- Highmark Health (Austin, TX)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with...various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards.… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… more
- AIG (Dallas, TX)
- Join AIG's Forensic Accounting Unit as a Senior Forensic Accounting Analyst to play a crucial frontline role that will make the most of your technical expertise. ... Make your mark as a Forensic Analyst As a claims professional, you are...using data, analysis, experience, and judgment, along with a risk mindset. Ultimately, you take ownership for key outcomes.… more
- Houston Methodist (Bellaire, TX)
- …+ Conducts risk -based and baseline reviews of complex and escalated claims or records in a timely manner, evaluates corrective actions and processes applicable ... At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing...serving as subject matter expert, performing complex and high risk -based and baseline compliance reviews and identifying potential … more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Provides senior level analyst support for medical economics analysis activities, including extracting, analyzing and ... and manages information from large data sources. * Analyzes claims and other data sources to identify early signs...tools to monitor trend drivers and provides recommendations to senior leaders for affordability opportunities. * Leads projects to… more
- Amazon (Austin, TX)
- Description The Senior Product Safety and Quality Analyst is responsible for vetting the safety and quality of new and existing WFM products by investigating ... specifications for new and existing products across diverse product categories. The Senior PSQA shall provide technical guidance and recommendations for product and… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...deep dive to support HEDIS audit and revenue at risk reporting. + Calculate and track HEDIS rates for… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- …Information Posting NumberSRGV8219 Working TitleCOMPLIANCE CODING AND BILLING ANALYST Number of Vacancies1 LocationMcAllen, Texas DepartmentCompliance FTE1.0 ... reviews of billing and coding compliance functions and activities, compliance risk assessments, developing policies and procedures, and developing risk -based… more
- Sedgwick (San Antonio, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... Fortune Best Workplaces in Financial Services & Insurance Data Analyst Manager **PRIMARY PURPOSE OF THE ROLE:** To manage...and provides analysis for forecasting and/or benchmarking used by senior management. + Reports directly to senior … more
- Cayuse Holdings (Austin, TX)
- **Overview** **_JOB TITLE:_** Business Analyst /Product Owner **_CAYUSE COMPANY:_** Cayuse Civil Services, LLC **_LOCATION_** Austin, TX **_SALARY:_** $108,888.03 - ... submit your application to be considered for similar upcoming roles** The Business Analyst /Product Owner will perform work on the PEMS project and support activities… more