- Elevance Health (Grand Prairie, TX)
- …encounter data and provide actionable insights. + Assist in developing data quality management processes and procedures. + Provide support for CMS audits and other ... requirements. + Develop and analyze business performance reports (eg, for claims data, provider data, utilization data) and provides notations of performance… more
- Saia, Inc (Sherman, TX)
- …overages, shortages, and damages to reduce or eliminate loss and damage claims . **Major Tasks and Responsibilities** + Researches and investigates reported freight ... issues. + Follows established claims processes and procedures. + Communicates between internal and...shipping and freight disputes. + Provides clerical assistance to management as needed. **Preferred Qualifications** + High school diploma… more
- Evolent (Austin, TX)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more
- Kelly Services (Irving, TX)
- …issues. + Manual and electronic filing, printing, etc. + Breakdown/Distribution of management and operator productivity reports. + Assists the facility in various ... tasks, ie handling dealer claims , dealer order tracking/support, dealer return program, budget tracking, dealer contacts. + Processes inbound and outbound carrier… more
- Sedgwick (Dallas, TX)
- …not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the ... for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The… more
- BrightSpring Health Services (Corpus Christi, TX)
- …personnel costs, consultant services + Monitors worker's compensation and unemployment claims for assigned service site(s). Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas...area regulations. Exceptions must have written approval from Regional Management + A minimum of two years of verifiable… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …Act as subject matter expert (SME). Examine clinical health records and claims folders to determine eligibility and entitlement for items and services. Advise ... performance, resolves conflicts in administering purchase orders, such as protests, claims , duplicate billing & terminations for convenience or default, work… more
- Kemper (Dallas, TX)
- …on assigned cases Aggressively pursues files referred to Staff Counsel by the Claims Department. + Creates and maintains a documented strategy for case handling in ... of pleadings, briefs and memorandums. + Prepares and submits timely status reports to claims handlers on all significant activities as they occur, but at no greater… more
- Army Installation Management Command (Fort Sam Houston, TX)
- …retirees and the third party administrators. Examines, adjudicates and authorizes claims for benefits under the benefit plans. Applies and interprets statutory, ... Revenue Code and Department of Labor regulations. Responsible for updates and management of the plans, enrollment and termination of participants, verification of… more
- CVS Health (Austin, TX)
- …work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data. + Experience in healthcare industry, including health insurance, PBM or… more