- Molina Healthcare (Fort Worth, 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
- Molina Healthcare (Fort Worth, TX)
- … 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...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Elevance Health (Grand Prairie, TX)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- Lockheed Martin (Fort Worth, TX)
- …the impossible every day\. At Aeronautics, we leverage problem solving, creativity, and data to tackle the most exciting challenges in the industry\. Our people are ... at Lockheed Martin\! **Who You Are** As a Global Supply Chain Contracts Analyst, Sr Staff you are an experienced professional with a legal, contracts or supply chain… more
- Elevance Health (Grand Prairie, TX)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... healthcare fraud in order to recover corporate and client funds paid on fraudulent claims . **How you will make an impact:** + Claim reviews for appropriate coding,… more
- OneMain Financial (Fort Worth, TX)
- …Military, State, and other leave of absence programs. + Analyzes leave and ADA data to identify trends, gaps in processes or compliance concerns. + Conducts periodic ... reporting, performs data audits, reconciles pay discrepancies and adjusts absence ...leave programs to ensure compliance. + Updates internal HR systems accurately to ensure appropriate pay and leave dates… more