- Molina Healthcare (TX)
- …Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen....operations + Must have strong understanding of QNXT claims processes + Must be able to identify and… more
- Air Education and Training Command (Lackland AFB, TX)
- …perform a variety of duties in the analysis and evaluation of cyber operations , and to complete developmental assignments and training outlined in the formal ... an education requirement. You MUST provide transcripts to support your educational claims . Education must be accredited by an accrediting institution recognized by… more
- Highmark Health (Austin, TX)
- …efficient working relationships with key internal areas, such as Customer Service Operations ( Claims , Dental Benefits, Customer Service, Membership & Billing), ... resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. This… more
- Highmark Health (Austin, TX)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations , Customer Service, Regulatory Affairs, IT, Legal and other departments, ... federal, and industry regulatory changes and assess their potential impact on Claims Operations , Customer Service and other operational areas processes and… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique ... of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams (EAS, Specialty… more
- US LawShield (Houston, TX)
- …2 million people in their self-defense journey. US LawShield is seeking a Senior Data Analyst to join our data and analytics team. This role will be pivotal in ... similar platforms. + Conduct in-depth analyses of member engagement, retention, claims , and operational performance to identify trends, risks, and opportunities. +… more
- FREEMAN (Dallas, TX)
- …technologies to deliver moments that matter. **Summary** The Senior Benefits Analyst is responsible for the analysis, administration, and continuous improvement of ... retirement, and leave of absence/disability plans. The Senior Benefits Analyst serves as a key member of the Benefits...due to qualifying life events. + Resolve escalated vendor claims issues and ensure timely resolution. + Provide employee… more
- Molina Healthcare (Fort Worth, TX)
- … operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms (eg, PMPM, ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Humana (Austin, TX)
- …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral… more
- Molina Healthcare (San Antonio, TX)
- **Job Description** **Job Summary** The Senior Analyst will serve a key role on the RADV (Risk Adjustment Data Validation) team, contributing to the end-to-end data ... Databricks, not all required elements are neatly organized or centralized. The analyst will be expected to investigate and connect disparate data sources, with… more