- Highmark Health (Austin, TX)
- …Utilize robust, data-driven insights from complex healthcare datasets (eg, claims , clinical, utilization, pharmaceutical) to inform policy development, identify ... liaison between the Medical Policy department, other internal departments (eg, Operations , Provider Relations, Clinical Programs), and external vendors to ensure… more
- Mass Markets (Killeen, TX)
- …companies in the USA, with a strong call center footprint and operations that extend across multiple countries. We deliver Customer Experience (CX), Business ... personalized solutions. + Use internal systems to manage accounts and process claims accurately. + Follow established scripts, policies, and procedures to ensure… more
- Allied Universal (Austin, TX)
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... driving experience** **RESPONSIBILITIES:** + Conduct independent investigations of insurance claims across a range of coverage types, including workers'… more
- Humana (Austin, TX)
- …by addressing conditions identified during IHWA visits. + Analyze performance and claims data to monitor and inform strategic decisions. + Generate innovative ideas ... + Leverage experience with provider front end and backend operations , workflows, and systems to inform best practices and...+ Proven ability to compare, read, and report on claims data. + Proven ability to conduct causal analysis… more
- Mass Markets (Killeen, TX)
- …companies in the USA, with a strong call center footprint and operations that extend across multiple countries. We deliver Customer Experience (CX), Business ... systems to support customer needs + Accurately document interactions and process claims in internal systems + Engage customers in solution-focused conversations to… more
- Humana (Austin, TX)
- …and auditing experience * Knowledge of healthcare payment methodologies, claims , submissions, and payments * Strong organizational, interpersonal, and communication ... AHFI) * Experience testifying in court * Understanding of healthcare industry, claims processing, and investigative process development * Experience in a corporate… more
- Mass Markets (Killeen, TX)
- …companies in the USA, with a strong call center footprint and operations that extend across multiple countries. We deliver Customer Experience (CX), Business ... to resolve issues when needed + Accurately document and process customer claims in appropriate systems. + Lead fact-finding discussions to determine the best… more
- The Raymond Corporation (Addison, TX)
- …by managing employee relations, leave of absence cases, and unemployment claims , while proactively partnering with supervisors on performance and development plans ... requests and cases, ensuring compliance and employee support. * Respond to unemployment claims and represent the company at appeals. * Utilize HRIS and workflow… more
- Health Care Service Corporation (Richardson, TX)
- …in business testing, business analysis, process improvement,** project management, business operations or relevant health care industry experience * 3 years of ... Member Collaterals + . Provider Credentialing - sCRED application + . Claims Intake process + . Claims Adjudication logic - FACETS application + . EOB + .… more
- Sedgwick (Fort Worth, TX)
- …the activities of other internal departments such as information technology, operations and business development. + Coordinates client invoicing, audits and accounts ... 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