuracy in record-keeping. +… more
- Capgemini (El Paso, TX)
- …software systems to create Prescription cases and determine coverage, determination and appeals process *Good written and verbal communication skills *The ability to ... display soft skills while moving the call forward *Meeting or exceeding government mandated timelines *Complying with turnaround time, productivity, and quality standards *Conveying resolution to beneficiary or provider via direct communication and… more
- AECOM (Dallas, TX)
- …your #H2Opportunity **Job Description** We are accepting resumes for various technical specialist positions to perform the tasks listed above in the Project ... Inspection Process (https://training.fema.gov/is/courseoverview.aspx?code=IS-1004〈=en) IS-1018: Determination Memorandums and Appeals (https://training.fema.gov/is/courseoverview.aspx?code=IS-1018〈=en) **Preferred Qualifications:** + Bachelor's degree… more
- Justice, Bureau of Prisons/Federal Prison System (Grand Prairie, TX)
- …responding to grievances, unfair labor practice complaints, disciplinary decision appeals , and making presentations in third-party arbitration hearings. Experience ... participating in negotiation or on-going administration of the master labor agreement. GS-13: Knowledgeable in statutes, regulations, rules and contractual provisions which pertain to federal sector labor and employment law matters. Experience providing… more