- Prime Therapeutics (Austin, TX)
- …functional areas within the corporation (can include Government Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations, Paper Claims , ... future of pharmacy with us. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory...primary point of contact for new internal and external business partners with regard to related regulatory activity and… more
- Evolent (Austin, TX)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- Highmark Health (Austin, TX)
- …experience within one or more Epic modules. **Preferred** + 2+ years of Healthcare Revenue Cycle experience ( Claims , Patient Access, Billing) + Epic ... supporting the Epic Resolute Hospital Billing application. Responsibilities include business /systems analysis, requirements definition and documentation, system design, and… more
- Capgemini (El Paso, TX)
- …and career. For eligible employees, we offer: + Flexible work + Healthcare including dental, vision, mental health, and well-being programs + Financial well-being ... Groups + Disaster Relief **About Capgemini** Capgemini is a global business and technology transformation partner, helping organizations to accelerate their dual… more
- Elevance Health (Grand Prairie, TX)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- Catholic Health Initiatives (Houston, TX)
- …requirements. Reports are produced for Revenue Cycle functions such claims submission, insurance follow‐up, cash management, credits/refunds, charge/payment posting, ... Indicator (KPI) dashboards, reimbursement and payer mix analyses and clinic/ business operational reports; 2) interpreting/explaining report findings to clinic… more
- CVS Health (Austin, TX)
- …**Required Qualifications** + 3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and ... for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing...to determine the impact of the scheme on Aetna business . + Keep current with new and emerging fraud,… more
- Molina Healthcare (Houston, TX)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
- CVS Health (Austin, TX)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
- CVS Health (Austin, TX)
- …**Position Summary** The Senior Manager Analytic Consultant is an experienced customer-facing analyst who supports the Account Team's ability to craft a compelling ... and actionable information. This role is responsible for medical claims and economics reporting and analytics for a book...collaborate with field leaders, making certain to understand their business retention and growth objectives and how the work… more