• Payment Integrity Subrogation Manager…

    Molina Healthcare (TX)
    …in Medicaid, Medicare, and Marketplace lines of business. + Familiarity with QNXT claims processing platform. + Knowledge of legal procedures related to complex ... across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice,… more
    Molina Healthcare (07/23/25)
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  • Senior Analyst, Medical Economics - REMOTE

    Molina Healthcare (Fort Worth, TX)
    …of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
    Molina Healthcare (07/10/25)
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  • Remote Accountant

    Mass Markets (TX)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... MCI Federal Services (MFS), OnBrand24, The Sydney Call Center, Valor Intelligent Processing (VIP), BYC Aqua, EastWest BPO, TeleTechnology, and Vinculum. The purpose… more
    Mass Markets (07/10/25)
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  • Remote Insurance Customer Service…

    Mass Markets (TX)
    …736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing , Collections, Customer Experience Provider (CXP), Customer ... MCI Federal Services (MFS), OnBrand24, The Sydney Call Center, Valor Intelligent Processing (VIP), BYC Aqua, EastWest BPO, TeleTechnology, and Vinculum. The purpose… more
    Mass Markets (07/08/25)
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  • Japanese Customer Service Senior Representative…

    The Cigna Group (Austin, TX)
    …+ Receive requests by email or telephone regarding insurance claims /policies while operating on multiple computer applications. Respond to inquiries ... route claim forms and supporting documentation to various units for final processing + Independently respond to inquiries, grievances, complaints or appeals ranging… more
    The Cigna Group (08/08/25)
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  • Director, Enrollment (Duals) - REMOTE

    Molina Healthcare (San Antonio, TX)
    **Job Description** **Job Summary** Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's ... rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database.… more
    Molina Healthcare (08/08/25)
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  • Senior Analyst, Risk Adjustment - Predictive…

    Molina Healthcare (San Antonio, TX)
    …**Required Experience** + 3-5 Years of experience with healthcare-related data ( claims /encounters, provider, CMS/EDGE response files, etc. + 3-5 Years of experience ... of programming experience in python to support automated data validation / processing at scale (functions and objects) **PHYSICAL DEMANDS** Working environment is… more
    Molina Healthcare (08/03/25)
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  • Manager, Enrollment - REMOTE

    Molina Healthcare (Austin, TX)
    **Job Description** **Job Summary** Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's ... rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database.… more
    Molina Healthcare (08/01/25)
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  • Employee Services Representative II…

    Ryder System (Austin, TX)
    …to areas such as: I-9 compliance, Pre-employment services, Unemployment Insurance claims , Immigration Services, Leave Administration, Drug and Alcohol program, HR ... etc.) required + Two (2) years or more relevant work experience (ie processing mass data uploads, payroll, organizational changes, etc.) required + Proficient in… more
    Ryder System (07/24/25)
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  • Medical Audit Field Auditor

    WTW (Dallas, TX)
    … administration, as well as of vendors' processes and operating environment + Claims processing knowledge/exposure to one or more administrator claim systems ... As a Field Auditor, you will apply your medical claims audit, project management and claim processing ...work in a "hybrid" style, with a mix of remote , in-person and in-office interactions dependent on the needs… more
    WTW (08/08/25)
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