- TEKsystems (Dallas, TX)
- …of the servicer and/or client + Files respective investor/insurer initial and final claims based on the respective guidelines for allowable limits + Reviews MI claim ... and research curtailment reasons for potential rebuttal + Files Appeal or Supplemental Claims ensuring all allowable advances and interest are recovered from the MI… more
- Molina Healthcare (Fort Worth, 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
- Molina Healthcare (Fort Worth, TX)
- … claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are appropriately applied. Manages and leads ... claims projects + Assists with reducing re-work by identifying and remediating claims processing issues + Locate and interpret regulatory and contractual… more
- PNC (Dallas, TX)
- …have an opportunity to contribute to the company's success. As a Loan Support Analyst Senior within PNC's Midland organization, you will be based in office within ... and also supports remote and hybrid work environments As a Loan Support Analyst Senior in PNC Midland's Insurance department you will be responsible for determining… more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Maintains SharePoint… more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... by various internal departments, or in support of requests from regulatory agencies, contracting agencies, or other external organizations. + Demonstrate Healthcare… more
- Molina Healthcare (Fort Worth, TX)
- …to staff for mentoring, coaching, and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory ... or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL… more