- Kyndryl (Austin, TX)
- …Contact Center operations for enterprise organizations, particularly those in the Healthcare or State or Local Government and / or Educational (SLED) spaces. ... innovative solutions that enhance customer journeys, improving customer technology operations , and integrate cutting-edge capabilities such as Agentic AI. The… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …Information Management (HIM) Director to lead the organizational and administrative operations of our Medical Records Department. This individual will be responsible ... and accreditation standards. + Monitor and update policies to align with evolving regulations. Claims & Revenue Cycle Support + Review claims data to ensure… more
- NTT DATA North America (Plano, TX)
- …Denials * Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process * Knowledge of healthcare insurance policy concepts including ... now. We are currently seeking a HC and Insurance Operations Associate to join our team in Plano, Texas...Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and… more
- Molina Healthcare (Houston, TX)
- …DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and ... provider training and education, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and...3 - 5 years customer service, provider service, or claims experience in a managed care setting. + 3-5… more
- Molina Healthcare (Fort Worth, TX)
- …DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and ... provider training and education, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and...2 - 3 years customer service, provider service, or claims experience in a managed care setting. + Working… more
- The Cigna Group (Houston, TX)
- …of communication with matrix partners including but not limited to, Claims Operations , Medical Management. Credentialing, Legal, Medical Economics, Compliance, ... or complex provider contracts and alternate contract terms. + Creates healthcare provider agreements that meet internal operational standards and external provider… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …and every day. **Position Overview:** The Director of Field Strategy and Operations serves as the orchestrator of field strategy, ensuring that prioritization, ... federal laws, regulations and guidelines including PhRMA Code on Interactions with Healthcare Professionals as well as complying with all OAPI standards and policies… more
- Molina Healthcare (San Antonio, TX)
- …The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee, and recommend business practices to ensure ... Analyst develops and performs audits and oversight functions involving business-critical operations and vendor outsourcing arrangements for the company. The Sr.… more
- Texas Health Resources (Arlington, TX)
- **Program Director, Compliance Operations and Project Management - Hybrid** This role is hybrid, remote and in office at Texas Health Resources Corporate Offices at ... noncompliance such as billing, coding, Stark laws, fraud & abuse laws, false claims , or other identified risk areas. Participate in workgroups and other forums… more
- TEKsystems (San Antonio, TX)
- …team dedicated to ensuring patients receive timely and appropriate therapy. As a Healthcare Intake Specialist, you will play a critical role in qualifying orders for ... authorization, verification, or medical billing OR a bachelor's degree in healthcare . + Strong interpersonal and communication skills. + Proficiency in Excel… more