• Claims Investigator

    Allied Solutions (Plano, TX)
    …insurance coverage to certain claim types prior to the assignment to a Claims Adjuster or Analyst . The key responsibilities of this job are both ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim...assigned + Obtain adjuster licenses as needed Qualifications: + Associate college degree required except in the following circumstances:… more
    Allied Solutions (07/13/25)
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  • Sr Risk & Insurance Analyst - Workers…

    Rush Enterprises (New Braunfels, TX)
    …as individual claims required. + Perform regular audits of individual claim files and review workers' compensation claims . + Efficiently manage caseload ... The Senior Risk and Insurance Analyst - Workers' Compensation serves as the central...as a Workers' Compensation Professional (WCP), Certified Workers' Compensation Claims Professional (CWCCP), Associate in Claims more
    Rush Enterprises (07/26/25)
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  • Analyst - Insurance Risk

    Toyota (Plano, TX)
    …of any materials for presentation to various audiences. + Manage insurance program claims activities (ie, collection of claim detail information from business ... within the Compliance & Audit seeks a passionate and highly motivated **Insurance Risk Analyst ** . Reporting to the Senior Risk Manager, the person in this role will… more
    Toyota (08/20/25)
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  • Senior Compliance Coding Analyst - Audit…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and third-party ... potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide feedback regarding documentation and… more
    Houston Methodist (05/30/25)
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  • Senior Analyst , Operational Regulatory…

    Molina Healthcare (San Antonio, TX)
    …have experience working in Medicare + Must have experience analyzing claims . **Job Qualifications** **REQUIRED EDUCATION:** Associate 's Degree and/or equivalent ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
    Molina Healthcare (08/22/25)
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  • Manager Account Installation & Receivables…

    Highmark Health (Austin, TX)
    …incumbent to work closely with the section's Accountant, Accounting Coordinators, Associate Analyst , providing, guidance, feedback, training, motivation, and ... for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead or… more
    Highmark Health (08/12/25)
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  • Analyst , Integration Quality

    Evolent (Austin, TX)
    …Stay for the culture. **What You'll Be Doing:** Job Description ** Analyst , Integration Quality** Integration testing in the healthcare ecosystem requires complete ... exercised to ensure source to target integrity. The IQ Analyst (IQA) performs analysis, reporting, and technical testing across...the most valuable defects. The IQA reports to a associate director or a manager. One or many IQAs… more
    Evolent (08/13/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Austin, TX)
    …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new… more
    Humana (08/14/25)
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  • Senior Analyst , Healthcare Analytics

    Molina Healthcare (Austin, TX)
    **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * Build and maintain efficient… more
    Molina Healthcare (08/22/25)
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  • Senior Analyst , Healthcare Analytics - ETL

    Molina Healthcare (San Antonio, TX)
    **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines… more
    Molina Healthcare (07/30/25)
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