- Point32Health (TX)
- …general direction of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations ... the professional and compliant management and coordination of assigned member appeals and grievance (complaints) received by Point32Health. This individual works… more
- Molina Healthcare (TX)
- **Molina Healthcare is hiring a Sr Business Analyst , Appeals & Grievances** and experience in data reporting. **Highly Qualified Candidates Will Have The ... Following Experience-** + Solid understanding of the full Appeals & Grievances process + Experience working with claims...Payment Integrity, Excel, Power User, Power BI, Enrollment, Enrollment Analyst , Analyst , Business Analyst , BA,… more
- Sharecare (Austin, TX)
- **Job Description:** Job Summary: The role of the Family Health Advocate-Research Analyst is an exciting and integral role in providing meaningful advocacy support ... but are not limited to the coordination of benefits, health claim appeals , re-submissions and/or re-coding, EOB reviews and researching provider availability and… more
- Alamo Group Inc. (Seguin, TX)
- …Inc. is currently accepting applications to fill the position of **Financial Business Analyst ** at its Corporate Headquarters in Seguin, TX (25 miles east of San ... Antonio, TX). Under direction, the Financial Business Analyst assists the Director of Financial Systems in supporting...and material in a clear and concise manner that appeals to all levels of the organization. 9. Ability… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Operational Analytics** The Operational Performance Analytics team, a part of ... Evolent's Analytics department, is seeking a Senior Analyst to collaborate cross-departmentally to help our organization gain efficiencies and drive decision-making… more
- Evolent (Austin, TX)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from multiple ... Evolent's clinical services (ie, specialty care, utilization management, care management, appeals & grievances) + Using analytical tools to integrate various data… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Accounting and Reporting Analyst position is responsible for identifying and compiling information for various governmental reports, ... Houston Methodist (HM) hospital and assists in cost report amendments, audit, appeals and reopening process. + Independently prepares federal and state tax returns… more
- BrightSpring Health Services (Anna, TX)
- …consistently follows up on unpaid claims utilizing AlphaCollector and filing appeals when appropriate to obtain maximum reimbursement. Responsibilities * Process ... manual billing for various DSS/CSA Localities in Virginia, verifying to Purchase Orders/Invoices received.* Analyze claims for assigned payor sources and follow up on all outstanding claims.* Good phone skills are essential, as this person will have to call… more
- Capgemini (El Paso, TX)
- …software systems to create Prescription cases and determine coverage, determination and appeals process + Good written and verbal communication skills + The ability ... to display soft skills while moving the call forward + Meeting or exceeding government mandated timelines + Complying with turnaround time, productivity, and quality standards + Conveying resolution to beneficiary or provider via direct communication and… more
- Capgemini (El Paso, TX)
- …software systems to create Prescription cases and determine coverage, determination and appeals process *Good written and verbal communication skills *The ability to ... display soft skills while moving the call forward *Meeting or exceeding government mandated timelines *Complying with turnaround time, productivity, and quality standards *Conveying resolution to beneficiary or provider via direct communication and… more