claim specialist - healthcare professional liability

case manager

bilingual call center representative Jobs in Houston

bilingual call center representative

branch administrator

claim specialist - correctional medicine Jobs in Houston

claim specialist - correctional medicine

claim specialist - healthcare professional liability Jobs in Houston

claims field claims representative

The Cincinnati Insurance Companies

<div></div><div><div>US-TX-Houston<div>
</div></div><div><b>
Description</b><div></div><p><b><br>
Make a difference with a career in insurance</b><br>
<br>
At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into action, we&rsquo;re looking for extraordinary people to join our talented team. Our service-oriented, ethical, knowledgeable, caring associates are the heart of our vision to be the best company serving independent agents. We help protect families and businesses as they work to prevent or recover from a loss. Share your talents to help us reach for continued success as we bring value to the communities we serve and demonstrate that Actions Speak Louder in Person&reg;.</p><p>
If you&rsquo;re ready to build productive relationships, collaborate within a diverse team, embrace challenges and develop your skills, then Cincinnati may be the place for you. We offer career opportunities where you can contribute and grow.</p><p><b>
Build your future with us</b><br>
<br>
Our Field Claims department is currently seeking field claims representatives to service the territory surrounding: <b>Houston, TX</b> <b>. The candidate is required to reside within the territory.</b></p><p>
This territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements.</p><p><b>
Be ready to</b>:</p><ul><li>
complete thorough claim investigations</li><li>
interview insureds, claimants, and witnesses</li><li>
consult police and hospital records</li><li>
evaluate claim facts and policy coverage</li><li>
inspect property and auto damages and write repair estimates</li><li>
prepare reports of findings and secure settlements with insureds and claimants</li><li>
use claims-handling software, company car and mobile applications to adjust loss in a paperless environment</li><li>
provide superior and professional customer service</li><li>
once eligible, become a certified and active Arbitration Panelist</li></ul><p><b>
To be an Entry Level Claims Representative:</b></p><p>
The pay range for this position is <b>$57,000 - $79,800</b> annually. The pay determination is based on the applicant&rsquo;s education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance.</p><p><b>
Be equipped with</b>:</p><ul><li>
be available and communicative during your regular business hours</li><li>
a desire to learn about the insurance industry and provide a great customer experience</li><li>
the ability to work unsupervised</li><li>
excellent verbal and written communication skills</li><li>
strong interpersonal skills</li><li>
excellent problem-solving, negotiation, organizational and prioritization skills</li><li>
preparedness to follow-up with others in a timely manner</li><li>
a valid driver&rsquo;s license</li></ul><p><b>
Bring education or experience from</b>:</p><ul><li>
a bachelor&rsquo;s degree</li><li>
AINS, AIC, or CPCU designations preferred</li></ul><p><b>
Benefits in addition to compensation include</b>:</p><ul><li>
company car</li><li>
company stock options, including Restricted Share Units and Incentive based stock options</li><li>
paid time off (PTO)</li><li>
401K with 6% company match</li></ul><p><b>
To be an Experienced Claims Representative:</b></p><p>
The pay range for this position is <b>$62,000 - $94,500</b> annually. The pay determination is based on the applicant&rsquo;s education, experience, location, knowledge, skills and abilities. Eligible associates may also receive an annual cash bonus and stock incentives based on company and individual performance.</p><p><b>
Be equipped with</b>:</p><ul><li>
be available and communicative during your regular business hours</li><li>
multi-line claims experience preferred</li><li>
ability to completely assess auto, property, and bodily injury type damages</li><li>
capacity to work unsupervised</li><li>
excellent verbal and written communication skills</li><li>
strong interpersonal skills</li><li>
excellent problem-solving, negotiation, organizational, and prioritization skills</li><li>
preparedness to follow-up with others in a timely manner</li><li>
a valid driver&rsquo;s license</li></ul><p><b>
Bring education or experience from</b>:</p><ul><li>
one or more years of claims handling experience</li><li>
AINS, AIC, or CPCU designations preferred</li><li>
bachelor&rsquo;s degree or equivalent experience required</li></ul><p><b>
Benefits in addition to compensation include</b>:</p><ul><li>
company car</li><li>
company stock options, including Restricted Share Units and Incentive based stock options</li><li>
paid time off (PTO)</li><li>
401K with 6% company match</li></ul><p><b>
Enhance your talents</b></p><div><p>
Providing outstanding service and developing strong relationships with our independent agents are hallmarks of our company. Whether you have experience from another carrier or you&rsquo;re new to the insurance industry, we promote a lifelong learning approach. Cincinnati provides you with the tools and training to be successful and to become a trusted, respected insurance professional &ndash; all while enjoying a meaningful career.</p></div><div><p><b>
Enjoy benefits and amenities</b></p></div><div><p>
Your commitment to providing strong service, sharing best practices and creating solutions that impact lives is appreciated. To increase the well-being and satisfaction of our associates, we offer a variety of benefits and amenities.</p></div><div><p><b>
Embrace a diverse team</b></p></div><div><p>
As a relationship-based organization, we welcome and value a diverse workforce. We grant equal employment opportunity to all qualified persons without regard to race; creed; color; sex, including sexual orientation, gender identity and transgender status; religion; national origin; age; disability; military service; veteran status; pregnancy; AIDS/HIV or genetic information; or any other basis prohibited by law. All job applicants have rights under Federal Employment Laws. Please review this information to about those rights.</p></div></div></div>

