- Centene Corporation (Austin, TX)
- …managing, and owning workforce management strategy, process, and execution for claims . Will focus on tactical and strategic plans, capacity planning, quality, ... in business administration or analytical field preferred. 7+ years of professional level experience. Experience to include strategy development, identifying and… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex claims business problems and issues using data from internal and external sources to provide insight to ... task and workflow analysis. + Interpret customer business needs in the claims space and translate them into application and operational requirements + Communicate… more
- USAA (San Antonio, TX)
- …Opportunity** As a dedicated **Strategic Account Relationship Manager Senior for Claims Optimization** , you will be responsible for developing, managing, growing, ... + Travel may be required. **What sets you apart:** + P&C Claims Operational experience, industry knowledge of contract requirements and experience with oversight… more
- Guidehouse (Lewisville, TX)
- …denials for trends and issues and reports findings to supervisor + Bills or re-bills claims as necessary + Ensures the client follows all state and federal rules and ... by leadership + Handles all customer calls both internal and external in a professional and courteous manner. **What You Will Need** **:** + High School Diploma /… more
- Command Investigations (Laredo, TX)
- …all assignments. If you have the desire to operate at your highest professional level within an organization that values and rewards excellence, please submit your ... hire. Visit our website and find out why at www.GoCommand.com . The Claims Investigator should demonstrate proficiency in the following areas: + AOE/COE, Auto, or… more
- UTMB Health (Galveston, TX)
- …through a claims processing vendor and/or for appeal of denied professional and/or hospital claims . Identifies billing issues affecting hospital and/or ... Performs follow-up activities and identifies reimbursement issues affecting these claims . Takes necessary actions to insure timely and appropriate reimbursement… more
- Baylor Scott & White Health (Temple, TX)
- …and staff for timely reviews, feedback, recommendations, and resolution of professional liability claims . Coordinates follow-up and collaborates with multiple ... position type and/or level **Job Summary** Manages detailed assessments of high-risk claims with a medical/legal plan to prevent claim elevation. Reviews and… more
- The Hartford (San Antonio, TX)
- …oversight, appropriate file disposition and adherence to statutory guidelines for all claims * Leverage a network of professional resources that may include: ... Claims Representative - CH09CNSr Representative Claims ...to achieve accurate and efficient claim outcomes* Consistently demonstrate professional diplomacy during all interactions with customers* Contribute to… more
- Evolent (Austin, TX)
- …mining, advanced/ statistical analysis, and data manipulation + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider, ... RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and… more
- Humana (Austin, TX)
- …caring community and help us put health first** The Encounter Data Management Professional ensures data integrity for claims errors. The Encounter Data ... of the appropriate courses of action. The Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of… more