22 senior data analyst jobs found in Fort Worth

The Payment Integrity Analyst (Team Lead) assists with leading the Policy and Payment Integrity (PPI) team while maintaining the regular duties and responsibilities of this role which is accurately reviewing pre and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. The Team Lead must also be knowledgeable of the application of client policy and industry standards within reviews conducted by CERIS including but not limited to itemized bill review, professional review, hospital outpatient; trend analysis of internal auditing, appeals of pre and post payment claims, and any other claim or record that requires quality review to determine claim accuracy; assist with development of internal quality assurance measures based on client policy and industry guidelines; perform quality assurance reviews; assist in researching and implementing best practices related to payment policy, and/or policy initiatives; researching various healthcare policies....

The Payment Integrity Analyst (Team Lead) assists with leading the Policy and Payment Integrity (PPI) team while maintaining the regular duties and responsibilities of this role which is accurately reviewing pre and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. The Team Lead must also be knowledgeable of the application of client policy and industry standards within reviews conducted by CERIS including but not limited to itemized bill review, professional review, hospital outpatient; trend analysis of internal auditing, appeals of pre and post payment claims, and any other claim or record that requires quality review to determine claim accuracy; assist with development of internal quality assurance measures based on client policy and industry guidelines; perform quality assurance reviews; assist in researching and implementing best practices related to payment policy, and/or policy initiatives; researching various healthcare policies....

The Repricing Quality Assurance Analyst is responsible for reviewing, analyzing, and monitoring repricing audit data across multiple platforms to ensure accuracy, compliance, and efficiency. Works closely with internal teams to maintain contractual and organizational standards, enhance operational effectiveness, and improve client satisfaction. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify and resolve quality issues within repricing processes Develop and implement QA policies and procedures Monitor compliance with pricing guidelines and contractual requirements Investigate repricing discrepancies and apply corrective actions Prepare QA reports and documentation Collaborate with stakeholders to align quality objectives Provide training and guidance on repricing standards Conduct risk assessments to mitigate potential errors Maintain confidentiality of client data, PHI, and PII Additional duties as assigned...

Why GM Financial? GM Financial is the wholly owned captive finance subsidiary of General Motors and is headquartered in Fort Worth, U.S. We are a global provider of auto finance solutions, with operations in North America, South America, and the Asia Pacific region. Through our long-standing relationships with auto dealers, we offer attractive retail financing and lease programs to meet the needs of each customer. We also offer commercial lending products to dealers to help them finance and grow their businesses. At GM Financial, our team members define and shape our culture — an environment that welcomes new ideas, fosters integrity, and creates a sense of community and belonging. Here we do more than work — we thrive. Our Purpose:  We pioneer the innovations that move and connect people to what matters. This position will be posted until filled.  About the role: The Financial Analyst II – IT Services has a fundamental role in the development, tracking, reporting and...

Why GM Financial? GM Financial is the wholly owned captive finance subsidiary of General Motors and is headquartered in Fort Worth, U.S. We are a global provider of auto finance solutions, with operations in North America, South America, and the Asia Pacific region. Through our long-standing relationships with auto dealers, we offer attractive retail financing and lease programs to meet the needs of each customer. We also offer commercial lending products to dealers to help them finance and grow their businesses. At GM Financial, our team members define and shape our culture — an environment that welcomes new ideas, fosters integrity, and creates a sense of community and belonging. Here we do more than work — we thrive. Our Purpose:  We pioneer the innovations that move and connect people to what matters. This position will be posted until filled. About the role: The Risk Analyst - Portfolio Analytics is responsible for conducting analysis and developing reporting to...

The Setup Team Lead is responsible for assisting and supporting the Setup Supervisor with ensuring the Setup Team meets protocol. This role will assist with supervisory functions when the Setup Supervisor is absent. The Setup Team Lead is responsible for ½ production. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Must maintain ½ production quota Organize and distribute claims according to established priority Provide guidance to analysts, aiding with resolution of problems or questions Process complex/problematic claims according to protocol Maintain production standards and production requirements Comply with standard protocol for processing problem claims Function as liaison between analysts and clients Professionally communicate with other offices and internal departments Train new team members Assist co-workers, supervisor and management in accomplishing production goals Maintain HIPAA compliance in all aspects of...

The Procurement Analyst plays a critical role in supporting Enhanced Bill Review Programs by securing essential medical documentation, including itemizations and medical records needed to process claims accurately and efficiently. This position involves proactive outreach to providers, managing inbound inquiries, and ensuring all documentation meets quality and compliance standards, including HIPAA regulations. The Procurement Analyst is detail-oriented, organized, and thrives in a fast-paced environment where meeting production goals and collaborating with team members are key to success. This is an onsite position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Spend approximately 80-85% of the shift making outbound calls to providers to obtain required information; may also send email or fax requests Respond to inbound calls regarding claim status and related inquiries Maintain accurate records of all communications between the company, providers, and...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and analytical skills for...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and...

Why Global Business Lending Risk at GM Financial?   The Global Business Lending Risk team at GM Financial operates on multiple fronts. First, the team is dedicated to helping decision makers navigate lending risks by providing insights on a wide-ranging variety of topics such as economics and performance trends across markets in North and South America. Second, the team manages the retail and lease lifecycle on business borrowers by monitoring trends on customer behaviors, industry practices, and various other attributes related to the portfolio. Third, the team is engaged in working with operations and IT to implement strategic initiatives that provide value to customers and efficiencies to the enterprise.  Working in this environment requires attention to detail and accuracy due to the evolving nature of the auto industry and the strict financial regulations.  A creative mindset is paramount for this role. If you are creative, detail oriented, have a love for collaborating...

