- 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)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… 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
- Amazon (Dallas, TX)
- …of different types of products from custom electronic assemblies to large integrated systems . In this capacity the Business Manager has the responsibility to: * Lead ... * Financial Management: Managing business relationships, contracts, pricing, and claims while maintaining effective negotiation strategies. * Relationship Building:… 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
- DriveTime (Dallas, TX)
- …which provides quality warranty and ancillary products, and a customer-friendly claims process. SilverRock offers a variety of ancillary products and administrative ... contracts, products, and warranties, and over $300 million in claims . **That's Nice, But What's the Job?** **_This is...eligible for hire at this time._** In long, our Senior Analyst, Strategic Analytics are responsible for: + Innovate… more
- Walgreens (Grand Prairie, TX)
- …with Company policies and procedures. + Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Assists ... and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the pharmacy...those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a… more
- Kemper (Dallas, TX)
- …to achieve growth & profit objectives may include training on products, systems , service, and underwriting, book transfers, development of existing accounts, new ... + Operates as the point of contact for operations, systems and policy training for account products as well...Utilizes agency segmentation, reports and technology to manage account data and performance. + Documents all completed activities with… 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
- Methodist Health System (Dallas, TX)
- …Monitor and analyze denial trends, reporting key metrics and root causes to senior leadership. Use data to develop strategies for reducing denials and ... include automation. Ensure accurate and timely follow up on claims and submission of appeals. Strong skills in writing...health and wellness. Named one of the fastest-growing health systems in America by _Modern Healthcare_ , Methodist has… 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
- Wolters Kluwer (Dallas, TX)
- …in some cases, exceeding customer expectations + Creating, tracking, and analyzing data on reviewer performance metrics using customer lens to provide upwards ... recommendation to management, senior leadership, and customers on how to improve customer...prior supervisory experience, preferably in a legal billing or claims environment. + 5+ years' experience in the legal… more
- GAF (Ennis, TX)
- …And under this roof, we protect what matters most. **Job Summary** The Senior Process Engineer is responsible for engineering needs, demonstrating skills in plant ... the field. Maintain communication with main lab at Parsippany to track claims , elaborate reports, and lead improvement projects associated with customer claims… more