- 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
- 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
- Molina Healthcare (San Antonio, TX)
- …maintain contract, benefit or reference table information into the claim payment system and other applicable systems . + Participates in defect resolution for ... claims databases. Synchronizes data among operational and claims systems and application of business rules...housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Prime Therapeutics (Austin, TX)
- …and document the requirements and technical solutions for changes to Prime's claims systems . **Responsibilities** + Ensure understanding of business requirements ... to elicit and document business needs for moderately complex modifications to Claims system applications, and define functional, high-level, and detailed … more
- Jack Henry & Associates (Allen, TX)
- Fraud System Administrator/Card Fraud Support Analyst General information Press space or enter keys to toggle section visibility JobID 16604 Position Level ... reports or complaints of discrimination of any kind, pursuing any discrimination claim , or cooperating in related investigations. Requests for full corporate job… more
- Elevance Health (Grand Prairie, TX)
- …claim identification, and documentation purposes (eg, letter writing). + Identifies new claim types by identifying potential claims outside of the concept ... or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement… more
- Health Care Service Corporation (Richardson, TX)
- …development. **Job Summary** We are seeking a motivated and collaborative Systems Analyst to provide skilled leadership on complex assignments/projects. This ... for designing enhancements and new business applications and/or information systems solutions through integration of technical and business requirements; serving… more
- UTMB Health (Galveston, TX)
- …rejections from billing system daily to bill submit hospital and/or physicians claims + Performs online corrections to edited claims according to procedures ... Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital … more
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