Claims - Field Claims Representative

Crane Worldwide Logistics

<div><p><b>Essential Job Functions</b></p>
<ul>
<li>Log and respond to all incoming cargo claims through the claims management system</li>
<li>Report appropriate claims to the insurance carrier in a timely manner</li>
<li>Develop action plans to move claims to resolution</li>
<li>Responsible for the adjustment and handling of all cargo liability claims from third parties</li>
<li>Partners with the insurer, insurance broker and TPA to ensure best claims practices are followed from submission to final resolution.</li>
<li>Handles subrogation recoveries</li>
<li>Responsible for maintaining all loss data in the claims data base.</li>
<li>Collect, organize, analyze and provide claim reports to management and other departments as required</li>
<li>Responsible for submitting claims to accounting for payment.</li>
<li>Ensure claims are paid as appropriate, following company procedure and approval levels. Book claims appropriately to the correct business units</li>
<li>Recognize and elevate claims to the Senior Manager that could have significate exposures to the company.</li>
<li>Communicates claims activities with the Senior Manager and appropriate parties as needed.</li>
<li>Participates in insurer claim file reviews and conducts regular internal claim reviews</li>
<li>Coordinate with insurance claim teams, holding them accountable for providing superior claim management services</li>
<li>Assist department with responding to internal and external requests for information</li>
<li>Other duties as assigned</li>
</ul>
<p><b>Other Skills &amp; Abilities</b></p>
<ul>
<li>Must have the ability to prioritize and follow through in providing accurate and reliable information in a fast-paced, multitasking environment</li>
<li>Understanding of basic accounting principles and processes; computer skills &ndash; including heavy Excel knowledge; verbal and written communication skills; adept at problem resolution.</li>
<li>Excellent computer skills; requires Excel competency.</li>
<li>Data investigation knowledge</li>
</ul>
<p><b>Physical Requirements</b></p>
<ul>
<li>Job requires the ability to use vision, adjust focus and work on a standard computer screen.</li>
<li>Job may require extended sitting or standing, use of standard office equipment.</li>
<li>Job will require presence on-site at the assigned work location.</li>
<li>Job requires attendance and dependability.</li>
</ul>
<p> <b>Education &amp; Experience</b></p>
<ul>
<li>2-3 years cargo claims handling. Accounting experience a plus</li>
<li>Knowledge of intermodal transportation, shipping industry standards and practices</li>
<li>Maritime, Air and domestic regulations (e.g. US COGSA, Hague-Visby Rule, Montreal Convention) preferred.</li>
<li>Prior experience in a claims management system preferred.</li>
</ul>
<p><b>WHY SHOULD YOU WORK FOR CRANE?</b></p>
<p>
At Crane, we believe in providing our employees with excellent benefits at a Great Place to Work.</p>
<p>
We offer:</p>
<ul>
<li>136 hours of Paid Time Off which equals 17 days for the year, that can be used for Sick Time or for Personal Use</li>
<li>Excellent Medical, Dental and Vision benefits</li>
<li>Tuition Reimbursement for education related to your job</li>
<li>Employee Referral Bonuses</li>
<li>Employee Recognition and Rewards Program</li>
<li>Paid Volunteer Time to support a cause that is close to your heart and contributes to our communities</li>
<li>Employee Discounts</li>
<li>Wellness Incentives that can go up to $100 per year for completing challenges, in addition to a discount on contribution rates</li>
<li>Potential to earn a quarterly bonus</li>
</ul>
<p>Come join the leader in logistics and take your career in the right direction.</p>
<p><b>
Disclaimer:</b></p>
<p>
The above statements are intended to describe the general nature and level of work being performed by people assigned to this position. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.</p>
<p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p>
<p>
We maintain a drug-free workplace and perform pre-employment substance abuse testing.</p>
<p>
This position requires the final candidate to successfully pass an E-Verify Check.</p>
<p>
More Information: http://www.dhs.gov/e-verify</p>
<p>
Company benefits are contingent upon meeting eligibility requirements and plan conditions.</p>
<p>
We are preparing to comply with the Biden Administration's mandate on COVID-19 vaccination. Please be advised that employment with the Company may be contingent upon your ability to provide proof of vaccination except in limited circumstances where you are eligible for a legal accommodation.</p></div><p></p>

