- Molina Healthcare (Austin, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Zelis (Plano, TX)
- …the personal interests that shape who you are. Position Overview The Sr. Medicaid Regulatory Pricer Analyst will collaborate with the Zelis Regulatory Pricer ... an accurate and timely fashion. What you'll do: + Research and decipher regulatory sources such as legislative rules, state registers, waiver programs and bulletins… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
- Molina Healthcare (Fort Worth, TX)
- …**Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Highmark Health (Austin, TX)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, ... proactively identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational… more
- Prime Therapeutics (Austin, TX)
- …passion and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior ... and partners with key internal stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement.… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Senior - Remote **Job Description** The Senior Pricing Analyst participates ... of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation and analytic insight… more
- Prime Therapeutics (Austin, TX)
- …fuels our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing ... Analyst participates in the assessment of value generated by...or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses and provide consultation… more
- Elevance Health (Grand Prairie, TX)
- **Business Information Analyst Senior - Medicaid Encounters Data** The **Business Information Analyst Senior** is responsible for analyzing and validating ... data, identifying trends, and providing insights to support decision-making and regulatory compliance. **Location:** Norfolk, VA; Grand Prairie, TX; Tampa, FL;… more
- Intermountain Health (Austin, TX)
- …identify trends, and recommend changes to care site and revenue cycle leadership. The analyst should also be able to lead committee meetings and present their ... **Job Description:** The Revenue Cycle Analyst is responsible for tracking revenue performance metrics...areas of denial prevention in compliance with policy and regulatory requirements. + Lead and drive revenue… more