- Ryder System (Frisco, TX)
- …and supporting documentation. + Track and follow up on open returns and claims ; escalate issues when appropriate. + Maintain detailed records of all return and ... to build relationships and follow up effectively. + Experience with OS&D processes or claims management in a logistics setting. + Exposure to working with CPG or… more
- USAA (San Antonio, TX)
- …to collect and analyze data. **What sets you apart:** + P&C Property Claims Operations and/or Optimization experience + 2+ years MCO experience + Deep operational ... knowledge of end-to-end Property Claims processes + Demonstrated knowledge of new and emerging...experience through military service or a military spouse/domestic partner ** Compensation range:** The salary range for this position is:… more
- Humana (Austin, TX)
- …it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, and ... Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience in a… more
- Molina Healthcare (San Antonio, TX)
- …software and medical record vendors, and other Molina departments, such as Claims , Enrollment, IT etc,. to get appropriate responses and manage contracts and ... + Maximizes use of information from multiple sources, including claims /encounters, pharmacy, utilization management, clinical indicators, industry benchmark, and/or… more
- Evolent (Austin, TX)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Sedgwick (Austin, TX)
- …#medicaresetaside _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency ... in job postings. Actual compensation is influenced by a wide range of factors...other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating… more
- Evolent (Austin, TX)
- …accounts + Strong knowledge of health plan operations, care/utilization management, claims processing, value-based care, and the levers to optimize financial ... be leveraged to identify opportunities and actions (including EMR, clinical, authorization, claims , SDoH, etc.); understanding of how to translate data and insights… more
- Molina Healthcare (TX)
- …models to support analytical and operational use cases, including healthcare claims and utilization data. * Collaborate with cross-functional teams, including data ... * Prior experience working in the healthcare industry with familiarity in clinical, claims , or care management data. * Experience with cloud platforms (AWS, Azure)… more
- UIC Government Services and the Bowhead Family of Companies (Plano, TX)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- Evolent (Austin, TX)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more