- CVS Health (Austin, TX)
- …Respond to customer benefits questions, and clarifications on billing, eligibility, and claims processes. + Retain and grow the client relationship and effectively ... position our products with an emphasis on expanding our book of business. **Required Qualifications** + 2-5 years industry experience, with experience in Self- funded customers preferred. + Customer service experience, preferably with complex accounts.… more
- CVS Health (Richardson, TX)
- …NextGen Production Support Environment team, focusing on Non-Production Support: + Claims system: Health Rules Payer (HRP) + Enrollment systems: Market Prominence ... (MP) & Softheon The position requires collaboration with business, QA, release delivery, infrastructure, and vendor partners, driving system stability and maintaining code releases. Key Responsibilities + Monitor system upgrades. + Analyze defect reports… more
- CVS Health (Richardson, TX)
- …and/or Rebate knowledge beneficial. + Experience with Caremark business systems, claims adjudication, formulary, drug, and client systems with an emphasis on ... the RxClaim adjudication platform beneficial. + Medicare knowledge beneficial. + Ability to work independently and with people across functional area. + Ability to work in a hybrid team environment. + Strong reading comprehension skills. + Capability to… more
- CVS Health (Austin, TX)
- …position is open in a data engineering team that is responsible for processing Claims , Revenue, Medicare Specific files and data from 30+ payors into our Data ... Warehouse. **Required Qualifications** + 6 + years of experience working with SQL and relational database management systems + 4+ years of experience in Cloud technologies + 3+ years of experience in Microsoft SQL server + 3+ years of experience in Databricks… more
- Baylor Scott & White Health (College Station, TX)
- …explanation of benefits from payers. This helps patients and guarantors understand claims processing or denial of services. **Key Success Factors** + 3 years ... of healthcare experience or education equivalency required. Proven ability to problem-solve, perform critical thinking. + Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette. + Maintain… more
- GE HealthCare (TX)
- …+ Review, sort and/or prioritize retrieved search results, with analysis of claims and prosecution histories as needed. + Monitor third-party activities for ... potential misappropriation of company IP. **Qualifications** + Qualified US or European Patent Agent or Attorney or equivalent (or near completion). + Technical background in chemistry, pharmacology, or related life sciences field. + Strong communication and… more
- Thrivent Financial (San Antonio, TX)
- …S&P Global Ratings. Ratings are based on Thrivent's financial strength and claims -paying ability, but do not apply to investment product performance. Thrivent values ... diversity and inclusion, and we're committed to providing an Equal Employment Opportunity (EEO) without regard to race, religion, color, gender, gender identity, national origin, age, disability, marital status, citizenship status, military or veteran status,… more
- Republic Finance, LLC (Lufkin, TX)
- …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, promote our core values, and ensure an outstanding client experience. If you love digging in to get the job done and seeing your hard work pay off in the growth of… more
- Houston Methodist (Cypress, TX)
- …charges, business practice complaints, and Texas Workforce Unemployment Claims . Identifies appropriate options for management/senior leadership consideration, makes ... recommendations as necessary, and writes summary reports to support employment-related business decisions. + Proactively gathers and interprets data; identifies opportunities for improvement. Conducts workforce data analysis, prepares summary reports, and… more
- CVS Health (Austin, TX)
- …abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and ... prepares cases for clinical and legal review. + Documents all appropriate case activity in case tracking system. + Prepare written case summaries and make referrals to State and Federal Agencies within the timeframes required by Law. + Facilitates the recovery… more