- Molina Healthcare (TX)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business ...experience ** Required Experience** + 3-5 Years of business analysis + 4+ years managed care experience +… more
- Wolters Kluwer (Dallas, TX)
- …Location:_** Riverwoods, IL (USA) **About the Role:** We are seeking a highly skilled Business Analyst to join the Mediregs team focusing on claims ... proficient in analyzing CMS rules as it relates to claims and processes. The candidate will be able to...contribute to software maintenance and final acceptance testing. The Business Analyst works closely with a cross-functional… more
- XPO, Inc. (North Richland Hills, TX)
- Associate Analyst , Claims - Hybrid Requisition Id: 376916 Business Unit: LTL Location: North Richland Hills, TX, US, 76180 **What you'll need to succeed as ... an Associate Analyst , Claims at XPO** Minimum qualifications: +...who receive a conditional offer of employment may be required to take and pass a pre-employment drug test.… more
- USAA (Plano, TX)
- …creativity, collaboration, and continuous learning in support of growing the Business Intelligence capability within the P&C Claims Analytics organization.** ... will have the opportunity to support all areas of Claims operations through partnership with decision science analysts and...influences. Crafts specifications for reports and analysis based on business needs and required or available data… more
- Acosta Group (Irving, TX)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position...position will be a communicator to internal and external business partners and a problem solver/agent for change to… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements ... are appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may...REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** + 1-3 years claims analysis experience + 5+ years medical claims… more
- Molina Healthcare (San Antonio, TX)
- …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... Required Education** Associate's Degree or equivalent combination of education and experience ** Required Experience** + 3-5 Years of business analysis + 4+… more
- Guidehouse (Lewisville, TX)
- **Job Family** **:** PFS General **Travel Required ** **:** None **Clearance Required ** **:** None **What You Will Do** **:** The **Billing Analyst ** is ... expected to perform specific billing processes, follow-up, account analysis as required . This position works with other departments to facilitate the meeting of both… more
- Elevance Health (Grand Prairie, TX)
- **Clinical Content Analyst ** **Location:** This position will work a hybrid model (remote and in office one day per week). Ideal candidates will live within 50 miles ... MO, Wallingford, CT, Grand Prairie, TX or Louisville, KY. The **Clinical Content Analyst ** will be responsible for driving the development and execution of the… more
- Molina Healthcare (TX)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
- AIG (Milano, TX)
- …insurance industry. Role Overview We are looking for a dedicated and detail-oriented EMEA Claims Analyst to join our EMEA team, based in Luxembourg. This role ... International TPA Analyst - EMEA About AIG American International Group,...and onboarding of local smaller Third-Party Administrators (TPAs) with claims delegations across EMEA. You will be responsible for… more
- Prime Therapeutics (Austin, TX)
- …flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm + Constantly required to sit, use hands ... our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides… 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 ... dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
- Prime Therapeutics (Austin, TX)
- …flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm + Constantly required to sit, use hands ... every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- Elevance Health (Plano, TX)
- **Managed Care Analyst (Payor Contracting)** A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing ... of our Plano, Texas PulsePoint location. The **Risk Management Analyst ** is responsible for supporting the department regarding all...control reports as needed. Reports and tracks all P&C claims . + Provides claims bordereau to brokers… more
- Cotton Holdings (Houston, TX)
- **Risk Analyst ** **Department:** Legal/Risk **Employment Type:** Full Time **Location:** Houston, TX **Compensation:** $65,000 - $70,000 / year **Description** ... success through innovative risk management strategies. As a **Risk Analyst ** , you'll play a vital role in ensuring...language to ensure adherence to Cotton insurance standards. + ** Claims and Risk Analysis** : Support claims … more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
- Sedgwick (Irving, TX)
- …years of related experience or equivalent combination of education and experience required . Experience in multi-line claims management processes and system ... requirements preferred. **Skills & Knowledge** + Knowledge of third-party administration and claims management business and technology + Oral and written… 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, ... and create mitigation strategies. **Responsibilities:** + Recommends ways to help the business achieve desired outcomes and make informed business decisions… more
- The Hartford (San Antonio, TX)
- …by applying them to meaningful work at The Hartford. The Senior Ability Analyst primarily investigates claims to make timely, accurate and customer focused ... Sr Ability Analyst - C409ANAbility Specialist - C409BN We're determined...with the expectation of coming into an office as business needs arise. Start Date: 3/17/2025 Training Hours: Core… more