- CVS Health (Irving, TX)
- …with a collaborative, close-knit reporting team on pharmacy and member specific claims data including, but not limited to, financial and operational information ... Linux OS, GCP/ AWS/ Azure + Experience working with medical and/or pharmacy claims data + Experience in healthcare industry, including health insurance, PBM or… more
- Centene Corporation (Austin, TX)
- …recurring and ad hoc data analysis needs of the Health Plan to enable management to control medical costs and ensure delivery of quality healthcare to members + ... and application of high level mathematical models in medical and pharmacy claims data preferred. Understanding of health insurance business, claims payment… more
- Walgreens (Bee Cave, TX)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... as assigned by the Pharmacy Manager. + Leads Pharmacy Department inventory management activities, such as, ordering, unpacking, checking and storing shipment of… more
- Sedgwick (Austin, TX)
- …medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness ... but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account,… more
- Kemper (Houston, TX)
- …collaborating with peers in the sales organization, State Product Managers, Claims , Agency Support and Licensing, Marketing, and Customer Service/Underwriting. + The ... Bilingual English/Spanish a plus. + Working knowledge of insurance operations: underwriting, claims , marketing, and product. + Must have and maintain an acceptable… more
- Saia, Inc (Sherman, TX)
- …overages, shortages, and damages to reduce or eliminate loss and damage claims . **Major Tasks and Responsibilities** + Researches and investigates reported freight ... issues. + Follows established claims processes and procedures. + Communicates between internal and...shipping and freight disputes. + Provides clerical assistance to management as needed. **Preferred Qualifications** + High school diploma… 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
- Kemper (Dallas, TX)
- …on assigned cases Aggressively pursues files referred to Staff Counsel by the Claims Department. + Creates and maintains a documented strategy for case handling in ... of pleadings, briefs and memorandums. + Prepares and submits timely status reports to claims handlers on all significant activities as they occur, but at no greater… more
- IQVIA (Houston, TX)
- …cards or vouchers. The **Care Navigator** is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific ... employee. **Job Responsibilities:** + Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation… more
- Adecco US, Inc. (Dallas, TX)
- …for healthcare providers, guiding them through benefit investigations, prior authorizations, claims , and appeals. This client-facing role blends remote work with ... services. + **Reimbursement Support:** Help offices navigate insurance processes-BI, PA, claims , and appeals. + **Relationship Building:** Serve as a trusted advisor… more