- Molina Healthcare (San Antonio, TX)
- …laws and regulations, which will protect the Business from liability and potential risk . Ensures that the Business understands and complies with applicable laws and ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- Position Information Posting NumberSRGV8219 Working TitleCOMPLIANCE CODING AND BILLING ANALYST Number of Vacancies1 LocationMcAllen, Texas DepartmentOffice of the ... reviews of billing and coding compliance functions and activities, compliance risk assessments, developing policies and procedures, and developing risk -based… more
- PNC (Dallas, TX)
- …activities to ensure they adhere to and support PNC's Enterprise Risk Management Framework. **Qualifications** Successful candidates must demonstrate appropriate ... have an opportunity to contribute to the company's success. As a Loan Support Analyst within PNC's Midland organization, you will be based in office within the PNC… more
- Molina Healthcare (Fort Worth, TX)
- …of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management , Network, and other departments to enable critical ... + Knowledge of healthcare operations (utilization management , disease management , HEDIS quality measures, claims processing, etc.) + Knowledge of… more
- Sedgwick (Houston, TX)
- …equivalent combination of education and experience required. Experience in multi-line claims management processes and system requirements strongly preferred. ... Workplaces in Financial Services & Insurance Sr IT Systems Analyst Specialist **PRIMARY PURPOSE OF THE ROLE** : To...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Evolent (Austin, TX)
- …Stay for the culture. **What You'll Be Doing:** Job Description ** Analyst , Integration Quality** Integration testing in the healthcare ecosystem requires complete ... testing is exercised to ensure source to target integrity. The IQ Analyst (IQA) performs analysis, reporting, and technical testing across multiple domains. Active… more
- Acosta Group (Lewisville, TX)
- …including high-severity Workers' Compensation and liability claims . Supervise the Sr. Risk Claims Analyst and ensure alignment with best practices. ... internal stakeholders, third-party administrators, brokers, and insurers to ensure effective claims management , litigation, risk financing, and compliance.… more
- CVS Health (Austin, TX)
- …to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to continuously innovate ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- Keurig Dr Pepper (TX)
- …return to work + Partners with claims adjusters, nurse case managers, EHS, Risk Management , managers, and employees and works with team to develop claims ... and key stakeholders to identify preventative opportunity areas + Assesses all new claims and immediately engage in those that are serious, questionable, or lost… more
- Citigroup (San Antonio, TX)
- The Fraud Ops Sr Analyst is a senior level positions responsible for contributing to the development of fraud management policies, processes and procedures to ... fraud losses by ensuring analysts make appropriate decisions using risk /reward balanace methodology. **Responsibilities:** + Solve complex fraud prevention and… more