- Canon USA & Affiliates (Austin, TX)
- …and review of collaterals for clinical accuracy and adherence to clinical claims . Effectively interacts with multiple teams including R&D, global and local business, ... of the business unit. + Support regulatory activities by managing image quality review with external medical experts, providing clinical expertise, and reviewing… more
- Molina Healthcare (Houston, TX)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... appropriate information has been provided. + Audits loaded provider records for quality and financial accuracy and provides documented feedback. + Assists in… more
- Prime Therapeutics (Austin, TX)
- …experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to ... relations + Implementation experience + Thorough understanding of pharmaceutical claims data and general understanding of medical claims...new ideas and work collaboratively to provide the highest quality of care and service to our members. If… more
- Sedgwick (Houston, TX)
- …Adjuster - Power/Energy (SE & SW Regions) **PRIMARY PURPOSE** : To investigate claims internationally of any size or complexity, against insurance or other companies ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probable costs. + Prepares loss experience reports to help… more
- Sedgwick (Dallas, TX)
- …Adjuster - Southwest Region **PRIMARY PURPOSE** **:** To investigate losses or claims internationally on any size National Account (Maintaining a minimum of five ... be negotiated. + Attends litigation hearings. + Revises case reserves in assigned claims files to cover probably costs. + Prepares loss experience reports to help… more
- Evolent (Austin, TX)
- …cost and use trends, and estimate Evolent's ability to reduce costs and improve quality . + Develop models to quantify and articulate value of new and existing ... fostering trust, expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. + Process and validate… more
- Sedgwick (Dallas, TX)
- …+ Ensures software scalability and data integrity throughout all claims -related applications. + Ensures software compatibility and alignment with overall ... + Assists in projecting software and hardware requirements for claims -related applications. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …departmental staff. + Establish and maintain efficient workflows, turnaround times, and quality standards. Medical Records Management + Ensure the quality of ... and accreditation standards. + Monitor and update policies to align with evolving regulations. Claims & Revenue Cycle Support + Review claims data to ensure… more
- NTT America, Inc. (Houston, TX)
- …we know that with the right people on board, anything is possible. The quality , integrity, and commitment of our employees are key factors in our company's growth, ... team. **Client's business problem to solve?** Our client provides access to high- quality healthcare, innovative programs and a wide range of health solutions that… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …and guidelines. - Confirms submission documents are accurate, compliant, and high- quality to allow for smooth and expeditious approvals from regulatory authorities. ... department to execute departmental initiatives to improve overall efficiency, quality , and/or output. - Assess and develop innovative ideas...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more