- Elevance Health (Houston, TX)
- …principles, clinical guidelines and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, clinical guidelines, ... and industry knowledge to substantiate conclusions. + Utilizes audit tools and auditing workflow systems and reference information...years of experience in claims auditing, quality assurance, or recovery auditing. + Requires at least one of the… more
- Highmark Health (Austin, TX)
- …agencies, Credentialing or Medical Review Committee. + Engages in delivery of audit results and overpayment negotiations.Responsible for recovery / savings of ... waste and abuse case, conducting the initial investigations and coordinating the recovery /savings of money related to fraud, waste and abuse. The incumbent must… more
- Citigroup (Irving, TX)
- …for optimal performance. + Develop and maintain contingency plans for database recovery and business continuity. + Participate in annual disaster recovery ... maintain database security measures, including FID/Policy access management. + Support audit and compliance requirements related to data security and access control.… more
- DriveTime (Fort Worth, TX)
- …as a Vendor Support Specialist, you will be involved in assisting recovery vendors with questions, invoicing, and feedback regarding contracted expectations. In ... within the network. In long, you will: + Review, audit , and submit invoices for payments associated with repossession...invoices for payments associated with repossession charges owed to recovery vendors as well as research and resolve any… more
- Molina Healthcare (TX)
- …COB and TPL processing logic. + Assist in developing and refining internal SOPs and audit tools related to COB claim reviews. + Act as subject matter expert for ... + Assists manager in establishing standards, guidelines, and best practices for the audit team + Interprets and validates accuracy of complex reports and automated… more
- Deloitte (Austin, TX)
- …and maintain documentation to meet ISO 22301 requirements. + Lead internal audit and gap assessments against ISO 22301 standards. + Business Continuity Exercises ... and drive continuous improvement. + Train business areas in response and recovery procedures. + Business Impact Analysis (BIA) + Lead and facilitate enterprise-wide… more
- Molina Healthcare (Houston, TX)
- …for supporting the prevention, detection, investigation, reporting, and when appropriate, recovery of money related to health care fraud, waste, and abuse. ... order to maintain coding accuracy and excellence. The position also entails producing audit reports for internal and external review. The position may also work with… more
- HP Inc. (Spring, TX)
- …interaction with senior executive management across HP's leadership team, internal audit function, external auditors, and finance and wider business teams across ... to financial controls as well as ITGC, ITAC. + Regularly report to the Audit Committee on risk and financial controls + Undertake second-line assurance testing of… more
- CVS Health (Austin, TX)
- …HP Nonstop software infrastructure to achieve peak performance and reliability. ** Audit and Compliance/Risk Management:** Develop and enforce security measures to ... remediation measures. Contribute to the formulation and maintenance of disaster recovery plans and business continuity strategies for the HP software infrastructure.… more
- CVS Health (Austin, TX)
- …Security & Compliance, Performance Monitoring, User Access Control, and Disaster Recovery planning and execution._ _This role requires expertise in the IBM ... SANs, VTLs, and other storage devices._ + _Participate in Disaster Recovery planning, testing, and_ _implementation._ + _Troubleshoot system issues, identify and… more