- Cognizant (Austin, TX)
- …work collaboratively across business and technical stakeholders to ensure accurate claims processing and benefit configuration aligned with organizational goals. ... **Facets Benefits and Claims Configuration Lead ** **Location: Remote** **Job ID: 00065904022** **About the role** As a Facets Benefits and Claims … more
- Molina Healthcare (San Antonio, TX)
- …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... **Job Description** **Job Summary** Provides lead level support as a highly capable business...operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to… more
- Highmark Health (Austin, TX)
- …progressions, and treatment efficacy? Highmark Health is seeking a groundbreaking Lead Data Scientist, Research & Development, specializing in Graph Intelligence, ... insights in healthcare. This is a premier R&D position where you will lead the charge in inventing and proving out transformative graph-native analytical solutions.… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- The Area Business Lead , LTC will collaborate with cross-functional partners to develop and execute a comprehensive business plan tailored to the Long-Term Care ... LTC facilities, including operational demands, patient outcomes, and compliance objectives. + Lead a team of Neuroscience LTC Specialists within an ecosystem to… more
- CVS Health (Irving, TX)
- …applications is required. Desired proficiencies and experience include: All Payer Claims Database (APCD) experience, Audit Command Language (ACL), or SQL; knowledge ... of claim processing , claim quality audit program, patient management, and/or a...+ Support regulatory data requests related to All Payer Claims Databases (APCD) + Continuous monitoring of key day… more
- EPAM Systems (Austin, TX)
- …into E2E testing strategies + Develop and communicate test strategies covering pharmacy claims processing , NCPDP transactions, and benefit designs + Design test ... Lead the planning, strategy, and coordination of end-to-end...large, complex, cross-functional teams + Extensive knowledge of pharmacy claims adjudication, NCPDP protocols, formulary management, and benefit design… more
- Guardian Life (Austin, TX)
- ** Lead AI Innovation Lead - Data Science Lab** **Overview** Guardian is on a transformation journey to evolve into a modern, forward-thinking insurance company ... of pioneering research into practical, enterprise-wide solutions. In this role as Managing Lead Data Scientist for the DSL, you'll be entrusted with the crucial task… more
- Mass Markets (Killeen, TX)
- …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... the overall adherence to corporate policies and procedures Key Responsibilities: + Lead and manage a team of 15-25 front-line agents handling inbound customer… more
- Elevance Health (Houston, TX)
- …is granted as required by law._ The **Patient Enrollment Specialist Team Lead ** is responsible for providing technical direction, guidance, and resources to ... claims , customer service, or membership associates on a day-to-day...years of experience and expertise with company relevant automated processing systems; or any combination of education and experience… more
- Walmart (Austin, TX)
- …types programs and benefits to current and prospective members processing memberships upgrades and credit accounts encouraging membership renewals participating ... up orders are filled Oversees assigned area of responsibility by handling claims and returns zoning the area arranging and organizing merchandise identifying shrink… more