- Elevance Health (Grand Prairie, TX)
- …required by law. The ** Payment Innovation Director** is responsible for Payment Innovation business solution research, design, development, and ... candidates not within a reasonable commuting distance from the posting location(s) will not be considered for ...conceptualizing innovative payment solutions for healthcare providers thru provider… more
- Molina Healthcare (Dallas, TX)
- …projects and tasks to ensure CMS and State regulatory requirements are met for pre-pay edits, post payment datamining, and overpayment recovery which improves ... **Job Description** **Job Summary** The Health Plan Operations, Payment Integrity Program Manager is an individual contributor...Integrity Program Manager is an individual contributor role designed for a highly capable individual who serves as a… more
- Molina Healthcare (Austin, TX)
- …and responsibility for oversight, production, and resolution of Health Plan Payment Integrity (PI) recovery concepts. This role executes and monitors Health Plan ... to ensure CMS and State regulatory requirements are met for pre-pay edits, post payment datamining, and...- $171,058 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or… more
- Elevance Health (Grand Prairie, TX)
- …on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an ... Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to...for this role at the time of this posting . This range may be modified in the future… more
- Molina Healthcare (San Antonio, TX)
- …This role focuses on identifying and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied ... Operational Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met … more
- Molina Healthcare (TX)
- …seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and ... in Medicaid managed care is required, and a background in payment integrity-either at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities**… more
- Robert Half Accountemps (Dallas, TX)
- …Records (EMR) and electronic remittance processing. * Strong understanding of medical payment posting and patient accounting practices. * Familiarity with ... Description We are looking for a skilled Medical Payment Poster...you will play a key role in ensuring accurate posting of payments and maintaining compliance with healthcare regulations.… more
- Molina Healthcare (San Antonio, TX)
- …Summary** Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and ... deploying reports to provider networks and other end users for operational and strategic analysis. **Knowledge/Skills/Abilities** The Director of Reporting &… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** Responsible for all the aspects of architecture, design and implementation of Data Management solution using Big Data platform on ... Architecture, Evaluating tools and Frameworks, define Standards & Best Practices for implementing scalable business solutions * Implement Batch and Real-time data… more
- Molina Healthcare (TX)
- **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace ... knowledge. + Prepare performance dashboards, recovery reports, and operational updates for senior leadership. **Required Qualifications:** + 5+ years of experience… more