Location
Irving, Texas
Job Type
Full-time
Posted
May 14, 2026
Job Description
Job Summary:
- This position requires the ability to work independently researching and reviewing inquiries from members and providers that also requires knowledge of benefit interpretation, claims reviews, CPT and ICD coding.
- Bachelor's Degree and minimum 5 years of relevant experience.
Requirements:
- Research and provide resolution to issues such as claim denials, member and provider complaints, and reconsideration and redetermination requests.
- Review and respond to complaints, grievances and appeals within the stated time frame for each request
- Certify that providers and members are reimbursed accordingly using Medicare reimbursement policies and procedures Requirements.
...
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