- Highmark Health (Austin, TX)
- …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... + 3 years of relevant, progressive experience in the health insurance industry and/or healthcare fraud investigations **Preferred** +...in Financial Analysis in an acute care hospital or health insurance setting + 1 year in professional billing,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …datasets from IQVIA, Symphony, Market Access Data (ie patient longitudinal data, claims data, distribution, sales, demand, promotion, formulary) + Strength in one or ... tools such as MicroStrategy, PowerBI, etc + Experience in processing , analyzing, and synthesizing various data sources (syndicated, specialty...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- HUB International (Fort Worth, TX)
- …providing a broad array of property, casualty, risk management, life and health , employee benefits, investment and wealth management products and services. HUB has ... in service related activities in support of clients. Issues related to policy processing , maintenance of client data on the EPIC agency management system, routine… more
- Prime Therapeutics (Austin, TX)
- …combined pharmacy and PBM experience to include:##1 year of work experience in claims processing in an operations, audit or quality assurance environment##1 year ... understanding of the point of sale and on-line pharmacy claims processing environment + Excellent oral, written...ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and… more
- Intermountain Health (Austin, TX)
- …of clinical pharmacy services to members and affiliated providers. **Select Health Pharmacy Coordinator - Remote Position** This position requires rotating holiday ... call scheduling. **Job Essentials** + Provides clinical pharmacy support for Select Health and affiliated members. + Develops and implements innovative programs that… more
- Molina Healthcare (Fort Worth, TX)
- …appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . + Identifies and reports quality of care issues. + ... denial and modification of payment decisions + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more
- Walmart (Mckinney, TX)
- …by ensuring proper policies and procedures are followed Ensures the timely processing of claims forexample damaged defective returned liquidated items and ... Manages facilitylevel training and execution of asset protection safety and claims and receiving procedures by reviewing the application of policiesprocedures… more
- Catholic Health Initiatives (Pasadena, TX)
- **Responsibilities** Responsible for the timely processing of all patient charges assuring maximum revenue capture; reconciliation of all patient charges & ... coordinating with Patient Financial Services to expedite resolutions to facilitate claims reimbursement. In addition plays an important role in patient satisfaction… more
- Highmark Health (Austin, TX)
- …years of experience specific to the Dental Solutions Application Portfolio (eg, Concordia Claims Processing & RENO, Portal applications, UCD billing, etc.) may ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
- Molina Healthcare (TX)
- …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare data, including ... support and consultation to the Clinical Center of Excellence, Health Plan, and Finance teams through analyzing key business...and manage information from large data sources + Analyze claims and other data sources to identify early signs… more