- Molina Healthcare (Houston, 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 (Houston, 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
- Medtronic (Houston, TX)
- …for these individuals. We are hiring a passionate, fast-paced, and strategic ** Sr . Group Market Development Manager** to manage the healthcare professional (HCP) ... and provides strategic support to reimbursement, clinical, and sales teams. The Sr . Group Market Development Manager will focus on increasing healthcare professional… more
- Molina Healthcare (Houston, 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
- Molina Healthcare (Houston, 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
- Walgreens (Spring, 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
- Houston Methodist (Houston, TX)
- …and service areas regarding action taken and resolution. + Enters patient and operational data into various database systems with a high level of thoroughness, ... At Houston Methodist, the Senior Patient Services Representative is responsible for performing...to less experienced staff. This position supports timely, accurate claims submission and may perform registration and/or other revenue… more
- Kemper (Houston, 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
- Entergy (The Woodlands, TX)
- …This role will be titled Contract Specialist I, II, III, or Senior , based on education and qualifications.** **JOB SUMMARY/PURPOSE:** The Contracts Specialist ... + Work with stakeholders to analyze and develop company position on claims and disputes; + Establish/maintain relationships with suppliers/partners, based on the… more
- Entergy (Spring, TX)
- …position may be filled as a Right-of-Way (ROW) Agent I, II, III or Sr . depending on the qualifications and or the experience of the candidate._** **_This posting ... and cultural assessment. + Interpret market analysis, ie, comparable sales data provided within limited appraisals. + Develop initial compensation offers. +… more
- Catholic Health Initiatives (Houston, TX)
- …and Baseware. **_Required Minimum Knowledge, Skills, Abilities_** **_and Training_** Strong Data Mining/ Business Systems proficiency Multidimensional Billing ... requirements. Reports are produced for Revenue Cycle functions such claims submission, insurance follow‐up, cash management, credits/refunds, charge/payment posting,… more
- Elevance Health (Houston, 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
- GE Vernova (Houston, TX)
- **Job Description Summary** Reporting to the GSI NAM Commissioning Leader, the Senior P&C Commissioning Lead is responsible for coordinating and supervising all site ... while working off site as part of the Service Commissioning team, the Senior P&C Commissioning leader will support the field specialists in troubleshooting, RCA and… more
- Houston Methodist (Houston, TX)
- …strategies, identifies opportunities for improvement, decision support and labor analytics systems . This position also focuses on HM labor objectives and provides ... conducting new hire feedback sessions, coaching/corrective counseling, and providing recognition /commendations to achieve desired outcomes. + Identifies opportunities and… more
- Wolters Kluwer (Houston, 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
- KBR (Houston, TX)
- …with the contract; the Contractor's policies and procedures and approved business systems ; and US Government and local regulations and policies. + Advises Project ... of the company's position on requests for equitable adjustment, potential disputes, claims , or protests. + Interfaces with US Government Contracting Officer and… more
- New Jersey Resources (Houston, TX)
- …and safety laws and regulations, company policies and operating procedures. Assist senior management in promoting a safety and compliance culture. Align with the ... response analysis reviews. * Assist in managing Workers' Compensation Claims , Return to Work programs, accident reports, claims...of experience focused on natural gas transmission and storage systems in leadership role. * Minimum 5 years of… more
- Celestica (Houston, TX)
- …growth plans. + Supports quarterly business reviews with customers, and with senior management at key/strategic suppliers. + Interfaces with cross functional teams ... flexibility and future process changes / improvements. + Supports customer claims related material, including excess & obsolete inventory, premiums and material… more
- Regions Bank (Kingwood, TX)
- …+ Ability to learn additional systems as needed + Ability to research, analyze data , and derive facts + Ability to work in a team environment when applicable + ... the assigned workload daily + Achieves delinquency goals as prescribed by senior management + Negotiates with customers, attorneys, and other parties of interest… more