- Evolent (Austin, TX)
- …system processing in detail + provide summary information to stakeholders & management answering business questions + create & maintain queries supporting precise ... Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1...(or test strategy) + Operating at least one test management and defect management tool + Creating… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance with ... processes. + Reviews, assesses and analyzes medical records, coding, billing, claims , reimbursements and workflow processes to ensure accuracy, completeness, and… more
- UNUM (Austin, TX)
- …+ Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% ... as requested by the client to the worker + Claims /Documentation Support: Remind workers where to go to file...Assurance via review of metrics, auditing of calls, coaching/performance management sessions with Supervisors, and job shadows of others.… more
- GAF (Ennis, TX)
- …skills in plant troubleshooting, process design, continuous improvements and quality management . The incumbent's primary focus is to maintain control over the ... the field. Maintain communication with main lab at Parsippany to track claims , elaborate reports, and lead improvement projects associated with customer claims… more
- BrightSpring Health Services (Denton, TX)
- …personnel costs, consultant services + Monitors worker's compensation and unemployment claims for assigned service site(s). Is proactive in efforts to reduce ... claims and minimize risk/exposure of agency in these areas...area regulations. Exceptions must have written approval from Regional Management + A minimum of two years of verifiable… more
- CVS Health (Austin, TX)
- …day. **Position Summary** -Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and ... communication, both internally and externally to enhance effectiveness of medical management services and health care team. -Performs non-medical research and… more
- Sedgwick (Fort Worth, TX)
- …required to include five (5) years of relationship building in the group life, disability , and absence management area. Advanced sales and technical ability in ... required. Bachelor's degree with major in Business Administration, Finance or Risk Management preferred. Licenses as required. Experience: Ten (10) years of related… more
- Kemper (San Antonio, TX)
- … management experience + Extensive knowledge of insurance operations: claims , coverages, products and underwriting is preferable to effectively communicate with ... requirements. + Works directly with strategic partners like Product, Claims , and Operations on issues impacting the account. +...a capable people developer + Should demonstrate excellent time management skills + Must be a logical problem solver… more
- Evolent (Austin, TX)
- …member-centric products. This role plays a critical part in both **Medical Cost Management ** and **Product Management ** , leveraging advanced analytics to solve ... + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to identify cost drivers, utilization patterns,… more
- PulteGroup (Coppell, TX)
- …determine insurability of real estate transactions and minimize exposure arising from claims on policies issued by Premier and the other title underwriters. Support ... support to the Deputy General Counsel and Leadership Team in handling and management of general corporate matters, regulatory and licensing issues; + Draft memos and… more