- Highmark Health (Austin, TX)
- …for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead or ... processes, Coordination of annual audits (such as PWC Revenue Audit and Support Senior Vice President of Operations in Monthly/Annual budget and expense analysis for… more
- Sanofi Group (Houston, TX)
- …knowledge of the US healthcare system, including formulary operations, claims adjudication, specialty pharmacy networks, and contract performance tracking. We ... performance and recommend operational optimizations. + Provide timely updates to senior leadership and account management teams, highlighting trends, gaps, and… more
- CVS Health (Austin, TX)
- …times, and client satisfaction. Provide regular reports and insights to senior management to inform strategic decision-making and drive continuous improvement in ... levers, underwriting and financial models. + Understanding of healthcare and pharmacy claims data and common tools used to manipulate data. + Exceptional… more
- Molina Healthcare (Houston, TX)
- …Help translate CMS audit requirements into data tasks under the guidance of senior analysts. + Document data sourcing steps, methodologies, and business rules to ... programming language + Basic familiarity with healthcare data types such as claims , encounters, or eligibility data + Comfortable working with data in spreadsheets… more
- Caris Life Sciences (Irving, TX)
- …professionals, program managers, clinical content creators, KOL developers. This is a senior member of the marketing leadership team who helps shape and inform ... the strategy for advisory boards and scientific KOL engagement. + Align clinical claims and product attributes with the product marketing team as they develop… more
- CenterWell (Mineral Wells, TX)
- …team at the branch to ensure other billing requirements are satisfied to release claims timely. + Adhere to and participate in Agency's mandatory HIPAA / Privacy ... that put patients at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of home health services, and… more
- Kiewit (Dallas, TX)
- **Requisition ID:** 176897 **Job Level:** Senior Level **Home District/Group:** Kiewit Building Group **Department:** Field Operations **Market:** Building ... (Ex: progress of projects, financial health, schedule adherence, risk and opportunities, claims ). * Work closely with "Get Work" teams and other internal departments… more
- Bowman (Austin, TX)
- …complex assignments, tasks, and execution. Work is frequently reviewed by more senior staff to ensure application of sound techniques and principles. Review work ... and resolve any issues that may arise as it relates to disputes, or claims + Act as liaison between operations and many corporate accounting functions including but… more
- JND (Plano, TX)
- …data trend analysis on a daily/weekly/monthly basis + Weekly review and monitoring of claims for proactive risk detection + Ensure SOP documentation is up to date, ... groups/stakeholders + Demonstrated ability to interact with peers, supervisors, managers and senior management + Team player, but able to work independently and… more
- Ally (Austin, TX)
- …presence and effectively communicate fraud-related insights and recommendations to senior leadership. * Maintain a positive consultative approach when working ... * Familiarity with Reg E and Mastercard's dispute rules to support accurate claims management and loss recovery. * Strong analytical skills including SQL, Python, or… more