- Molina Healthcare (San Antonio, TX)
- …and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed ... SAI targets are met. + Leads efforts to improve claim payment accuracy and financial performance without needing extensive...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
- CVS Health (Austin, TX)
- …a highly skilled and experienced Senior Product Owner to join our Commercial Claim Adjudication engineering team. As a Senior Product Owner, you will contribute to ... product strategy by: + Leading the development and enhancement of Commercial Claim products or services. + Conducting market research. + Collaborating with… more
- Baylor Scott & White Health (Dallas, TX)
- …handling risk management, medical malpractice and civil litigation matters. Reporting to the system Vice President overseeing claims for Baylor Scott & White ... the legal and risk management issues associated with a dynamic and growing healthcare system . The Dir-AGC will handle pre-litigation claim matters and other risk… more
- AECOM (San Antonio, TX)
- …**AECOM is actively seeking a talented and experienced need Mid-Level Mechanical Systems Inspector Position to support the US Army Corps of Engineers at ... in hand reviews. + Review, inspect and test mechanical systems and equipment installed in projects. + Monitor and...+ Review of controversial and/or complex change orders and claims to ensure they are adequately documented and justified.… more
- Health Care Service Corporation (Richardson, TX)
- …The Audit Specialist Intern responsibilities may include assisting with claim accuracy audits and performance tracking of Administrative Services Only ... findings for analysis and rebuttal with internal business partners that support claims and customer service to contribute to ensuring department, divisional and… more
- Elevance Health (Grand Prairie, TX)
- …data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . ... in order to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health insurance policies,… more
- KPH Healthcare Services, Inc. (Longview, TX)
- …balances. **Responsibilities** + Manage the collection process for outstanding claims , including contacting insurance companies, patients, and other responsible ... written correspondence. + Investigate and resolve denied or partially paid claims , identifying root causes and implementing corrective actions. + Collaborate with… more
- International (San Antonio, TX)
- …our Digital Transformation Journey. Supervisory Control and Data Acquisition (SCADA) systems help monitor and control operations and industrial processes within an ... be hands-on in designing, configuring, deploying, maintaining, and improving these systems in a fast-paced, dynamic Discrete Manufacturing environment. You will… more
- EPAM Systems (Austin, TX)
- …E2E testing strategies + Develop and communicate test strategies covering pharmacy claims processing, NCPDP transactions, and benefit designs + Design test scenarios ... leading large, complex, cross-functional teams + Extensive knowledge of pharmacy claims adjudication, NCPDP protocols, formulary management, and benefit design +… more
- CVS Health (Austin, TX)
- …+ Enter and process monthly fee claims for ancillary product offerings via claim system . **Required Qualifications** + 2+ years of experience working in an ... customers and accounts. + Balance deposits in the accounting system . + Follow systems of checks and...own accountability for open items. + Collect and post claim payments against monthly invoices in accounting system… more
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