- CVS Health (Austin, TX)
- …This position is accountable for successfully managing pharmacy and professional liability Risk claims . The Risk Analyst will be responsible to handle all ... aspects of claim resolution, including outreach, financial reserving, investigations, negotiations and...and resolution of primarily pre-suit druggist and professional liability claims against CVS throughout the United States. The Risk… more
- Molina Healthcare (San Antonio, TX)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Highmark Health (Austin, TX)
- …include business/ systems analysis, requirements definition and documentation, system design, and problem resolution. The analyst communicates ... and supports the needs of Epic software. + Analyzes and determines system requirements and specifications. Performs and documents workflow analysis while evaluating… more
- International (San Antonio, TX)
- …sustainable transport solutions. International is looking for an Sr. MES SCADA Analyst to support our Digital Transformation Journey. Supervisory Control and Data ... Acquisition (SCADA) systems help monitor and control operations and industrial processes...on delivering high-quality solutions* Relies on evidence to back claims and maintains high standards* Thinks independently, makes clear… more
- Molina Healthcare (Fort Worth, TX)
- …maintain contract, benefit or reference table information into the claim payment system and other applicable systems . + Participates in defect resolution for ... claims databases. Synchronizes data among operational and claims systems and application of business rules...housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Zelis (Plano, TX)
- …and consumers across our platform of solutions. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by ... personal interests that shape who you are. Position Overview The Healthcare Data Analyst will be responsible for analyzing and managing healthcare repricing claim… more
- Highmark Health (Austin, TX)
- …performs business analysis tasks by supporting stakeholders of a specific system application(s), handling user inquiries/issues, and enhancements to the system ... of applications he/she supports, how users use the application, and what other systems integrate with the application. Understands how work is being conducted, and… more
- UTMB Health (Galveston, TX)
- Analyst , 340B Program - Contract Pharmacy **Galveston, Texas, United States** Allied Health UTMB Health Requisition # 2504846 **_REQUIRED EDUCATION / EXPERIENCE:_** ... and inventory management is optimized to maximize benefits. Performs audits including claim analysis to determine if use is compliant per the 340B regulations… more
- Sedgwick (Dallas, TX)
- …needed in implementation of large client programs involving numerous interfaces or system modifications. + Manages analyst /programmers as needed. + Reviews ... Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance SAP GRC/Security Analyst SAP GRC/Security Analyst **PRIMARY PURPOSE OF THE ROLE** : To… more
- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more