- Molina Healthcare (San Antonio, TX)
- …leadership and direction to MMS Operational Units management staff (eg, Claims Processing, Provider Services, Provider Enrollment, Finance, Managed Care Provider ... equivalent experience **Required Experience** 3 years supervision/management experience in Claims Processing or Provider Services environment and/or any high volume… more
- Molina Healthcare (TX)
- **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace ... across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice,… more
- Molina Healthcare (Austin, TX)
- …organized and analytical thinking. Experience with Medicare/Medicaid, MS 365 and familiarity with claims is highly preferred. The Case Manager must be able to ... encouraged to apply. Further details to be discussed during our interview process. Remote with 10% travel to member's home or facility Work schedule Monday through… more
- Molina Healthcare (Houston, TX)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims , Provider Services and Contracting. * Identifies issues, resolves problems… more
- Molina Healthcare (Austin, TX)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... **Knowledge/Skills/Abilities** + Has direct oversight of enrollment, premium billing and reconciliation processes and all related staff + Coaches and mentors direct staff, including goal setting and score card development + Monitors and enforces compliance… more
- Molina Healthcare (TX)
- …Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of Coordination ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Prime Therapeutics (Austin, TX)
- …make. **Job Posting Title** Sr. Functional Bus Consultant (Compliance) - Remote **Job Description** The Senior Functional Business Consultant The Functional Business ... Consultant serves as a project manager **,** business system or business process subject matter...least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) +… more
- Guidehouse (San Antonio, TX)
- …Family** **:** General Coding **Travel Required** **:** None **Clearance Required** **:** None ** REMOTE REMOTE REMOTE !** **Join Our Growing Medical Coding ... Team! All roles are 100% REMOTE .** As an organization experiencing exponential growth, we are...certified. At Guidehouse, coding is more than charts and claims - it's about making an impact. As a… more
- GuideOne Insurance (Dallas, TX)
- …Business Collaboration: + Act as a trusted technology partner to Underwriting, Claims , Finance, and other business functions. + Translate business needs into ... Leadership and Talent Development: + Build and mentor a high-performing, manager -of-managers organization. + Establish clear career paths, promote engineering best… more
- AUI Partners (TX)
- The primary role of the Project Engineer is to assist the Project Manager and Project Team with the planning and daily execution of the construction project. You ... in daily time and quantities reporting * Assist with resolving potential claims with subcontractors/suppliers * Assist and prepare pending change orders * Interprets… more