- Evolent (Austin, TX)
- …audiences. + Synthesize complex analyses into succinct presentations. + Lead customer interactions fostering trust, expertise and cooperation. + Extract, ... manage, and analyze claims and operational data using industry-standard metrics. + Process...using industry-standard metrics. + Process and validate raw unadjudicated claims data. **Qualifications Required and Preferred:** + Bachelor's degree,… more
- CVS Health (Austin, TX)
- …who is skilled at identifying outliers through data extraction and analysis. The lead reviewer is accountable for the validation of existing Fraud Waste and Abuse ... to fraud, waste, and abuse when reviewing a new lead or referral. -Keep current with new and emerging...of data interpretation and analysis experience. -Experience with internal claims data and healthcare coding. -Must be able to… more
- Highmark Health (Austin, TX)
- …5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project leadership ... and non-technical, and internal and external audiences, and the ability to lead through influence + Healthcare industry expertise and experience, knowledge about the… more
- Molina Healthcare (Dallas, TX)
- …Prepare and design test plans and test cases with the help of testing lead for both new and existing features (regression testing). + Vendor Management: Provides ... + SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting… more
- OneMain Financial (Fort Worth, TX)
- …structure, role definition and system enhancements. + Process State Disability Claims as necessary. + Participates/drives special projects or assignments as needed. ... employee relations role. + HS Diploma or GED Equivalent + Previous management or lead experience a plus. + Deep understanding and application of federal and state… more
- Omnicell (Fort Worth, TX)
- **Reconciliation Lead ** The Lead Reconciliation Analyst leads the team that provides reconciliation services to FDS Amplicare customers and oversees the ... documentation. . Communicate any issues that may arise, including claims disputes. . Oversee development and communication of customer...improve. + In **Doing the Right Thing** , we lead by example in ALL we do. We are… more
- Omnicell (Fort Worth, TX)
- …4220 North Fwy, Fort Worth, TX 76137 **Day in the Life:** As a Lead Reconciliation Analyst , you'll serve as the primary liaison for independent pharmacies. ... resume will be reviewed and considered for upcoming opportunities._ **Reconciliation Analyst ** **What You Can Expect:** Career growth: Opportunity is limitless at… more
- Kemper (Dallas, TX)
- …drive business value. **Qualifications:** * 5+ years in data-centric roles ( analyst , developer, architect, consultant). * Experience functioning as or closely ... understanding of data and business architecture, with P&C Insurance and Claims experience preferred. * Excellent communication skills across disciplines and… more
- Acosta Group (Lewisville, TX)
- …high-severity Workers' Compensation and liability claims . Supervise the Sr. Risk Claims Analyst and ensure alignment with best practices. + Vendor and ... Maintain accurate records of risk-related expenses and exposures.Training & Communication: + Lead training initiatives for business units on claims reporting,… more
- Molina Healthcare (Dallas, TX)
- …of the role. + Validate findings and test assumptions through data, but lead with contextual knowledge of claims processing, provider contracts, and operational ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more