- CVS Health (Austin, TX)
- …day. **Position Summary** Reviews and adjudicates complex, sensitive, and/or specialized claims in accordance with plan processing guidelines. Acts as a subject ... customer service inquiries and problems. **Additional Responsibilities:** Reviews pre-specified claims or claims that exceed specialist adjudication authority… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …including governmental and private payors; accreditation-related issues; false claims ; tax; anti-trust; tissue or organ transplantation; collections; risk ... and management of potentially compensable events and malpractice or negligence claims ). + Ensure all aspects of the University's medical, podiatric, and… more
- Highmark Health (Austin, TX)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... and industry regulatory changes and assess their potential impact on Claims Operations, Customer Service and other operational areas processes and collaborate… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …fee, even if claimed you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to exercise caution when you receive ... legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,...will not be held liable or responsible for any claims , losses, damages or expenses resulting from job recruiting… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Senior Practice Manager position is responsible for independently managing and/or coordinating complex delivery of care within a large, ... for maximizing revenue through efficient, effective and compliant procedure. The Senior Practice Manager position works collaboratively with clinic medical staff and… more
- Citigroup (San Antonio, TX)
- The Fraud Ops Sr Analyst is a senior level positions responsible for contributing to the development of fraud management policies, processes and procedures to ... of experience in a related role + Intermediate to senior level experience in a similar position preferred +...models + Proven experience in the Investigation and Fraud claims process + Experience in trend analysis and alerts… more
- Elevance Health (Houston, TX)
- **Telephonic Nurse Case Manager Senior ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... and meet the criteria._** The **Telephonic Nurse Case Manager Senior ** is responsible for care management within the scope...as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of… more
- Ensono (Houston, TX)
- Senior Systems Engineer - IAMRemote - United StatesJR012224 At Ensono, our **Purpose is to be a relentless ally, disrupting the status quo and unleashing our clients ... **About the role and what you'll be doing:** The Senior Systems Engineer - IAM is responsible for managing...+ Experience with Fiscal Intermediary Shared System (FISS), Medicare Claims System (MCS), Clerk ID, Veteran-Directed Care (VDC) and… more
- Norstella (Austin, TX)
- Senior RWD Analytic Consultant Company: MMIT Location: Remote, United States Date Posted: Aug 5, 2025 Employment Type: Full Time Job ID: R-1384 **Description** ... The RWD Analytics and Platform Services team at Norstella is looking for a Senior Analytic Consultant to join our growing analytics team supporting Panalgo and IHD.… more
- Deloitte (Fort Worth, TX)
- US Health & Group Benefits Consulting Senior Consultant Human CapitalOur Human Capital practice is at the forefront of transforming the nature of work. As converging ... client expectations and working with leading global businesses? Your RoleAs a Senior Consultant in Employer Health, you will provide strategic and technical employee… more