- Molina Healthcare (Austin, TX)
- …Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst, Healthcare Analytics role will be responsible for work...Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents Risk Adjustment… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing, ... and healthcare professionals to resolve issues resulting from denied claims + Adhere to coding policies and procedures consistent with the industry-standard… more
- Evolent (Austin, TX)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Molina Healthcare (Austin, TX)
- …solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * ... **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Healthcare plays a critical role in supporting clinical and operational initiatives by… more
- Molina Healthcare (San Antonio, TX)
- …technical solutions. + Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst, Healthcare plays a critical role in supporting clinical and operational initiatives by translating … more
- Molina Healthcare (TX)
- …optimize data models to support analytical and operational use cases, including healthcare claims and utilization data. * Collaborate with cross-functional ... and outcomes Research) * Prior experience working in the healthcare industry with familiarity in clinical, claims ,...the healthcare industry with familiarity in clinical, claims , or care management data. * Experience with cloud… more
- Amazon (TX)
- …experience in a call center environment 1+ years with medical billing, insurance claims , or healthcare revenue cycle Demonstrated proficiency in Microsoft Office ... of customer-service, administrative work and are motivated to cultivate change in healthcare . You are currently looking for your next opportunity at an organization… more
- Baylor Scott & White Health (Temple, TX)
- …for testing, validating, and ensuring the accuracy of EDI transactions related to healthcare claims . This role involves working closely with developers, business ... compliance (HIPAA, CMS, etc.). **Key Responsibilities:** + Analyze, test, and validate healthcare EDI transactions, including: + **837 ( Claims )** + **835… more
- Evolent (Austin, TX)
- …analyses into succinct presentations. + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based ... RVUs, bundled payments, etc. is preferred + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Cognizant (Austin, TX)
- …claim processing is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist, you will be responsible for timely and accurate ... adjudication of professional and hospital claims utilizing payer specific policies and procedures. Provide support...* Good skills at problem resolution specifically related to healthcare claim adjudication. * Possess ability to work at… more