- Molina Healthcare (Austin, TX)
- …pharmacy prior authorization requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA, and CMS policy/guidelines, and any other necessary ... information to providers, members, and pharmacies. + Assists with clerical services/tasks and other day-to-day operations as delegated. + Effectively communicates plan benefit information, including but not limited to, formulary information, copay amounts,… more
- Centene Corporation (Austin, TX)
- …support for business operations in all or some of the following areas: claims , provider data, member data, clinical data, HEDIS, pharmacy, external reporting + ... Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources + Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management + Develop… more
- AIG (Dallas, TX)
- …is at the heart of everything we do, from underwriting risks to processing claims . The Information Technology (IT) team equips our colleagues with the latest tools ... to complete their work efficiently, with the highest standards of excellence. The team is responsible for shielding the company's systems from security risks, while designing technology strategies that enable AIG's businesses to achieve their goals. Innovation… more
- Kiewit (The Woodlands, TX)
- …by finishing paperwork, obtaining retainages, supporting supervisors, and expediting claims . \#LI-LH1 **Qualifications** * Bachelor's degree from an accredited ... university in Engineering, Construction, or related discipline, or in lieu of a degree, 20+ years of heavy industrial construction and senior leadership experience. * 10+ years of supervisory experience in construction management, preferably in a fixed-price… more
- Saia, Inc (Austin, TX)
- …Follows established bill and quality control procedures to ensure timely, claims -free, and cost-efficient shipments. + Logs, reports, and processes freight shortages ... and damages. + Promotes and maintains a safe and clean work environment. **Preferred Qualifications** + High school diploma or GED. + 2+ years of warehouse, freight, dock, forklift, or pallet jack experience. + Forklift certification or hazmat training. +… more
- Pearl Interactive Network (El Paso, TX)
- …+ Navigate pre-scripted responses, read them verbatim to provide basic and claims -specific information, and ensure callers receive accurate details. + Perform other ... related duties as assigned. **Education and/or Work Experience Requirements:** + HS Diploma + 6 months of customer service experience + Enrollment experience preferred + Dental experience a plus **Physical Requirements:** While performing the duties of this… more
- Dal-Tile Corporation (Sunnyvale, TX)
- …processing customer returns, and notifying management of damaged shipments for freight claims . + Operates forklift and order picker equipment. + Maintains the clean ... and organized facility by sweeping, trash removal, restroom, and general office maintenance, etc. + Maintains a safe working environment by obeying all safety rules as outlined in the Safety Program and by reporting all accidents, unsafe conditions, and acts… more
- AIG (Dallas, TX)
- …is at the heart of everything we do, from underwriting risks to processing claims . The Information Technology (IT) team equips our colleagues with the latest tools ... to complete their work efficiently, with the highest standards of excellence. The team is responsible for shielding the company's systems from security risks, while designing technology strategies that enable AIG's businesses to achieve their goals. Innovation… more
- Highmark Health (Austin, TX)
- …2 years of Coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 1 year of Project leadership in ... a complex, matrixed environment (payer and/or provider preferred) + 1 year of Providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + None **SKILLS** + Demonstrated record of data-driven discovery,… more
- Humana (Austin, TX)
- …on beneficiary needs; assists with beneficiary related issues which may include claims inquiries, enrollment issues, travel attestations, access to care, wait lists, ... coordination of services and other non-clinical beneficiary concerns. + Assist in researching and providing community resources when appropriate. Interface with providers as necessary and appropriate for issue follow-up and resolution. Discuss identified… more
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