- Molina Healthcare (TX)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for… more
- Molina Healthcare (Houston, TX)
- …for medical record collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory processes, and ... Experience** + 0-2 years of experience in data analytics, business intelligence, or healthcare operations + Foundational...Python or another programming language + Basic familiarity with healthcare data types such as claims , encounters,… more
- Molina Healthcare (Dallas, TX)
- **Job Description** **Job Summary** Assist business teams with developing requirements for major projects of considerable complexity, prepares system design ... debug/analyze problems. + Fields direct questions from Molina Operations Staff regarding business , technical and operations rules. + Develops technical solutions to … more
- Molina Healthcare (Dallas, TX)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect … more
- Centene Corporation (Austin, TX)
- …and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to ... outcomes. + Interpret and analyze data from multiple sources including healthcare provider, member/patient, and third-party data + Support execution of large-scale… more
- Elevance Health (Grand Prairie, TX)
- …are strongly preferred. + Knowledge of SAS. + Knowledge of systems capabilities and Healthcare business operations. + ASC X12 837 EDI experience. + Intermediate ... ** Business Information Analyst Senior - Medicaid...Analyst Senior** is responsible for analyzing and validating healthcare encounter data submissions to CMS (Centers for Medicare… more
- Molina Healthcare (Houston, TX)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Highmark Health (Austin, TX)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… 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 analysts, and EDI teams to ensure that claims data meets internal standards and regulatory compliance (HIPAA, CMS, etc.). **Key Responsibilities:** +… more
- NTT America, Inc. (Houston, TX)
- …this role include:** + Candidates must have Over all 5+ years' experience in US healthcare Claims Payer. + 6 + year(s) experience in Configuring client System ... Contract) as per the requirement and according to defined business rules of new claims processing platform....(UAT) and implement the modifications as suggested by the business owners and/or analyst + Creating manual… more