Global Cargo Claims Specialist

Gallagher

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><br>
<div><b>
Salary:</b> Salary can be up to $120,000 per year, dependent upon experience</div><div><b>
Claims Background:</b> Professional Liability Claims, Paralegal experience, or related insurance support role<br>
<b>Jurisdictional Experience:</b> Open to any<br>
<b>Active Adjuster Licenses:</b> Must be willing to obtain all licenses as required by the manager within a specified timeframe</div><div>
</div><div>
The Claims Specialist within GB Specialty is responsible for managing moderately complex <b>Healthcare Professional Liability</b> claims. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.</div>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Analyzes coverage and settles moderately complex claims in Healthcare Professional Liability.</li><li>
Generally, incumbent does not work on workers&rsquo; compensation claims.</li><li>
Able to manage the full-life cycle of all assigned claims files.</li><li>
Analyzes coverage and determines defense obligations.</li><li>
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.</li><li>
Creates reservation of rights and coverage denial letters.</li><li>
Negotiates settlements with clients, client attorneys, and Public Adjusters.</li><li>
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.</li><li>
Prepares reserve and settlement authority requests for client and carrier approval.</li><li>
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.</li><li>
Has a solid understanding of claims processing and the insurance brokerage business.</li><li>
Has a basic understanding of the terminology and case law associated with correctional medicine professional liability claims.</li><li>
Handles claims consistent with clients&rsquo; and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.</li><li>
Incumbents at this level should be able to work at full caseload capacity.</li></ul>
<br>
<b>About You</b><br>
<div><b>
Claims Background:</b> Paralegal experience, junior professional liability claims experience, or insurance claims support background, preferably within healthcare or medical professional liability</div><div><b>
Jurisdictional Experience:</b> Open to any<br>
<b>Active Adjusters&rsquo; Licenses:</b> Not required initially; must be willing to obtain licenses as directed</div><div></div><div><b><br>
Required:</b></div><br>
<div></div><ul><li>
Bachelor's Degree Required</li><li>
Minimum 2 years of experience in claims, insurance, paralegal, legal support, or a related environment.</li><li>
Strong insurance fundamentals and understanding of claims processes.</li><li>
Ability to analyze documentation, summarize facts, and support coverage and liability determinations.</li><li>
Computer proficiency with claims systems and standard business software.</li><li>
Must be able to obtain required adjuster licenses within designated timeframes.</li></ul><div><b><br>
Preferred:</b></div><ul><li>
Prior experience within healthcare (medical malpractice) claims is a plus</li></ul><div><b>
Behaviors:</b><ul><li>
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, and communicate effectively in writing and verbally.</li><li>
Strong analytical skills to support claims decisions and issue resolution.</li><li>
Ability to interpret policies, records, and related documentation.</li></ul><div>
#LI-TJ1</div><div>
#GBSpecialtyCareers</div></div></div><div></div>

