- Molina Healthcare (Houston, TX)
- …as the Provider Online Directory, Utilization Management, Customer Experience, Enrollment, and Claims Payment and Processing . + Develop and enforce operating ... and business leaders to enable enterprise wide capabilities. Synchronizes data among multiple claims systems and application of business rules as they apply to each… more
- CVS Health (Austin, TX)
- …Quality, CPHQ preferred. + Background in Managed Care. + Familiarity with claims processing workflows. + Experience with quality improvement, PIPs, ANE ... requirements. + Apply clinical criteria and policies to member/provider claims and coordinate clinical resolutions with MD support. **Performance Improvement… more
- Bechtel Corporation (Houston, TX)
- …with capacity to provider short-term leadership + Ensures timely audit and processing of Logistics service provider invoices in accordance with project procedures. + ... progress. + Assists with filing and resolution of Logistics service provider claims and Close-out documentation + Assists with preparation of logistics studies… more
- Sedgwick (Houston, TX)
- …is passionate about shaping strategy through insights rather than simply processing numbers. The ideal candidate is proactive, detail-oriented, forward-thinking, and ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- Kemper (Houston, TX)
- …and Salesforce processes. + Communicate with Home Office regarding policy status, claims , and underwriting. **Payment Processing & Balancing:** + Process ... Enter paper applications into FDE + Batch, scan, and index documents ( claims , underwriting, policy administration, policy delivery receipts) into the imaging system.… more
- ThermoFisher Scientific (Austin, TX)
- …regulatory strategies accounting for global requirements and desired marketing claims . + Author and/or review regulatory submissions, specifically device master ... reports as applicable. + Direct the process for evaluating and processing product change requests including impact assessment. + Propose innovative regulatory… more
- Dairy Farmers of America (Houston, TX)
- …concerns and disputes, escalating and recommending appropriate actions . Oversee payroll processing and process payroll as needed. Ensure that payroll processes are ... Maintain personnel files in assigned locations . Manage Worker's Compensation claims as needed. Participate in safety and risk initiatives, including… more
- Lowe's (Houston, TX)
- …(RTM) program, ensuring accurate documentation, vendor communication, and credit processing * Process and disposition damaged, discontinued, defective, special ... with third-party logistics (3PL) partners to address and resolve delivery claims * Maintain strong, professional relationships with vendors, liquidation partners,… more
- Elevance Health (Grand Prairie, TX)
- …+ Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and ... fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related questions as… more
- Norstella (Austin, TX)
- …to extract meaningful insights from **real-world data (RWD)** sources, including ** claims , laboratory results, billing codes, and electronic health records (EHRs)** ... teams to develop and refine database queries, data pipelines, and processing workflows, incorporating AI/ML methodologies for advanced analytics. + Partner with… more