- 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 ... analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field. + Previous experience using… more
- Norstella (Austin, TX)
- Sr . Medical Analyst Company: MMIT Location: Remote,...and support patients in need. We are seeking a Senior Medical Analyst to join our team and ... to extract meaningful insights from real-world data (RWD) sources, including claims , laboratory results, billing codes, and electronic health records (EHRs). You… more
- NTT America, Inc. (Plano, TX)
- …when executed as part of an overall sourcing strategy. NTT DATA currently seeks a ** Claims Processing Associate** to join our team for a remote position. **Role ... methodology/ fee schedule **Required Skills/Experience** + 1+ years hands-on experience in Healthcare Claims Processing + 2+ years using a computer with Windows… more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms… 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 ... Databricks, not all required elements are neatly organized or centralized. The analyst will be expected to investigate and connect disparate data sources, with… more
- Allied Solutions (Plano, TX)
- …Loss, GAP, CPI and others as assigned. This position will involve the initial processing and investigation of 20-40 claims per day. This position ensures that ... certain claim types prior to the assignment to a Claims Adjuster or Analyst . The key responsibilities...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
- Humana (Austin, TX)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... of experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience processing or reviewing facility claims + Prior professional experience… more
- Acosta Group (Lewisville, TX)
- …activities, including high-severity Workers' Compensation and liability claims . Supervise the Sr . Risk Claims Analyst and ensure alignment with best ... enterprise. The Director will manage a team including the Sr . Risk Claims Analysts and collaborate closely...+ Knowledge of insurance contract language, insurance underwriting, and claims processing + Deep knowledge of casualty… more