- Houston Methodist (Houston, TX)
- …with Clinical Research Billing Compliance. + Provides oversight and performs detailed claims analysis and medical record review as necessary, including the ... clinical trial protocols, study budgets, coverage analyses, etc. - Performs detailed claims testing and medical review. - Reviews Medicare Coverage Analysis… more
- Mass Markets (TX)
- …+ Maintain compliance with internal policies, accounting standards (GAAP/IFRS), and audit requirements. + Monitor and improve accounting processes and systems to ... and external audits by preparing required documentation and responding to audit inquiries. + Collaborate with FP&A, operations, and other cross-functional teams… more
- Texas A&M University System (Bryan, TX)
- …recommendations to leadership based on the collected and analyzed data, including claims history of medical malpractice policies, workers' compensation, and ... spreadsheet, and database applications. + Knowledge of accounting methods and audit standards. + Preferred Qualifications: + Advanced degree in applicable fields… more
- New Jersey Resources (Houston, TX)
- …changes to address deficiencies, improve programs and ensure company maintains an audit -ready status at all times. * Develop and maintain excellent working ... and subsequent response analysis reviews. * Assist in managing Workers' Compensation Claims , Return to Work programs, accident reports, claims and lead… more
- Humana (Austin, TX)
- …Compliance team that supports the PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This ... action plans, as needed. You will participate in all phases of the audit process including evaluating control design and adequacy, testing to ensure adherence with… more
- Citizens (Irving, TX)
- …and remediate deficiencies that are noted + Respond to internal and external audit findings by preparing formal responses and ensuring remediation of noted issues + ... and customer service + Strong collaboration skills across departments (eg, claims , legal, compliance) Communication & Customer Focus + Excellent written and… more
- The Cigna Group (Plano, TX)
- …and data informatics and data exchange using healthcare and clinical data such as Claims , Membership, Audit , Client Structure, and Benefits. If you will be ... using Tableau and Looker to create dashboards for campaigning and other internal audit reports; using Python to understand the ETL workflow; using ServiceNow to… more
- Ryder System (Frisco, TX)
- …and supporting documentation. + Track and follow up on open returns and claims ; escalate issues when appropriate. + Maintain detailed records of all return and ... OS&D activities for audit and reporting purposes. + Provide timely updates and...follow up effectively. + Experience with OS&D processes or claims management in a logistics setting. + Exposure to… more
- Walgreens (Beaumont, TX)
- …issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more
- Walgreens (Dallas, TX)
- …issues and prevent payment rejections. Follows- up with insurance companies as well as medical providers and participates in 3rd party audit . + Follows-up with ... privacy, generics, less expensive medicines, over-the-counter products, and refers to medical provider as needed to ensure medication is taken correctly, health… more