- TEKsystems (Dallas, TX)
- …deliver software. + Mentor and coach other team members in design, coding , and software engineering practices. + Understand the architectural direction and standards ... of $5,250 annually for eligible courses/programs Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Nov… more
- Humana (Austin, TX)
- …may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and ... teams or organizational committees. \#physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings… more
- Prime Therapeutics (Austin, TX)
- …we make. **Job Posting Title** Medication Therapy Management Technician - Remote **Job Description** Evaluates and authorizes approval of prior authorization ... formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.). + Proficiency in Pharmacy… more
- SitusAMC (Austin, TX)
- …scaling of APIs in the cloud. + **Programming & Automation:** 6+ years coding in Python, Shell, or equivalent scripting languages for automation. + **AWS Cloud ... domain-specific data + Understands Agentic RAG (Retrieval-Augmented Generation) architectures \#LI-AS1 #LI- Remote Note: This job description is not intended to be… more
- CVS Health (Austin, TX)
- …in analyzing monthly billing variances (20%) + Load new rates and specific coding relevant to the group plan and products sold. This set up information ... is critical for the import process from billing to accounts receivable/payable to ensure accurate and efficient revenue reporting and vendor payments (10%) + Process administrative claims to collect payment for monthly administrative invoices (5%) - Complete… more
- Molina Healthcare (Austin, TX)
- …risk adjustment models, quality metrics such as HEDIS and STARS, knowledge of coding + Knowledge of medical economics and financial reporting. Must be able to ... walk stakeholders (internal and external) through basic financial reconciliations. + Excellent leadership skills, especially ability to influence others who are not in a direct reporting line including ability to think strategically, develop vision, and… more
- Molina Healthcare (TX)
- …standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding /billing (UB04/1500 form) + Demonstrated understanding of key managed care concepts ... and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms. * Understanding of… more
- The Hartford (San Antonio, TX)
- …solutions. + Conduct code reviews and ensure adherence to best practices and coding standards. + Troubleshoot and resolve technical issues related to AWS services. + ... Implement security best practices to protect sensitive data. + Stay updated with the latest AWS technologies and industry trends. Qualifications: + Bachelor's degree in Computer Science, Information Technology, or a related field. + 8+ years of experience in… more
- Molina Healthcare (San Antonio, TX)
- …the financial impact to effectively negotiate new or amended contracts (eg coding and chargemaster impact analysis) * Strong written and verbal communication skills ... required to present analytical results and findings to healthplans' senior management team and key stakeholder meetings (PowerPoint) * Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ensure timely… more
- Molina Healthcare (Austin, TX)
- …the financial impact to effectively negotiate new or amended contracts (eg coding and chargemaster impact analysis) + Strong written and verbal communication skills ... required to present analytical results and findings to health plans' senior management team and key stakeholder meetings (PowerPoint) + Coordinates and provides peer review of our quarterly national contract performance analysis by team members to ensure… more