- CVS Health (Austin, TX)
- …standards. + Responsible for building contracts and amendments in contract management system in accordance with Aetna established guidelines, obtaining signatures, ... and ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or… more
- Travelers Insurance Company (Austin, TX)
- …Practices. Provide quality claim handling and superior customer service on assigned claims , while engaging in indemnity & expense management . Promptly manage ... reviewing appropriate records and damages documentation. + Utilize diary management system to ensure that all claims ...Provide mentoring or training as request by field severity management . + COMMUNICATION/INFLUENCE: + Consult with Manager … more
- Sedgwick (Irving, TX)
- …office or customer service experience required. One (1) year of benefits or claims management experience preferred. **Skills & Knowledge** + Knowledge of ERISA ... from some of the world's most reputable brands + An assigned mentor and manager who will guide you on your career journey + Career development and promotional… more
- WSP USA (Houston, TX)
- …Estimate to Completes (ETCs), and recovery plans, and invoices + Assist project manager with change management , such as documenting scope changes or scope ... initiating a search for an **Assistant Vice President, Program Management Support** for our **Tamuning, Guam** office. Be involved...additions. + Assist project manager in developing contract change orders. + Support subcontract… more
- Cognizant (Dallas, TX)
- …and Risk Management . The primary focus will be supporting traditional risk management functions such as claims management , insurance, renewal process, ... management projects._ **Insurance Risk Analyst:** 1.Assist corporate insurance manager with the efficient placement of corporate property and casualty insurance… more
- AECOM (Dallas, TX)
- …world. Join us. **Job Description** **Regional Business Line Leader (RBLL), Program Management (PgM), US West** Reporting to the Regional Chief Executive and PgM ... (GBL) Chief Executive, this role will serve as the leader of the Program Management business within the US West, collaborating with the regional leadership team, GBL… more
- Evolent (Austin, TX)
- …client contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager , Utilization ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...prior authorization requests and/or relevant health care experience in claims or appeal & grievances is required. + Ability… more
- Elevance Health (Houston, TX)
- …Coding Auditor Principal** is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case ... and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all...Validates accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and… more
- Elevance Health (Grand Prairie, TX)
- **Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... an accommodation is granted as required by law._ The **Utilization Management Representative II** is responsible for managing incoming calls, including triage,… more
- Public Consulting Group (Austin, TX)
- …through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist ... and medical record reviews that will include discussion with internal management to ensure understanding of results. **Summary of Functions** The Contract… more