- Molina Healthcare (Austin, TX)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Amazon (Austin, TX)
- …The Program, Project, Product, and Vendor Management Team within Amazon's Logistics Claims Management and Operations group is seeking a motivated and experienced ... Senior Risk Manager. The ideal candidate will be familiar with insurance and claims programs, and insurance policies, have a history of success in procurement,… more
- USAA (Austin, TX)
- …truly makes us special and impactful. **The Opportunity** As a dedicated Senior Auto Appraiser, you will work within defined guidelines and framework responsible ... for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in… more
- Sumitomo Pharma (Austin, TX)
- …computer systems . + Identifies and resolves discrepancies in submitted data invoices to ensure legitimacy of contract discounts. + Ensures detailed accuracy ... highly motivated, and experienced individual for the position of Sr . Manager, Medicaid Contract Administration. This position is responsible...of correct data input into company systems . + Maintains… more
- Evolent (Austin, TX)
- …mission. Stay for the culture. **What You'll Be Doing:** Evolent Health is looking for a Sr . Product Owner within our Common Data portfolio to be a key member of ... a technical field or relevant related field + Understanding of healthcare data formats (eg, eligibility, claims , configuration, authorizations, clinical data… more
- Evolent (Austin, TX)
- …data using industry-standard metrics. + Process and validate raw unadjudicated claims data . **Qualifications Required and Preferred:** + Bachelor's degree, ... Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the critical thinking skills to solve new problems… more
- Evolent (Austin, TX)
- …Familiarity with value-based care and utilization management is preferred + Understanding of data systems and the critical thinking skills to solve new problems ... interactions fostering expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. **Qualifications… more
- Evolent (Austin, TX)
- …skills + Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration, authorizations, clinical ... You'll Be Doing:** Evolent Health is looking for a Senior Product Owner to be a key member of...key member of the Product team, focused on client data integrations. This individual will play a critical role… more
- Cognizant (Austin, TX)
- …equivalent education or work experience; bachelor's degree preferred. + Experience working with claims payment systems and Medicare data analytics. + Strong ... issue resolution. **Primary Responsibilities** : + Identifies and interprets data , submission requirements, and performance metrics per the regulatory and… more
- Highmark Health (Austin, TX)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... of applications he/she supports, how users use the application, and what other systems integrate with the application. Understands how work is being conducted, and… more
- Molina Healthcare (Austin, TX)
- … systems to support executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical… more
- Walgreens (Austin, TX)
- …by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Highmark Health (Austin, TX)
- …overall business targets or assigned volume of new applications or RFP's.Utilize various systems and tools to obtain necessary data and accurately complete and ... quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …- Interacts effectively with internal/external functional business units to gather data and develop documentation required for on-time submissions. - Works closely ... (Word, Excel, PowerPoint, Outlook) and familiarity with electronic document management systems (EDMS). **Competencies** See OPDC Competencies Chart (Level X) **P**… more
- CVS Health (Austin, TX)
- …Salesforce. + Market and place stop loss policies, negotiating terms based upon claims data , strategy, relationships and cost avoidance/reduction efforts. + Work ... impacts for custom requests. + Manage and interpret operational data and apply to fee development and financial analysis....Meritain products and services along with strong business and systems knowledge. + Reviews work for accuracy and recommends… more
- Iron Mountain (Austin, TX)
- …solutions in records and information management, digital transformation services, data centers, asset lifecycle management, and fine art storage, handling, ... artifacts, extract more from their inventory, and protect their data privacy in innovative and socially responsible ways. Are...costs. This position will report directly to the Global Sr . Commercial Director, and will work closely with members… more
- EPAM Systems (Austin, TX)
- …high-impact, large-scale technology projects within the P&C insurance sector. This is a senior leadership role that requires a hybrid skill set: you must be ... platforms, digital transformation, and large-scale technology delivery (eg, cloud, AI, data analytics, automation tools) + Proven track record for building an… more
- HCA Healthcare (Round Rock, TX)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... and visitors. + You will collect, analyze and trend data on patient grievances utilizing the patient grievance and...incidents that could lead to professional or general liability claims + You will provide reports and take meeting… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …tailor solutions to support individual health needs and improve how people engage. Data is the cornerstone of our platform, connecting people and partners and ... platform across health experience services. This role requires a unique blend of systems thinking, product vision, and startup grit to translate ambiguous needs into… more