Position Summary: The Financial Reporting Manager reports to the Chief Accounting Officer and is responsible for leading the Company's financial consolidation and external reporting processes while delivering timely, accurate financial information that supports executive decision-making. This role oversees enterprise-wide financial reporting, technical accounting, operational reporting, and KPI/dashboard development across a multi-entity organization.   As a key business partner, the Financial Reporting Manager collaborates closely with Accounting, Treasury, Operations, and M&A teams to ensure financial reporting is accurate, compliant with U.S. GAAP, and aligned with the organization's strategic objectives.   Supervisory Responsibilities: Collaborate with Accounting, Treasury, FP&A, Operations, and M&A teams to improve reporting processes and financial transparency. Build trusted relationships with business leaders by providing timely, accurate, and...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to work independently...

The Itemization Review Supervisor will maintain a positive team building approach with emphasis on reporting, leadership and professional communication with all CERIS departments.    This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Maintain accurate, current data and analytics to support informed decision-making and reliable outcomes Manage and track client appeals as required Oversee the file assignment process and continuously monitor nurse workloads and queues Ensure daily prioritization of all claims is clearly understood and executed Prepare and maintain monthly metrics and reporting Demonstrate working knowledge of CERIS systems and databases Lead and support the team with minimal managerial oversight Foster a collaborative and positive work environment through effective team leadership Ensure strict adherence to HIPAA compliance standards Additional duties as assigned   KNOWLEDGE & SKILLS: Comprehensive...

The Revenue Cycle Specialist is responsible for analysis and monitoring of claims audit data across multiple platforms. Performs various follow-up activities to ensure the accuracy and appropriateness of reimbursement made to healthcare providers. Responsibilities include identifying payment variances and working internally and externally to resolve such issues. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Analyze and adjust/reprice claims to ensure accurate reimbursement rates in accordance with contractual agreements and payer guidelines Establishing and maintaining accurate pricing structures and rules to ensure competitive and profitable pricing strategies across various claims  Identify errors in reconciliation files across multiple work streams and business units for multiple sites and with external partners Perform contract and reimbursement variance analysis Analyze claims data to identify contractual overpayments and billing...

Why GM Financial? GM Financial is the wholly owned captive finance subsidiary of General Motors and is headquartered in Fort Worth, U.S. We are a global provider of auto finance solutions, with operations in North America, South America, and the Asia Pacific region. Through our long-standing relationships with auto dealers, we offer attractive retail financing and lease programs to meet the needs of each customer. We also offer commercial lending products to dealers to help them finance and grow their businesses. At GM Financial, our team members define and shape our culture — an environment that welcomes new ideas, fosters integrity, and creates a sense of community and belonging. Here we do more than work — we thrive. Our Purpose:  We pioneer the innovations that move and connect people to what matters This position will be posted until filled. About the role: The Economist I is responsible for assisting in the data collection and maintenance of data driven...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to work...

The Provider Management Analyst is responsible for verifying provider information and requests for documentation to audit claims including but not limited to itemized bills, medical records, UB04’s, HCFA’s, etc. Responsibilities include verifying patient information, provider contact information, and client information for accuracy to ensure proper delivery of requests.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Communicate with respective leadership on any issues or problems identified Maintain production standards, production requirements, and quality of work Assist coworkers, supervisor, or management to accomplish product goals; report potential issues in a proactive manner Timely forward misdirected requests to the correct recipient Ensure strict confidentiality of all medical records, PHI, and PII Outbound calling may be needed Additional duties as assigned KNOWLEDGE & SKILLS: Ability to...

The Itemization Review Nurse provides a summary and analysis of items by reviewing all charges on a UBIB submitted by a medical facility to determine accuracy of billed charges. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Collects supporting data and analyzes information to make decisions regarding accuracy of billing Appropriately documents work and final conclusions in designated computer program Understanding of Surgical Implants Meets department's expectations and standards  Additional duties as assigned   KNOWLEDGE & SKILLS: Understanding of Itemization Review for designated clients Understanding of CERIS systems and Data Base informatics Understanding of HIPAA regulations Exceptional organizational skills with the ability to handle stressful situations and adapt accordingly Demonstrated leadership skills; ability to work with Leadership Team(s) within a positive team environment...

Higginbotham , a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an immediate opening for an Employee Benefits Strategic Account Executive for our Fort Worth, TX office.  The  Employee Benefits Strategic Account Executive  serves as the strategic leader or member of the client management team for the most complex benefit accounts, and is responsible for client satisfaction, strategic planning, and quality assurance. Position Summary: The Account Executive serves as the strategic leader or member of the client management team for the most complex benefit accounts and is responsible for client satisfaction, strategic planning, and quality assurance. Essential Tasks: Manage a complex book of business comprised of clients with various funding methods, advanced contract features and structures that require a higher level of expertise. Provide strong insurance technical expertise to clients and members...

Position Summary: The Account Coordinator provides administrative support to internal account managers and maintains a professional relationship with our external clients. Supervisory Responsibilities: None Essential Tasks: • Conducts data entry into Excel spreadsheets, internal agency management system, carrier websites, House Bill requests • Assists in marketing of accounts as directed by account managers • Assists with the preparation of reports, proposals and other presentation materials • Audits billing statements for accuracy on behalf of clients • Generates open enrollment materials such as enrollment guides, election forms, personalized confirmation sheets, enrollment/change forms, etc • Assists in processing necessary paperwork for submission to carrier –implementation • Attend local enrollment/client meetings as needed • Delivers outstanding customer service • Maintains agency files accurately and consistently • Attends and completes any training sessions or...