- Evolent (Austin, TX)
- …- Payer side, Knowledge of Medicare, Medicaid, Commercial Plans and understanding on claims workflow, members, providers + A minimum of 1 years of experience in ... assurance and database testing, medical benefits, provider, enrollment, and / or claims data. + Demonstrable experience with Testing, Writing Test cases, Test Plans,… more
- Highmark Health (Austin, TX)
- …leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims , and clinical data to uncover hidden patterns, propagate insights ... to prototype. + **Healthcare Data Familiarity:** Understanding of healthcare data domains ( claims , clinical, EMR) and related ontologies or standards (eg, SNOMED CT,… more
- Centene Corporation (Austin, TX)
- …tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity ... with claims payment, utilization management, provider/vendor contracts, risk adjustment for...offers a comprehensive benefits package including: competitive pay, health insurance , 401K and stock purchase plans, tuition reimbursement, paid… more
- Marathon Petroleum Corporation (San Antonio, TX)
- …and approves complex freight, lightering, time charter hire invoices and post fixture claims for chartered vessels per the charter party contract. * Maintains close ... and spot-chartered vessels.* Reconciles and negotiates complex off hire/underperformance claims for company-chartered vessels.* Completes accurate review and payment… more
- Evolent (Austin, TX)
- …accounts + Strong knowledge of health plan operations, care/utilization management, claims processing, value-based care, and the levers to optimize financial ... be leveraged to identify opportunities and actions (including EMR, clinical, authorization, claims , SDoH, etc.); understanding of how to translate data and insights… more
- TAD PGS, Inc. (Plano, TX)
- …navigating sensitive or complex leave scenarios. + Analyze FMLA, STD and WC claims to determine eligibility and certification in compliance with State and Federal ... FMLA, ADA, personal leave, and company-specific time-off policies. Analyzing FMLA claims to determine eligibility and certification in compliance with state and… more
- Elevance Health (Grand Prairie, TX)
- …requirements. + Develop and analyze business performance reports (eg, for claims data, provider data, utilization data) and provides notations of performance ... Microsoft Excel experience. + Facets systems knowledge considered a plus. + Claims and/or Encounters experience preferred. + Experience with Medicaid data preferred.… more
- UIC Government Services and the Bowhead Family of Companies (Plano, TX)
- …and other protected characteristics EOE/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq., and federal contractual ... based on the provisions contained within The Alaska Native Claims Settlement Act. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. All… more
- Evolent (Austin, TX)
- …You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, and population ... with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including prior authorization data… more
- Kelly Services (Irving, TX)
- …reports. + Assists the facility in various tasks, ie handling dealer claims , dealer order tracking/support, dealer return program, budget tracking, dealer contacts. ... + Processes inbound and outbound carrier damage claims . **Job Qualifications:** + Excellent computer skills (Microsoft Office, Excel a major plus) coupled with a… more