- HCA Healthcare (Houston, TX)
- …as a Medical Insurance Claims Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team ... + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family...difference. We are looking for a dedicated Medical Insurance Claims Specialist like you to be a part of… more
- Providence (TX)
- … issues. + 7 years of relevant general and professional liability claims processing or management experience **Preferred qualifications for this position ... them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional,...include:** + Certified Professional Healthcare Risk Management (CPHRM) + 10+ years of medical… more
- Cognizant (Austin, TX)
- …duties as assigned by management. **Qualifications:** + A minimum of 2 years' claims processing experience is required. + Knowledge of physician practice and ... for payments, utilization review/quality assurance procedures. + Excellent problem-solving skill in healthcare claims adjudication. + Ability to work at a… more
- GuideOne Insurance (Houston, TX)
- … Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume their life's work without ... and cause of loss on routine to more complicated claims , which includes but is not limited to policy...Medical, dental and vision plans to meet your unique healthcare needs + Wellness incentives + Generous time off… more
- Prime Therapeutics (Austin, TX)
- …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare , and/or related field + Previous experience ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Austin, TX)
- …analysis to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare , and/or related field. + Previous experience ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Humana (Austin, TX)
- …payor operations, technology, communications, and processes + Solid understanding of healthcare operations, particularly around claims processing , ... make an impact** **Required Qualifications** + Bachelor's degree in healthcare administration, public health, information systems, business, policy administration or… more
- Molina Healthcare (TX)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... of Benefits (COB) claim pricing and processing . This role will focus on identifying, reviewing, and...guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen.… more
- Molina Healthcare (TX)
- …and test assumptions through data, but lead with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement… more
- Molina Healthcare (Fort Worth, TX)
- …concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system ... + Min. 2 years operational managed care experience (call center, appeals or claims environment). + Health claims processing background, including… more