- Prime Therapeutics (Austin, TX)
- …Thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly analytical + Self learns new processes/software ... experience in at least one of the specific areas for position (eg, claims , eligibility, product, benefits, implementations or related area) + Must be eligible to… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …and Risks will be reported periodically to Senior Management through the Management Review process to ensure alignment with Company policy and strategy and gain a ... develops systems for Clinical vendor management and vendor oversight. + **Management Review :** Establish and maintain a system to ensure R&D Management Reviews are… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …to ensure compliance with federal/state laws and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes ... billing, coding, and reimbursement processes. + Reviews, assesses and analyzes medical records, coding, billing, claims , reimbursements and workflow processes… more
- Elevance Health (Grand Prairie, TX)
- …law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently ... Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Senior** is responsible for the independent… more
- Adecco US, Inc. (Austin, TX)
- …is responsible for providing clerical support to clinical staff for their medical necessity review process. . Correspondence UM Coordinator is expected ... provider calls as needed. . Coordinates UM processes with Medical Directors, UM Nurses, hospitals, physicians and other various.... Reviews denials and determines whether the decisions are retro/ claims DOS or prospective DOS, and whether they are… more
- Meta (Temple, TX)
- …to support General Contractor (GC) and Trade Partner (TP) Baseline schedule review and approval, monthly schedule deliverables, commercial accountability, End to End ... and project CW scheduler mentoring. Area Schedule Lead will review and approve all Extension of Time (EOT) requests...for Delay Tracking, Extension of Time (EOT) requests and claims . Coordinate the change evaluation in collaboration with the… more
- Elevance Health (Houston, TX)
- …SPECIALIST III** is responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to ... **How you will make an impact:** + Audits paid claims for overpayments using various techniques including systems-based queries,...and all other cash applications as required. + May review and monitor associates work for quality standards. +… more
- AECOM (Dallas, TX)
- …ensure design projects stay on schedule and on budget. + Oversee the design review process to verify comments are tracked, responded to and closed out expeditiously ... and minimize client exposure. + Proactively work to avoid claims and resolve claims expeditiously to minimize...accomplishments, issues and current status of the project. + Review and concur in the proposed settlement of change… more
- AECOM (Dallas, TX)
- …with an eye on constructability, staging, phasing and construction methods + Review project baseline schedules for accuracy and compliance with Contract Documents + ... are in line with DFW goals and objectives + Review and verify progress payments of construction contractors +...to minimize client exposure + Proactively work to avoid claims and resolve claims expeditiously to minimize… more
- DriveTime (Fort Worth, TX)
- …and identify negative trends within the network. In long, you will: + Review , audit, and submit invoices for payments associated with repossession charges owed to ... and resolve any vendor invoice escalations + Handle customer complaint claims due to repossession activity through customer calls, research and communication… more