- Academy Sports + Outdoors (Katy, TX)
- …+ Understand the functions of each different vendor portal used to dispute claims with various financial institutes + Create reports using transactional data based ... weekly Fraud Analysis + Perform dispute review of Fraud claims that may be submitted in error or may...identify and mitigate potential operational gaps escalated by customer claims . + Analyze and report fraud related costs on… more
- Cardinal Health (Austin, TX)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... gaps + Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted HCPs/accounts touched)… more
- Centene Corporation (Austin, TX)
- …preferably healthcare (ie documenting business process, gathering requirements) or claims payment/analysis experience. Knowledge of managed care information systems ... and experience in benefits, pricing, contracting or claims preferred. Knowledge of provider reimbursement methodologies preferred. Previous structured testing… more
- Molina Healthcare (Austin, TX)
- …Experience working in a Medicare environment is highly preferred. + Claims adjudication experience is highly preferred. **Job Qualifications** **Required Education** ... encounter processes, provider and contract configuration, provider information management, claims processing and other related functions. **Preferred Education** Bachelor's… more
- Acosta Group (Lewisville, TX)
- …to perform the essential duties. Responsibilities With Regard to Workers' Compensation Claims : You are responsible for reporting any employment related injury you ... incur to your direct supervisor as soon as possible following an incident resulting in an injury. **QUALIFICATIONS** **Additional Requirements:** + **Education/Experience:** 2 years' experience in analyzing and interpreting data and delivering actionable… 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
- The Cigna Group (Houston, TX)
- **Provider Data Management Analyst ** Are you ready to make a difference in healthcare analytics? Join our Market Analytics, Pricing & Solutions team as a Provider ... Data Management Analyst and help drive innovation, accuracy, and compliance in...sight on rate schedules and projections. + Oversee the claim match and rating area review processes, driving improvements… more
- Lowe's (Desoto, TX)
- …Distribution Centers (BDC). Your day involves reviewing calls, emails, and claims , providing status updates, processing special orders, and monitoring load plans ... well-functioning distribution process. **Key Responsibilities** + Review voicemails, emails, and claims for developing issues, providing status updates to the Bulk… more
- Highmark Health (Austin, TX)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... data including, but not limited to: medical/surgical physician and institutional claims and encounters, clinical data, prescription drug data, membership data,… more
- Omnicell (Fort Worth, TX)
- **Reconciliation Lead** The Lead Reconciliation Analyst leads the team that provides reconciliation services to FDS Amplicare customers and oversees the customer ... forms and documentation. . Communicate any issues that may arise, including claims disputes. . Oversee development and communication of customer reports. . Partner… more