- Molina Healthcare (TX)
- …to all levels of leadership based on business requirements + Supports system integrity for Workforce Management software, Performance Manager and Cisco tools by ... communicating any known issues. **JOB QUALIFICATIONS** **Required Education** Associate degree or equivalent combination of education and experience **Required Experience** Requires at least 3-5 years relevant experience with Workforce Management methodologies… more
- Molina Healthcare (Fort Worth, TX)
- …and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program ... management. **Job Duties** + Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.… more
- The Cigna Group (Austin, TX)
- …through every stage of life. We guide our customers through the health care system , empowering them with the information and insight they need to make the best ... choices for improving their health and vitality. Join us in driving growth and improving lives. _Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions… more
- Molina Healthcare (San Antonio, TX)
- …Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received ... via claims, call tracking, or e-mail. Maintain records in the enrollment database. **Knowledge/Skills/Abilities** + Holds general oversight of enrollment and premium staff at each plan site within defined region. This may include employee reviews, coaching… more
- Sharecare (Austin, TX)
- …from standard screens, scripts and procedures. CSRs use a computerized system for tracking calls, information gathering, and/or troubleshooting and may assess ... needs, explain programs and suggest/promote alternative products or services. **Start date:** September 22, 2025 (new hires must be able to start on this day) **Training:** Two weeks from 8am - 4:30pm CT. New hires are unable to miss any days of training (9/22… more
- Cognizant (Austin, TX)
- …collaborate with stakeholders and other teams. **Primary Responsibilities** : + Review claim system data and verify against UB or HCFA paper or EDI information. + ... Evaluate medical records to determine if the service rendered was medically appropriate and criteria compliance. + Analyze claim and line-item edits, including warning messages, to determine payment eligibility. + Manage all tasks within designated timeline to… more
- CRC Insurance Services, Inc. (TX)
- …subjectivities and review information accordingly. 3. Maintain pending/suspense system per established procedures. 4. Evaluate policies, endorsements, audits, ... cancellations, etc., resolve any discrepancies and make changes as needed. 5. Produce cancellation and non-renewal notices according to statutory and contractual requirements. 6. Review and process policy servicing requests (endorsement, audits, Company… more
- Sysco (Houston, TX)
- …customer retention, penetration, and profitability. + Support the design of CRM system to enable defined sales processes; create training materials on sales ... processes and CRM enhancements for use by the National Sales and field contract sales organization + Engage National and Field Contract Sales colleagues to gain feedback, pressure test new enhancements and ensure adoption of processes and tools + Support… more
- Molina Healthcare (TX)
- …The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is ... required, and a background in payment integrity-either at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct secondary pricing logic and compliance with configuration and regulatory rules. +… more
- Molina Healthcare (Fort Worth, TX)
- …strategies to corporate provider network leadership for input. * Utilize standardized system (s) to track contract negotiation activity on an ongoing basis throughout ... the year. * Participates on the management team and other committees addressing the strategic goals of the department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates. Works with Legal and… more