- Molina Healthcare (San Antonio, TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Molina Healthcare (San Antonio, TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... application of business rules as they apply to each database. Validate and audit data to be housed on databases and ensure adherence to business and system… more
- Molina Healthcare (Dallas, TX)
- …all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims ... systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and… more
- Molina Healthcare (San Antonio, TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...as a QNXT SME. + Networx / Pricer and claims experience is highly preferred. + SQL is highly… more
- Molina Healthcare (Dallas, TX)
- …**R** **I** **E** **N** **C** **E:** + 1-3 years of experience in Healthcare (payer experience), Vendor Management, Data Analytics, Contract Terms and ... **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of...analyze business and vendor performance problems and issues using data from internal and external sources to provide solutions… more
- Molina Healthcare (Houston, TX)
- …all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims ... business rules as they apply to each database. Validate data to be housed on provider databases and ensure...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Baylor Scott & White Health (Austin, TX)
- …working with ACA and Medical Claims , MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with Healthcare claims , enrollment and pharmacy data ... + Performs analysis and reporting activities related to risk score calculation, claims /encounters data submission, chart review programs and audits, and related… more
- UTMB Health (Galveston, TX)
- Revenue Cycle Analyst - RCO Analytics **Galveston, Texas, United States** Business, Managerial & Finance UTMB Health Requisition # 2505275 **EDUCATION & EXPERIENCE** ... or related field. * 3 years progressive experience in healthcare related field with focus on Revenue Cycle. **Preferred...experience with successful outcomes **JOB SUMMARY** The Revenue Cycle Analyst serves as a valued team member that analyzes… more
- Evolent (Austin, TX)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data . **Qualifications Required and Preferred:** + Bachelor's degree, ... Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** QA Analyst PBM Implementation - Remote **Job Description** The Quality Assurance (QA) Analyst ... work experience; HS diploma or GED is required + 2 years of experience within Claims Processing, Audit, Quality or Pharmacy + Must be eligible to work in the United… more