- Molina Healthcare (TX)
- …Senior Analyst, Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key business issues related to cost, ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management, Network, and other departments to enable critical… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of ... you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims...* Experience in performing inpatient coding reviews/ audits in health insurance and/or hospital settings * Working knowledge of… more
- Sedgwick (Irving, TX)
- …a professional career? Bring your 2+ years' experience in a office setting or medical experience and grow with us! + A stable and consistent work environment in ... physical, financial and professional needs. **PRIMARY PURPOSE OF THE ROLE:** To process claims and determine benefits due pursuant to a disability plan; to make… more
- Elevance Health (Houston, TX)
- …for fraud and abuse prevention and control. + Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to ... abuse. **How you will make an Impact:** + Examines claims for compliance with relevant billing and processing guidelines...to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- **Job Summary** Otsuka is looking for a strong Clinical Statistician in the Medical and Real World Data Analytics organization to provide statistical expertise for ... evidence generation towards design new trials, assessing economic value, supporting health technology assessments through statistical analyses of clinical and other… more
- Sedgwick (San Antonio, TX)
- …- Hybrid **PRIMARY PURPOSE** : To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims ... involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service… more
- Sedgwick (Austin, TX)
- …promotional growth opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401K on day one. **PRIMARY PURPOSE** **:** To ... and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible for ... certain assets within the broader CNS TA portfolio Medical Affairs (both US and Global), with a specialization...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- **Job Summary** The Senior Manager, Medical Writing (MW) will be responsible for leading and advising on medical writing processes and activities for individual ... of operational plans, budgets, and innovative solutions for all medical writing activities across OPDC. He/she will also lead...you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to… more
- Molina Healthcare (Dallas, TX)
- … environment, or equivalent combination of relevant education and experience. * Health claims processing experience, including coordination of benefits (COB), ... care organization (Medicaid, Medicare, Marketplace and/or other government-sponsored program), or medical office/hospital setting. * Completion of a health care… more