- Molina Healthcare (TX)
- …Operations teams + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...Molina. Identifies the root cause of processing errors through research and analysis, coordinates and engages with appropriate departments,… more
- Zurich NA (Dallas, TX)
- General Liability Claims Analyst 117471 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes to ... our General Liability team. As a General Liability (GL) Claims Analyst , you will work with a...to GL claim assignments by Claim segmentation. + Conduct research , analysis, and interpretation of claim assignment information at… more
- Bank of America (Plano, TX)
- Consumer Product Strategy Analyst III - Information Control Charlotte, North Carolina;Belfast, Maine; Plano, Texas; Richmond, Virginia; New York, New York; Boston, ... potential fraud risk and create mitigation strategies. The Client Protection data analyst will provide analytical and data support for Consumer fraud and non-fraud… more
- Sumitomo Pharma (Austin, TX)
- …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... assets, and in-house advanced technology capabilities, we aim to accelerate discovery, research , and development to bring novel therapies to patients sooner. For… more
- CVS Health (Houston, TX)
- …EDI and Intake Business Operations team is looking for a dynamic and initiative-taking analyst with a strong background in EDI claim transactions and claims ... all potential sources of provider inquires around EDI and Claims Intake rejections and serve as the EDI Technical...to query and analyze large amounts of data for research and troubleshooting issues. **Primary duties and responsibilities** +… more
- Elevance Health (Houston, TX)
- …+ Requires a HS diploma or GED and a minimum of 3 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health ... **Provider Payment Appeal Analyst I** **Must be located within 50 miles...root cause and appropriate resolution. + Must work with Claims Operations to remediate impacted claims . **Minimum… more
- The Cigna Group (Houston, TX)
- **Summary** The Data Scientist Lead Analyst will contribute to the Medicare Clinical and Customer strategy, performing research and analysis within the Clinical, ... & Customer Data Science, the data scientist will analyze healthcare claims , clinical outcomes, customer enrollment patterns, and financial information to make… more
- UIC Government Services and the Bowhead Family of Companies (San Antonio, TX)
- **Overview** **MANAGEMENT PROGRAM ANALYST - INFORMATION MANAGEMENT DIVISION** **(BAMC-2024-21736):** Bowhead seeks aManagement Program Analyst to support the ... status updates on a regular basis. + Serve as a planner and analyst , assisting the Chief, Information Management Division, in gathering and analyzing information for… more
- Elevance Health (Grand Prairie, TX)
- …background. **Preferred Skills, Capabilities, and Experiences:** + Ability to conduct detail research of claims , systems reports, understanding of network and ... PulsePoint sites used for collaboration, community, and connection. The **EDI Ops Analyst ** is responsible for functioning as provider liaison for all electronic… more
- Bank of America (Plano, TX)
- Consumer Product Strategy Analyst III - Digital Fraud Strategies Analyst Charlotte, North Carolina;Belfast, Maine; Plano, Texas; Richmond, Virginia; New York, ... for senior management LOB Job Description: As a Client Protection Fraud Strategy Analyst , you will capitalize on your technical abilities and strategic thinking to… more
- Evolent Health (Austin, TX)
- …Stay for the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a Senior Analyst ... with a quantitative major (eg actuarial, statistics, biostatistics, operations research , mathematics, economics) or healthcare major (health administration, epidemiology,… more
- Evolent Health (Austin, TX)
- …culture. **What You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst , you will have the opportunity to shape the technical aspects and design of ... Doing:** Evolent Health is looking for a Senior Product Analyst to be a key member of the Product...with technical and non-technical audiences + Strong analytical and research skills + Microsoft Office experience (Excel, Visio) +… more
- USAA (San Antonio, TX)
- …of the Bank Data and Analytics organization supporting business partners in Bank Claims Operations. This will include support for issue mitigation and remediation as ... analysis to support driving operational efficiency. As a dedicated Decision Science Analyst , you will provide decision support for business areas across the… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... of assigned reports, document reporting processes and procedures. + Assist with research , development and completion of special projects as requested by various… more
- Molina Healthcare (TX)
- …Candidate must be able to work during EST hours **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and ... of assigned reports, document reporting processes and procedures. + Assist with research , development and completion of special projects as requested by various… more
- Prime Therapeutics (Austin, TX)
- …program manuals are effectively followed and/or maintained. Works independently to research and resolve regulatory inquiries/complaints related to claims , ... and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Regulatory Compliants & Inquires) - Remote **Job Description** The Regulatory… more
- Evolent Health (Austin, TX)
- …for the culture. **What You'll Be Doing:** Evolent is seeking a Senior Analyst , Primary Care Performance Analytics to join our Primary Care business, Evolent Care ... preferably with a quantitative major (eg actuarial, statistics, operations research , mathematics, economics) or healthcare major (health administration, epidemiology,… more
- Bank of America (Fort Worth, TX)
- Device and Non-Monetary Fraud Consumer Product Strategy Analyst III Newark, Delaware;Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, ... + Data and Trend Analysis + Innovative Thinking + Research **_This position is not eligible for sponsorship_** **_It...Qualifications:** - 2+ years of fraud, cyber, or risk analyst experience developing and/or optimizing mitigation strategies - 3+… more
- Molina Healthcare (TX)
- … research , financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable financial ... **JOB DESCRIPTION** **Job Summary** Analyst , Network Strategy, Pricing & Analytics guides the...basis using SQL, Excel, and other reporting software. + Research , develop, analyze and recommend cost savings opportunities in… more
- Molina Healthcare (TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... development of large, complex, critical configuration maintenance processes/solutions + Research and review new tools and techniques and provide...life cycle + Gains a deep understanding of Molina claims life cycle and all processes that affect … more