Claim Specialist - Healthcare Professional Liability

<div><b>Introduction</b><br>
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div><br>
<b>Overview</b><div><b><br>
Salary: </b>Salary for this position could go up to $119,000 per year, dependent upon experience.</div><div><div><b>
Jurisdictions:</b> Open to any</div><div><b>
Licenses:</b> Must be willing to obtain all licenses as required by the manager within a specified timeframe</div><div><b>
Location:</b> This role is eligible for fully remote work</div><div></div><div><br>
The Claims Specialist within GB Specialty is responsible for managing moderately complex <b>Healthcare Professional Liability</b> claims, with a primary focus on <b>Correctional Medicine</b>. This role manages the full claim life cycle, including coverage analysis, investigation, evaluation, and resolution, while ensuring claims are handled in accordance with client expectations, policy obligations, and regulatory requirements.</div></div>
<br>
<b>How you'll make an impact</b><br>
<ul><li>
Analyzes coverage and settles moderately complex claims in Correctional Medicine Professional Liability.</li><li>
Generally, incumbent does not work on workers&rsquo; compensation claims.</li><li>
Able to manage the full-life cycle of all assigned claims files.</li><li>
Analyzes coverage and determines defense obligations.</li><li>
Under minimal supervision, conducts thorough analysis and investigations necessary to determine claims exposure and recommend appropriate settlement strategies and action plans.</li><li>
Creates reservation of rights and coverage denial letters.</li><li>
Negotiates settlements with clients, client attorneys, and Public Adjusters.</li><li>
Interacts extensively with various parties involved in the claims process, and may recommend retaining the advice of outside experts as necessary.</li><li>
Prepares reserve and settlement authority requests for client and carrier approval.</li><li>
May act as a client advocate with carriers to ensure proper claims handling, including any necessary scoping, estimating, and addressing of coverage.</li><li>
Has a solid understanding of claims processing and the insurance brokerage business.</li><li>
Has a basic understanding of the terminology and case law associated with correctional medicine professional liability claims.</li><li>
Handles claims consistent with clients&rsquo; and corporate policies, procedures and best practices and in accordance with statutory, regulatory, and ethical requirements.</li><li>
Incumbents at this level should be able to work at full caseload capacity.</li></ul>
<br>
<b>About You</b><div><b><br>
Required:</b></div><ul><li><div>
Bachelor&rsquo;s degree required</div></li><li><div>
Minimum 2+ years of experience in handling professional liability claims</div></li><li><div>
Strong insurance fundamentals and understanding of claims processes.</div></li><li><div>
Ability to analyze documentation, summarize facts, and support coverage and liability determinations.</div></li><li><div>
Computer proficiency with claims systems and standard business software.</div></li><li><div>
Must be able to obtain required adjuster licenses within designated timeframes.</div></li></ul><div><b>
Preferred:
</b></div><ul><li>Prior experience within healthcare, medical malpractice, or correctional medicine claims a plus.</li><li>
Strong insurance background (carrier, TPA, brokerage, or claims support experience).</li><li>
JD preferred but not required</li></ul><div><b>
Behaviors:</b></div><div><ul><li>
Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, and communicate effectively in writing and verbally.</li><li>
Strong analytical skills to support claims decisions and issue resolution.</li><li>
Ability to interpret policies, records, and related documentation.</li></ul><div>
#LI-TJ1</div><div>
#GBSpecialtyCareers</div></div></div>

