- Prime Therapeutics (Austin, TX)
- …to be a part of our JUDI Team.** **The first role will be focused on Claims Compare - analyzing data to identify key points. Our second role will focus on ... platforms and products + Experience using queries, thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Adecco US, Inc. (San Antonio, TX)
- …patients and providers + Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are NCB or medically ... request, researches and provides requested information + Works with claims department to redirect claims related appeal...+ Works with claims department to redirect claims related appeal requests + Generates reports for analysis… more
- Sedgwick (Houston, TX)
- …combination of education and experience required. Experience in multi-line claims management processes and system requirements strongly preferred. **WORK ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Brink's (Coppell, TX)
- …end-to-end project planning, execution, and delivery for CX initiatives including Claims transformation, customer journeys, measuring success, AI pilots, and Shared ... tracking. . Process & Innovation . Document and optimize workflows related to claims and onboarding/offboarding. . Collaborate with AI and data teams to pilot and… more
- Centene Corporation (Austin, TX)
- …clinical outcomes. + Interpret and analyze data from multiple sources including claims , provider, member, and encounters data. Identify and assess the business ... Microsoft PowerBI. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity… more
- Kemper (Dallas, TX)
- …College Degree or equivalent work experience * Three years of insurance claims experience or related fraud analytics background. **Position Requirements:** + Strong ... are desirable. + Certified Insurance Fraud Analyst (CIFA), Fraud Claims Law Specialist (FCLS) or Fraud Claims ...Fraud Claims Law Specialist (FCLS) or Fraud Claims Law Associate (FCLA) designations and Certified Insurance Fraud… more
- Elevance Health (Grand Prairie, TX)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more