- Evolent (Austin, TX)
- …for the culture. **What You'll Be Doing:** **Job Summary:** The **Software Engineering Manager ** at Evolent will lead a team of software/data engineers in designing, ... and maintaining data pipelines to support healthcare data integration and operations . This role involves managing data from various healthcare systems, ensuring… more
- Berkshire Hathaway Automotive (Irving, TX)
- The Risk Manager at Berkshire Hathaway Automotive will develop and administer organization-wide risk management programs while continuously evaluating potential ... and/or overseeing the implementation of the risk solutions that help optimize operations . * Provide risk management consulting to assure compliance with all… more
- Molina Healthcare (Houston, TX)
- …Provider Relations functions and team members. Responsible for the daily operations of the department working collaboratively with other operational departments and ... In conjunction with the Director, Provider Network Management & Operations , develops health plan-specific provider contracting strategies, identifying specialties… more
- AdventHealth (Burleson, TX)
- …directors, physicians, and hospital management in conjunction with the Finance Manager to provide relevant, accurate, and timely information. Performs research, ... to coordinate projects as required in conjunction with the manager and staff. . Ensures all documentation is current...of one year of experience in accounting related duties, claims and/or customer service . Experience with Epic Systems… more
- Molina Healthcare (Austin, TX)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... audits as needed + Participate in process improvement initiatives to improve operations + Understands the compliance and regulatory guidelines for each state +… more
- Mass Markets (TX)
- …seeking a detail-oriented and hands-onManager of Accountingto oversee daily accounting operations and ensure accurate financial reporting. This role is dedicated to ... documentation and responding to audit inquiries. + Collaborate with FP&A, operations , and other cross-functional teams to provide financial insights and support… more
- Molina Healthcare (TX)
- …highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of ... confirm outcomes meet the specific state/federal requirements. + Assists manager in establishing standards, guidelines, and best practices for...operations + Must have strong understanding of QNXT claims processes + Must be able to identify and… more
- Rexel USA (Dallas, TX)
- …RHUSA + Daily Management of third-party administrator for all RHUSA workers compensation claims + Liaise with National Safety Manager on Workers Compensation ... Renewal negotiations + Daily liaison with adjusters and RHUSA Operations and Human Resources to troubleshoot claims ...RHUSA Operations and Human Resources to troubleshoot claims issues + Assist in settlement negotiations on all… more
- Houston Methodist (Houston, TX)
- …and/or manager regarding trends to avoid further delay in claims processing. + Demonstrates understanding of fundamentals of all payors, including Medicare, ... and claim edits, payor rejections, unresolved or no response insurance claims and processing of financial correspondence. The Insurance Biller demonstrates general… more
- Academy Sports + Outdoors (Katy, TX)
- …controlling for other potential avenues for fraudulent activity such as carrier claims fraud, returns fraud, social engineering of Academy's Customer Care team. + ... with key internal teams such as Loss Prevention, Customer Care, and Store Operations to create holistic processes and procedures for detecting and prevent fraud both… more