- Humana (Austin, TX)
- …community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and readiness to ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Prime Therapeutics (Austin, TX)
- …is responsible for the synthesis of data findings in support of clinical claims and programs. **Responsibilities** + Synthesizes a wide variety of data and outputs ... in producing reports, scorecards, or other data using Pharmacy and/or Medical claims data to support projects and initiatives throughout the Integrated Care &… more
- Prime Therapeutics (Austin, TX)
- …with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness & ... accuracy of Prime's financial pricing programs against adjudicated claims to identify trends and draw insights to provide pricing recommendations + Apply… more
- Zurich NA (Houston, TX)
- …Diploma or equivalent and 10 or more years of experience in the claims or underwriting support areaOR + Zurich approved Apprenticeship program including an associate ... including an associate degree and 8 or more years of experience in the Claims or Underwriting Support area. + Knowledge of Microsoft Office + Experience working on… more
- Zurich NA (Houston, TX)
- …School Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support area OR + Zurich Certified Insurance Apprentice including an ... including an Associate Degree and 8 or more years of experience in the Claims or Underwriting Support area OR AVP, Underwriting Director - Excess Casualty Basic… more
- USAA (San Antonio, TX)
- …assistance is not available for this position. **These positions will support Claims Litigations.** **What you'll do:** + Develop and implement strategic customer ... to collect and analyze data. **What sets you apart:** + P&C Litigation Claims Operations and/or Optimization experience. + 2+ years Manager, Claims Operations… more
- Insight Global (Dallas, TX)
- …client's team. Responsibilities will include managing complex workers' compensation claims , ensuring fair and efficient resolution while maintaining compliance with ... The ideal candidate will have extensive experience handling indemnity claims , negotiating settlements, and collaborating with medical and legal professionals.… more
- Elevance Health (Houston, TX)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
- The City of Houston (Houston, TX)
- …with the following skillset(s): Previous experience adjusting workers' compensation claims and/or previous experience in Risk Management, including but not ... an individual's sex, race, color, ethnicity, national origin, age, religion, disability , sexual orientation, genetic information, veteran status, gender identity, or… more
- Elevance Health (Houston, TX)
- …the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries. **How ... audits. + Participates in pre and post implementation audits of providers, claims processing and payment, benefit coding, member and provider inquiries, enrollment &… more