- Elevance Health (Grand Prairie, TX)
- …visits, referral practices, and specialty care procedures and recommends policy changes and claim 's system changes to pursue cost savings. + Reviews results ... **Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to...Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing… more
- Quality Technology Services, LLC (Irving, TX)
- …This position supports the delivery of scalable infrastructure solutions by ensuring systems excellence and cross-functional collaboration. The analyst will be ... The Senior PLM Analyst will play a key role in both...Ensure data integrity, consistency, and accuracy across all PLM-related systems . + Implement and optimize tools and processes that… more
- Molina Healthcare (Austin, TX)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +...quality. + Assists in planning and coordination of the claim payment system upgrades and releases, including… more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, accurate, ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
- CVS Health (Austin, TX)
- …in healthcare or claims processing experience. + Experience with Aetna claims processing systems . **Education** + High School diploma/GED and equivalent work ... and external customers. + Track requests, maintain status reports, and investigate claim /file failure trends. + Configure EDI setups and support implementation leads… more
- CVS Health (Austin, TX)
- …Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the negotiation ... **What you will do** + Learn to navigate the systems , and create networking, for this role + Develop...Qualifications** + 3-5 years of experience in a medical claim background with demonstrated ability and strong understanding of… more
- Jack Henry & Associates (Allen, TX)
- Card Services Application Support Analyst General information Press space or enter keys to toggle section visibility JobID 16243 Position Level Individual ... is currently looking for a Card Services Application Support Analyst to join our team. Our Symitar Card Services...products/processes and consults with customers to map the existing system to the Jack Henry product. + Prepares the… more
- Prime Healthcare (Farmers Branch, TX)
- Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 ... million patient visits annually. It is one of the nation's leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare… more
- UTMB Health (Galveston, TX)
- Clinical Trials Coverage Analyst (Research Administration - Galveston) **Galveston, Texas, United States** Research Academic & Clinical UTMB Health Requisition # ... and/or other codes in the Institution's Clinical Trial Management System . + Remains knowledgeable and up to date with...the revenue cycle, including charge review, account work queues, claim edits, and claim submission. + Reviews… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- Position Information Posting NumberSRGV8219 Working TitleCOMPLIANCE CODING AND BILLING ANALYST Number of Vacancies1 LocationMcAllen, Texas DepartmentOffice of the ... and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance with… more