- Health Care Service Corporation (Richardson, TX)
- …objectives. Recognized internally as a subject matter expert on US Healthcare medical claims operations and processing . **NOTE:** **This hybrid role can be ... located in CHICAGO IL, NASHVILLE, TN or RICHARDSON TX ~ relocation will not be offered; sponsorship is not available.** **Required Job Qualifications:** *Bachelor degree and 7 years of Technology experience, including experience in Project management, OR 11… more
- ADP (El Paso, TX)
- …to support client benefits administration, resolve eligiblity, vendor invoicing and claims issues. + Coordinates with back office the audits, reconciliation and ... that govern the regular deliverables such as vendor invoices, QA, transaction processing + Provides service support related to the administration of health -… more
- Walgreens (San Antonio, TX)
- …enhancements to pharmacy systems to further promote productivity. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent ... payment rejections. Follows-up with insurance companies as well as medical providers and participates in 3rd party audit. + Follows-up with medical providers' offices to clarify prescribed medications, dosages, refills, interactions and allergies to suggest… more
- Oracle (Austin, TX)
- …of AI agents and multi-agent systems that orchestrate complex RCM workflows ( claims processing , charge capture, revenue integrity, denial management, and ... follow-up). Review and contribute to design docs, system diagrams, and critical code paths as needed. + **AI/ML solution delivery** Oversee end-to-end delivery of scalable AI/ML solutions, including data pipelines, model integration, inference services, and… more
- Highmark Health (Austin, TX)
- …within the healthcare industry. + Understanding of health plan operations, including claims processing , enrollment, billing, and customer service. + Proven track ... record of successfully managing complex projects and delivering results on time and within budget. + Strong understanding of the market and competitive landscape. + Excellent communication, interpersonal, and presentation skills. + Demonstrated ability to… more
- Republic Finance, LLC (Tyler, TX)
- …by explaining the loan process, answering questions regarding loan products and loan processing . + Takes ownership of customer concerns and works with management to ... to quickly and efficiently resolve any customer issues. + Processes insurance claims , follow-ups and payments daily and maintains insurance log. + Provides excellent… more
- Republic Finance, LLC (Tyler, TX)
- …performing risk analysis, making credit decisions, administering loan closings, and processing insurance claims . Your management abilities shine as you ... assist the Branch Manager with recruiting and training as well as developing and implementing plans to meet sales goals while promoting our core values, and ensuring an outstanding customer experience. If you love digging in to get the job done and seeing your… more
- CVS Health (Austin, TX)
- …regulations, and security requirements. **Required Qualifications** + 1 year minimum of claims processing experience + Experience with system testing and post ... go-live validation + QNXT Experience + Familiarity with clinical and code editing concepts and products (Example: ClaimsXten, Cotiviti PPM & CV) + Extensive knowledge of CPT, HCPCS, ICD-10 coding **Preferred Qualifications** + Prior Relevant Work Experience… more
- Walmart (San Antonio, TX)
- …types, programs, and benefits to current and prospective members; processing memberships, upgrades, and credit accounts; encouraging membership renewals; ... up orders are filled. Oversees assigned area of responsibility by handling claims and returns; zoning the area; arranging and organizing merchandise; identifying… more
- Walgreens (San Antonio, TX)
- …accordance with Walgreens standard operating procedures for entering, third party processing , filling, and dispensing prescriptions. + Assists pharmacists and other ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more