NewPharmacy Claims Adjudication Specialist Onco360Pharmacy Claims Adjudication SpecialistHouston, TexasSkills/Knowledge Required: Pharmacy/NDC medication billing, Pharmacy claims resolution, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, NCPDP claim rejection resolution, coordination of benefits, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills. ensure prescription claims are adjudicated correctly according to the coordination of benefits, resolve any third-party rejections, obtain overrides if appropriate, and be responsible for patient outreach notification regarding any delay in medication delivery due to insurance claim rejections Pharmacy Adjudication Specialists at Onco360.
Pricing & Review Specialist Insperity IncPricing & Review SpecialistKingwood, TXPrinciples and practices of business administration; principles and practices of mathematics including algebra and ratios; knowledge and understanding of the PEO industry, ability to interpret, analyze, organize, and apply company operations to the sales process; proven problem-solving skills. Principles, practices, and procedures of Health and Welfare Pricing, including advanced medical terminology, benefits structure, and renewal of existing client base; methods and techniques related to reviewing health and welfare exposure, pricing, and maintaining reports and records.
Medical Biller & Coder Woodlands Primary HealthcareMedical Biller & CoderSpring, TexasRemote$20–$40 / hourAbility to multitask effectively in a fast-paced environment---If you are dedicated to enhancing healthcare documentation accuracy, improving collections, and maintaining billing compliance, we'd love to hear from you! Compensation: $20.00 - $40.00 per hour Founded on a Vision of Comprehensive Care & Lifestyle Medicine At Woodlands Primary Healthcare, we're revolutionizing the way you experience healthcare.
Medical Front Office Specialist (3017) US Heart and VascularMedical Front Office Specialist (3017)Houston, TXUS Heart and Vascular needs a full-time Medical Front Office Specialist to join our team at Willowbrook Cardiovascular Associates in Houston, TX. Schedule patient appointments in an efficient and timely manner, ensuring optimal utilization of office resources.
NewMedical Front Office Specialist (3115) US Heart and VascularMedical Front Office Specialist (3115)Houston, TXResponsibilities: Provide exceptional customer service to every patient, whether in person or via telephone in a professional and timely manner, determining their needs and responding accordingly. US Heart and Vascular is in need of a Medical Front Office Specialist to join our team at Memorial Cardiology Associates in Houston, TX.
NewFront Office Specialist I - TCP Pediatric Medical Group (PMG) Texas Children's HospitalFront Office Specialist I - TCP Pediatric Medical Group (PMG)Houston, TXAs part of our goal to build a community of healthy children, Texas Children''s Pediatrics Community Cares Program provides trusted, high-quality pediatric medical services for children who otherwise would seek care from emergency centers or possibly go without care or treatment due to low family incomes and/or lack of health insurance. Texas Children's Pediatrics is the nation's largest primary pediatric care network with more than 200 physicians dedicated to the health care needs of infants to teenagers in over 50 locations throughout the greater Houston area.
Registered Nurse RN Clinical Research Specialist Banner HealthRegistered Nurse RN Clinical Research SpecialistHouston, TXEnsures that the clinical research staff and/or students conduct the clinical aspects of the projects appropriately and adhere to the clinical trial schedule, which may include: Maintaining, dispensing and recording drug and medical device supplies according to regulations. This department conducts Phase I-III treatment clinical trials across all disease groups, with a mission to provide trial treatment options to patients in a safe and ethical manner while ensuring full compliance with FDA and institutional regulations.
Paramedic Allegiance Mobile HealthParamedicHouston, TXESSENTIAL DUTIES AND RESPONSIBILITIES: (Responsibilities include, but not limited to) Responds to emergency and non-emergency calls 24 hours per day, drive a variety of emergency vehicles in all road conditions including inclement weather, dense traffic, and rural off-road settings. Works under physically and psychologically taxing conditions to include inclement weather, temperature extremes, hazardous environments, loud noises and high-stress situations.
Clinical Quality Improvement Coordinator - Eye Exam Specialist - GuidehealthClinical Quality Improvement Coordinator - Eye Exam Specialist -Houston, TXRemote$60,000–$64,000 / yearSuccess in this role requires comfort operating specialized retinal imaging equipment (full training and camera provided), strong attention to detail, willingness to travel daily to provider practices and patient homes for scheduled eye exam appointments, knowledge of healthcare quality measures, comfort working with health data and multiple systems, strong communication skills, and the ability to manage deadlines in a field/remote hybrid environment. On days without scheduled eye exam appointments, this role supports the broader quality improvement initiatives across delegated entities and contracted Accountable Care Organizations (ACOs), including quality reporting, performance improvement, patient outreach, quality gap closure, and data abstraction activities across Medicare Advantage STAR, Commercial, Medicaid, and MSSP ACO quality programs.
Insurance Verification Specialist I - Kelsey Seybold Clinic - Pearland - Hybrid UnitedHealth Group Inc.Insurance Verification Specialist I - Kelsey Seybold Clinic - Pearland - HybridPearland, TX$16.15–$28.80 / hourCommunicates with patients by phone or electronically to explain coverage and benefits, pre-treatment cost estimates and patient financial liability, advises of non-coverage, takes payments, and sets up payment plans for services following department policies. One year in similar field involving insurance verification, patient accounts or medical office functions; OR 6 months similar experience with an Associate or higher degree or completion of Medical Billing & Coding Course; OR 6 months registration, scheduling, or front desk experience at Kelsey-Seybold Clinic.
Risk Adjustment Coding Specialist II - Houston Astrana Health, Inc.Risk Adjustment Coding Specialist II - HoustonHouston, Texas$70,000–$85,000 / yearPerform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines. Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.