• Clinical Risk Manager - Heart Hospital Region

    Baylor Scott & White Health (Plano, TX)
    …other); d) the 'lessons learned' from studying the event. + Assists the Manager of Insurance in managing claims related to property loss and visitor injury. + ... patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM...incidents. Works to resolve issues before they become liability claims . + Receives information from team members who manage… more
    Baylor Scott & White Health (08/28/25)
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  • Associate Director, Small Molecule Analytical…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match, ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
    Otsuka America Pharmaceutical Inc. (08/27/25)
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  • Manager, Medical Economics (Medicaid) - REMOTE

    Molina Healthcare (Austin, TX)
    …executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical decision… more
    Molina Healthcare (08/27/25)
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  • Clinical Provider Auditor II

    Elevance Health (Houston, TX)
    …with fraud and abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities ... fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately… more
    Elevance Health (08/26/25)
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  • Senior Director, ADHD Brand Lead

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match, ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
    Otsuka America Pharmaceutical Inc. (08/26/25)
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  • Program Manager Senior

    USAA (San Antonio, TX)
    …documentation may result in disqualification.** + Experience leading $1B+ Claims transformation programs. + Demonstrated experience managing programs with ... to translate business needs into technical specifications. + Recent experience supporting Claims in a Program Management role. + PMP, Agile and Change Management… more
    USAA (08/22/25)
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  • Instructional Developer Senior

    USAA (Plano, TX)
    …for consultation on and programming of instructions and alerts within the Claims Center (Guidewire) and Training Environments. These alerts will be programmed within ... **What sets you apart:** + 2 years of experience adjusting or managing Claims within Guidewire. + 2 years of experience programming within digital adoption tools… more
    USAA (08/22/25)
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  • Senior Manager, Global Regulatory Affairs

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …basic life, accidental death & dismemberment, short-term and long-term disability insurance , tuition reimbursement, student loan assistance, a generous 401(k) match, ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
    Otsuka America Pharmaceutical Inc. (08/22/25)
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  • Sr IT Systems Analyst Specialist

    Sedgwick (Houston, TX)
    …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr IT Systems Analyst Specialist **PRIMARY PURPOSE OF THE ROLE** : To lead ... combination of education and experience required. Experience in multi-line claims management processes and system requirements strongly preferred. **WORK… more
    Sedgwick (08/21/25)
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  • Provider Reimbursement Adm-Certified Professional…

    Elevance Health (Grand Prairie, TX)
    …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... research and responds to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues and to audit … more
    Elevance Health (08/20/25)
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