- Providence (TX)
- …Directors and Officers, Employment Practices, Fiduciary, Property, Cyber, Managed Care, and Auto Claims . The Senior Quality Analyst assists the Claims ... and regulations pertaining to self-insured health care organizations. The Senior Quality Analyst is also responsible for maintaining a claims quality assurance… more
- DXC Technology (Houston, TX)
- …office-while enhancing customer experiences. We are seeking a **detail-oriented and customer-focused Annuity Analyst - Death Claims ** to support one of our key ... innovation across their IT ecosystems. We offer solutions across business process outsourcing, insurance, analytics and engineering, applications, security, cloud,… 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 (TX)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Prime Therapeutics (Austin, TX)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Senior - Remote **Job Description** The Senior Pricing Analyst ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Austin, TX)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… 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
- Prime Therapeutics (Austin, TX)
- …passion and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior ... Compliance Analyst assists in the implementation of Prime's compliance programs,...claims , contracting and pharmacy reimbursement. Works directly with business partners across the enterprise. **Responsibilities** + Executes compliance… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- Molina Healthcare (Dallas, TX)
- **Job Description** **Job Summary** Assist business teams with developing requirements for major projects of considerable complexity, prepares system design ... debug/analyze problems. + Fields direct questions from Molina Operations Staff regarding business , technical and operations rules. + Develops technical solutions to … more