- Highmark Health (Austin, TX)
- …inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly ... information system . + Enter all authorizations into the Argus IPNS information system to allow claim adjudication. + Complete other assigned duties as… more
- System One (Turkey, TX)
- Job Title: Project Manager - Data Center Location: rural West Texas Type: Direct Hire System One is assisting a client in hiring a Project Manager for their Data ... EPC/EPCM contractors delivering HV AIS substations and 3rd-party power integration systems . Manage performance guarantees, liquidated damages, change orders, and … more
- System One (Lockhart, TX)
- Job Title: Electrical Project Manager Location: Lockhart, Texas Type: Direct Hire System One is assisting a client in hiring an Electrical Project Manager to support ... and third-party technical groups. + Oversee protection & controls, EMS/SCADA systems , plant controllers, power quality troubleshooting, and other technical needs… more
- USAA (San Antonio, TX)
- …assess coverages, and make sound decisions + Proficiency with Guidewire or similar claims management systems + Bachelor's degree or industry designation (eg, ... of liability, setting and managing services throughout life of the claim while providing excellent service. Within defined guidelines and framework, you… more
- Rexel USA (Dallas, TX)
- …and implementing programs and processes to control the cost of insurance and claims . **What You'll Do:** + Provide best practices in workers compensation management ... + Daily Management of third-party administrator for all RHUSA workers compensation claims + Liaise with National Safety Manager on Workers Compensation claims… more
- System One (Houston, TX)
- …excellent communication skills, and demonstrated proficiency in utilizing Cost Point Procurement systems is preferred + US Person/Citizen System One, and its ... Senior Subcontract Administrator Remote System One is seeking a Senior Subcontract Administrator...storage. Ensures retention of hard copy of reports and claims for seven years. + Serves as liaison between… more
- System One (Houston, TX)
- …excellent communication skills, and demonstrated proficiency in utilizing Cost Point Procurement systems is preferred * US Person/Citizen System One, and its ... Senior Subcontract Administrator Remote System One is currently seeking a motivated/seasoned individual...storage. Ensures retention of hard copy of reports and claims for seven years. * Serves as liaison between… more
- Molina Healthcare (San Antonio, TX)
- …agencies to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate ... Researches claims processing guidelines, provider contracts, fee schedules and systems configurations, to determine root causes of payment errors. * Resolves and… more
- Molina Healthcare (Houston, TX)
- …all payment integrity (PI) solutions. * Independently leads efforts to improve claim payment accuracy, claim referrals, adjustment analysis and financial ... Analysis_ * Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. * Applies understanding of… more
- Sedgwick (Fort Worth, TX)
- …equivalent combination of education and experience required. Experience in multi-line claims management processes and system requirements strongly preferred. ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance IT Systems Analyst Specialist Sr **PRIMARY PURPOSE OF THE ROLE** : To lead the… more
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