Claim Specialist - Correctional Medicine

NPAworldwide

<div>
 <strong>
  Job Description
  <br/>
  <br/>
 </strong>
 In this role, you will assist with translating medical services into standardized billing codes, preparing claims for insurance reimbursement, supporting patient billing questions, and performing essential administrative tasks that keep clinical operations running smoothly. No prior medical office experience is required, but strong attention to detail and communication skills are essential.
 <br/>
 <br/>
 <strong>
  Key Responsibilities
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Translate medical procedures and diagnoses into standardized billing and coding formats
  </li>
  <li>
   Prepare and submit insurance claims with accuracy
  </li>
  <li>
   Review claims for completeness and correct coding errors when necessary
  </li>
  <li>
   Communicate with patients regarding billing questions, payment options, and payment plans
  </li>
  <li>
   Verify insurance information and update billing records
  </li>
  <li>
   Work closely with medical providers and administrative teams to ensure accurate claim documentation
  </li>
  <li>
   Perform general office tasks such as data entry, document processing, and file management
  </li>
  <li>
   Support ongoing billing, reimbursement, and coding workflow as assigned
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Qualifications
  <br/>
  <br/>
 </strong>
 <strong>
  Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   High School diploma or equivalent
  </li>
  <li>
   MediClear or equivalent HIPAA certification (required)
  </li>
  <li>
   Strong attention to detail and accuracy
  </li>
  <li>
   Excellent communication and customer service skills
  </li>
  <li>
   Organized, dependable, and eager to learn
  </li>
  <li>
   Ability to manage multiple tasks in a structured office environment
  </li>
  <li>
   Basic computer proficiency; comfort with data entry
   <br/>
   <br/>
  </li>
 </ul>
 Preferred (Not Required)
 <br/>
 <br/>
 <ul>
  <li>
   Interest in medical billing, coding, or healthcare administration
  </li>
  <li>
   Coursework or certificates in billing/coding (optional)
  </li>
  <li>
   Experience in customer service or administrative roles
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Why Is This a Great Opportunity
  <br/>
  <br/>
 </strong>
 <strong>
  Benefits &amp; Career Growth
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   On-the-job training
  </li>
  <li>
   Opportunities for advancement within the organization
  </li>
  <li>
   Supportive, professional work environment
  </li>
  <li>
   Health insurance options
  </li>
  <li>
   Long-term stable career path in healthcare administration
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Salary Type
 </strong>
 : Hourly
 <br/>
 <br/>
 <strong>
  Salary Min
 </strong>
 : $ 22
 <br/>
 <br/>
 <strong>
  Salary Max
 </strong>
 : $ 32
 <br/>
 <br/>
 <strong>
  Currency Type
 </strong>
 : USD
</div>


Entry-Level Medical Billing & Coding Assistant

UTHealth Houston

<div><p><b>What we do here changes the world.</b> UTHealth Houston is Texas&rsquo; resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That&rsquo;s where you come in.</p><p>
UTHealth Houston School of Dentistry &ndash; UT Dentists is hiring for a <b>Patient Account Representative I</b> to join their team of professionals in the Department of Clinical Business and Financial Services. The PAR will be responsible for the day-to-day role and duties in revenue cycle, including understanding dental and medical insurance policy benefit information, assisting with insurance claims follow-up, patient account balance, account transaction auditing and more. The ideal candidate will adhere to assigned metrics, and uphold the core values of our team while maintaining volume productivity. Experience with axiUm and/or EPIC is a plus!</p><p><b>
Location: </b>7500 Cambridge, Houston, Texas 77054</p><p><b>
Once you join us you won't want to leave.</b> It&rsquo;s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you&rsquo;d expect from a top healthcare organization (benefits, insurance, etc.), plus:</p><ul><li>
100% paid medical premiums for our full-time employees</li><li>
Generous time off (holidays, preventative leave day, both vacation and sick time &ndash; all of which equates to around 37-38 days per year)</li><li>
The longer you stay, the more vacation you&rsquo;ll accrue!</li><li>
Longevity Pay (Monthly payments after two years of service)</li><li>
Build your future with our awesome retirement/pension plan!</li></ul><p><b>
We take care of our employees!</b> As a world-renowned institution, our employees&rsquo; wellbeing is important to us. We offer work/life services such as...</p><ul><li>
Free financial and legal counseling</li><li>
Free mental health counseling services</li><li>
Gym membership discounts and access to wellness programs</li><li>
Other employee discounts including entertainment, car rentals, cell phones, etc.</li><li>
Resources for child and elder care</li><li>
Plus many more!</li></ul><p><b>
Position Summary:</b></p><p>
Under general supervision, position is responsible for accurate and timely collection of third party and private pay receivables.</p><p><b>
Position Key Accountabilities:</b></p><ul><li>
Reviews general accounts receivable incoming correspondence and takes timely and appropriate action.</li><li>
Analyzes account for errors, adjustment, credits, issuing corrected entries when required.</li><li>
Escalates complex issues.</li><li>
Updates account information.</li><li>
Documents communications accurately and completely and follows up as required.</li><li>
Performs other duties as assigned.</li></ul><p><b><br>
Certification/Skills:</b></p><ul><li>
None</li></ul><p><b>
Minimum Education:</b></p>
High School Diploma or equivalent required Graduate from a vocational business school with a minor in a job related field preferred<p><b>
Minimum Experience:</b></p>
6 months of hospital/medical collections experience with understanding of third party reimbursement procedures, as well as state and federal regulations governing healthcare required<p><b>
Physical Requirements:</b></p>
Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.<p><b>
Security Sensitive:</b></p>
This position is a security-sensitive position pursuant to Texas Education Code &sect;51.215 and Texas Government Code &sect;411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code &sect;117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. &sect;791.4.<p><b>
Residency Requirement:</b></p><p>
Employees must permanently reside and work in the State of Texas.</p></div>

