- Molina Healthcare (San Antonio, TX)
- …software and medical record vendors, and other Molina departments, such as Claims , Enrollment, IT etc,. to get appropriate responses and manage contracts and ... + Maximizes use of information from multiple sources, including claims /encounters, pharmacy, utilization management, clinical indicators, industry benchmark, and/or… more
- Molina Healthcare (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
- UNUM (Austin, TX)
- …Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The ... and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to… more
- Molina Healthcare (TX)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL ... 2005/2008 SSRS and Power BI report development + Familiar with relational database concepts, and SDLC concepts **Preferred Education** + Masters' Degree in Finance, Economics, Math, Computer Science, Information Systems, or related field. + Preferred… more
- VetsEZ (TX)
- …or related degree. + 7+ years Pega PRPC v7.x+ experience (including Smart Claims & Healthcare Foundation). + 3+ years Java development experience. + Certified Senior ... System Architect CSSA certification required; Lead System Architect LSA preferred. + Strong knowledge of Pega architecture and PRPC implementation, including Direct Capture of Objectives DCO, enterprise Class Structure, Ruleset design and REST/SOAP… more
- Option Care Health (Austin, TX)
- …and revenue cycle teams in order to insure success of clean claims payment. Manage external implementations and foster ongoing relationships with assigned accounts ... Manage communication with assigned accounts as it relates to demographic changes to Option Care Facilities to insure health plan agreements are current in order to facilitate clean claim billing. Initiate and lead meetings with health plans and corporate… more
- Molina Healthcare (Dallas, TX)
- …+ SQL expertise + Excel expertise + Medicare, Medicaid, Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting ... and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made… more
- Carrington (Plano, TX)
- …title records, organizing documents, creating chronologies, preparing and submitting title claims , monitoring for response from insurers and working with carrier ... retained counsel. + Ensure compliance with outside counsel guidelines and oversee adherence to loan servicing agreements and delegated authority matrixes. + Create, maintain, and deliver weekly, monthly and quarterly matter related reports. + Resolve routine… more
- Molina Healthcare (Fort Worth, TX)
- …activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors + Maintains professional and technical ... knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies + Contributes to team effort by accomplishing related results as needed + Other duties as assigned + 2… more
- AUI Partners (TX)
- …in daily time and quantities reporting * Assist with resolving potential claims with subcontractors/suppliers * Assist and prepare pending change orders * Interprets ... designs and drawings; prepares takeoffs; researches and recommends resolutions to drawing interpretation problems, RFI's, conflicts and errors * Coordinate and oversee completion of As-Built Drawings * Assist in reviewing and approving Material Invoices &… more