- Molina Healthcare (Houston, TX)
- **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... CMS and internal audit activities. This position contributes to the development of...collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and third-party ... potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide feedback regarding documentation and… more
- TEKsystems (Dallas, TX)
- …of the servicer and/or client * Files respective investor/insurer initial and final claims based on the respective guidelines for allowable limits * Reviews MI claim ... and research curtailment reasons for potential rebuttal * Files Appeal or Supplemental Claims ensuring all allowable advances and interest are recovered from the MI… more
- Molina Healthcare (San Antonio, TX)
- …to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee, ... and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and performs audits and oversight functions involving business-critical… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen....+ Assist in developing and refining internal SOPs and audit tools related to COB claim reviews. + Act… more
- Molina Healthcare (San Antonio, TX)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Toyota (Plano, TX)
- …for** Toyota's Corporate Insurance & Risk Management Department within the Compliance & Audit seeks a passionate and highly motivated **Insurance Risk Analyst ** ... North American region, processing insurance requests, creating/updating analytical reports, claims management, providing risk management support, and consultation to… more
- Baylor Scott & White Health (Temple, TX)
- **Job Description :** We are seeking a detail-oriented and experienced **System Analyst 2** to join our team. The ideal candidate will be responsible for testing, ... validating, and ensuring the accuracy of EDI transactions related to healthcare claims . This role involves working closely with developers, business analysts, and… more
- NTT America, Inc. (Houston, TX)
- …and forward-thinking organization, apply now. We are currently seeking a Sr. Configuration Analyst to join our team in Houston, Texas (US-TX), United States (US). ... which involves Payor Platform configuration, perform UAT, Integration Testing and Audit . Our NTT Business Process Outsourcing (BPO) team has helped client… more
- CVS Health (Austin, TX)
- …opportunity to join our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health strives to continuously ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more