Patient Account Representative I - UT Dentists, Revenue Cycle Services

Onco360 Oncology Pharmacy

<div>
 <strong>
  Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy
  <br/>
  <br/>
 </strong>
 <em>
  Houston, TX
 </em>
 |
 <em>
  Full-Time
 </em>
 |
 <em>
  Starting at $23.00/hr and up
  <br/>
  <br/>
 </em>
 <strong>
  Join a mission-driven team making a difference in the lives of cancer patients.
  <br/>
  <br/>
 </strong>
 Onco360 Pharmacy is seeking a
 <strong>
  Pharmacy Prior Authorization Specialist
 </strong>
 to join our dedicated team in Houston, TX. This is a full-time position ideal for candidates local to the area.
 <strong>
  Remote work possible after initial on-site training.
  <br/>
  <br/>
 </strong>
 <strong>
  Why Join Us?
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   A career with purpose: Help patients access life-saving medications.
  </li>
  <li>
   Supportive culture: We value teamwork, respect, integrity, and passion.
  </li>
  <li>
   Growth opportunities: We invest in your professional and personal development.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Company Benefits
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Medical; Dental; Vision
  </li>
  <li>
   401k with a match
  </li>
  <li>
   Paid Time Off and Paid Holidays
  </li>
  <li>
   Tuition Reimbursement
  </li>
  <li>
   Quarterly Incentive Bonus
  </li>
  <li>
   Paid Volunteer Day
  </li>
  <li>
   Referral Incentive Program
  </li>
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   Company Paid Life Insurance; and Short/Long-Term Disability
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  </li>
 </ul>
 <strong>
  What You&rsquo;ll Do
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 The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.
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  How You&rsquo;ll Do This
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 <ul>
  <li>
   Manage prior authorization requests and appeals with insurance carriers.
  </li>
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   Collaborate with physicians, pharmacists, and other departments.
  </li>
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   Ensure HIPAA compliance while handling sensitive patient information.
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   Maintain accurate documentation of authorization details.
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   Proactively monitor and renew expiring authorizations.
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  </li>
 </ul>
 <strong>
  What You Bring
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  <br/>
 </strong>
 <em>
  <strong>
   Required:
   <br/>
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  </strong>
 </em>
 <ul>
  <li>
   High School Diploma or GED
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  <li>
   1+ years of pharmacy or prior authorization experience
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  <li>
   Registration with Board of Pharmacy (as required by state law)
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  <li>
   Strong communication, organizational, and customer service skills
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  <li>
   Self-motivated, organized, detail-oriented, and adaptable to changing priorities
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  <li>
   Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds
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   <br/>
  </li>
 </ul>
 <strong>
  Preferred:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Associate degree or Certified Pharmacy Technician (PTCB)
  </li>
  <li>
   3+ years of experience in pharmacy or prior authorizations
  </li>
  <li>
   Specialty pharmacy experience
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.
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  <br/>
 </strong>
 <strong>
  #Company Values: Teamwork, Respect, Integrity, Passion
  <br/>
  <br/>
 </strong>
 #IH
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Pharmacy Prior Authorization Specialist

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