- Evolent (Austin, TX)
- …mission. Stay for the culture. **What You'll Be Doing:** **Manager, Coding Support Specialist ** Evolent Care Partners is seeking a Risk Adjustment Coding Support ... Adjustment coding team members, including coding support specialists. + Provides leadership, management , and ongoing training to Risk Adjustment coding support… more
- Prime Therapeutics (Austin, TX)
- …systems, particularly those that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + ... drives every decision we make. **Job Posting Title** Business Intelligence Specialist - Sacramento, California market **Job Description** Delivers against business… more
- Caris Life Sciences (Irving, TX)
- …Caris is where your impact begins.** **Position Summary** The Sr. Compliance Specialist , Conflicts and Provider Auditing will provide support to the Compliance ... supports the evolution of Caris' compliance program by assisting in assessing risk as well as developing and implementing compliance work plan initiatives; +… more
- Molina Healthcare (Austin, TX)
- …the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. Ongoing… more
- AIG (Houston, TX)
- …Net Worth individuals. We are reimagining how we help customers to manage risk , transforming our operating model, and reshaping our role responsibilities and career ... business to help drive the profitable growth of our Management Liability business. + You will be responsible for...You will be responsible for assessing the desirability of risk through regular contact with brokers, close co-ordination with… more
- MTC (Rosharon, TX)
- …+ Bereavement leave + Civic duty and military leave Impact lives with Management & Training Corporation (MTC)! At the **Stringfellow Unit in Rosharon, Texas** , ... provide a safe and secure working environment for our staff while helping an at- risk population receive the treatment necessary for success on their road back to a… more
- Caris Life Sciences (Irving, TX)
- …trends and root causes from investigation data to inform compliance training and risk mitigation strategies. * Assist in the development and delivery of training ... Working knowledge of federal healthcare regulations, including HIPAA, Anti-Kickback Statute, False Claims Act, and Stark Law. * Strong writing skills, especially in… more
- Molina Healthcare (Dallas, TX)
- …the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to ... credentialing database necessary for processing of recredentialing applications. * Reviews claims payment systems to determine provider status, as necessary. *… more
- Sedgwick (San Antonio, TX)
- …information that meets both the internal and external customer's requirements accurately into the claims management system. + Assigns new claims to the ... contact at multiple locations or escalates to Service Center Specialist / management as needed. + Attendance during scheduled...Knowledge** + Knowledge of medical terminology + Understanding of claims management + Excellent oral and written… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …reviews of billing and coding compliance functions and activities, compliance risk assessments, developing policies and procedures, and developing risk -based ... and regulations and UTRGV policies. To review and analyze medical records, claims , and workflow processes to ensure accuracy, completeness, and compliance with… more