Risk Management Analyst jobs in Corpus Christi, TX

Risk Management Analyst provides data analysis and builds risk models to support risk programs and activities. Prepares reports needed to comply with clinical, environmental, and privacy compliance regulations. Being a Risk Management Analyst identifies loss trends by analyzing incident reports, claim and insurance data. Utilizes advanced data analysis tools and techniques. Additionally, Risk Management Analyst requires a bachelor's degree. Typically reports to a manager or head of a unit/department. The Risk Management Analyst occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Risk Management Analyst typically requires 2-4 years of related experience. (Copyright 2024 Salary.com)

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Denials Management Analyst I
  • Driscoll Health
  • Corpus Christi, TX FULL_TIME
  • Where compassion meets innovation and technology and our employees are family.
    Thank you for your interest in joining our team! Please review the job information below.
    General Purpose of Job:
    Under direct supervision, the Denial Management Analyst will assist with the Billing, Follow-Up, Collection, Root Causing, Recovery, and Reporting of assigned Insurance or Self-Pay claims. Applying a scientific approach, to include research and analysis, the Denials Management Analyst will assist with the discovery of denials or denial trends and offer recommendations for solutions as a denial preventive. Additionally, the Denial Management Analyst will serve as a liaison between entities, promoting opportunities for inclusion and awareness, through communication to stakeholders, as denials or denial trends are discovered.
    Essential Duties and Responsibilities:
    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.
    The above statements should be included on all job descriptions.
    List the job's essential or most important functions and responsibilities. Include all important aspects of the job - whether performed daily, weekly, monthly, or annually; and any that occur at irregular intervals. Standard functions listed below should be included on all job descriptions.
    • Maintains utmost level of confidentiality at all times.
    • Adheres to hospital policies and procedures.
    • Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
    • Assist with the Billing, Follow-Up, Collection, Root Causing, Recovery, and Reporting of assigned Insurance or Self-Pay claims.
    • Familiarity and adherence to payer timely filing, corrected claim, and appeal deadlines, and apply to assigned claims as necessary.
    • Familiarity and adherence to payer reimbursement policies and apply to assigned claims as necessary.
    • Familiarity and adherence to payer clinical policies and apply to assigned claims as necessary.
    • Familiarity and adherence to Health System contractual agreement(s) and apply to assigned claims as necessary.
    • Familiarity and adherence to Texas Administrative Code(s), or Bylaws, and apply to assigned claims as necessary.
    • Root cause claim denials and offer recommendation for prevention.
    • File appeals as appropriate to resolve payer denials and work with payers to monitor appeals in process.
    • Document efforts, conversations as correspondences with clarity and comprehension, within the Electronic Medical Record System.
    • Track and trend denials and recovery efforts by utilizing various departmental tools and appropriately reporting on-going problems specific to payers, health system departments, and/or contracts.
    • Collaborate with clinical personnel as needed to appeal and resolve assigned claims.
    • Ability to communicate effectively with all stakeholders across the health system, furthermore, disseminate denial efforts to key stakeholders as appropriate.
    • Maintain a comprehensive payor and managed care intelligence database; to source research and analysis as needed.
    • Recommends appeal templates for denial trends, as appropriate.
    • Evaluates opportunities and financial terms for the health system.
    • Assist with the strategic and financial judgment necessary to achieve profitable growth with payors.
    • Supports and participates in the continuous assessment and improvement of the quality of care and services provided.
    • Assist departmental leadership in resolving managed care operational issues and provide interpretation of managed care contract language, terms, and conditions.
    • Consistently meet the current productivity standards in addressing and resolving denied accounts.
    • Consistently meet the current quality standards in taking appropriate actions to identify and track root causes, successfully appeal denied accounts, and trend issues.
    • Gather, verify, and evaluate confidential and sensitive organizational information, consistent with assigned claims.
    • Provide individual contribution to the overall team effort of achieving departmental goals.
    • Demonstrate proficient use of systems and execution of processes in all areas of responsibilities.
    • Maintains a sense of professional and self-validation.
    • Assure patient privacy and confidentiality as appropriate or required.
    • Maintain professional relationships and convey relevant information to other members of the healthcare team, within the facility and any applicable referral agencies.
    • Assist with special projects as assigned.
    • Other duties as assigned.
    EDUCATION AND/OR EXPERIENCE:
    Bachelor's degree (B. A.) from four-year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience.
    Minimum of one year healthcare experience in a healthcare setting. Outstanding analytical ability and financial skills. Working knowledge of managed care operations and practices preferred. Working knowledge of health system admitting, billing, and utilization review as well as physician office practices, physician credentialing and physician billing practices preferred. Effective communication, organization, and interpersonal skills essential. Work independently. Excellent oral and written communication skills. PC skills necessary with experience in Microsoft Office products, including PowerPoint.
  • 7 Days Ago

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Property Management Operations Manager - Corpus Christi, TX
  • PURE Property Management
  • Corpus Christi, TX FULL_TIME
  • PURE Property Management is looking for an Operations Manager. Come join our team! PURE Property Management offers a comprehensive package of benefits such as: Healthcare coverage, a 401K plan with a ...
  • 1 Month Ago

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Management trainee
  • CVS
  • Corpus Christi, TX FULL_TIME
  • The Shift Supervisor Trainee role is an entry-level, short-term role that prepares an employee to perform a higher-level supervisory role, such as Operations Supervisor or Shift Supervisor. The Shift ...
  • 1 Day Ago

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Management Trainee
  • D.L. Rogers Corp
  • Mathis, TX FULL_TIME
  • As a SONIC Drive-In restaurant General Manager, you are indeed a general—leading your troops in a never-ending campaign to give America an infinitely more delicious food service experience. You will b...
  • 2 Days Ago

F
Management trainee
  • Furniture Row
  • Corpus Christi, TX FULL_TIME
  • Our Furniture Row Center in Corpus Christi, TX is now hiring! Be part of a growing company where the only place to go is up! Looking for : SALES / MANAGEMENT TRAINEES no previous exp. necessary we wil...
  • 2 Days Ago

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Management Trainee
  • DLR Sonic
  • Mathis, TX FULL_TIME
  • As a SONIC Drive-In restaurant General Manager, you are indeed a general—leading your troops in a never-ending campaign to give America an infinitely more delicious food service experience. You will b...
  • 9 Days Ago

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0 Risk Management Analyst jobs found in Corpus Christi, TX area

Corpus Christi (/ˌkɔːrpəs ˈkrɪsti/), colloquially Corpus (Latin: Body of Christ), is a coastal city in the South Texas region of the U.S. state of Texas. The county seat of Nueces County, it also extends into Aransas, Kleberg, and San Patricio Counties. It is 130 miles southeast of San Antonio. Its political boundaries encompass Nueces Bay and Corpus Christi Bay. Its zoned boundaries include small land parcels or water inlets of three neighboring counties. The city's population was estimated to be 320,434 in 2014, making it the eighth-most populous city in Texas. The Corpus Christi metropolita...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Risk Management Analyst jobs
$66,130 to $85,880
Corpus Christi, Texas area prices
were up 1.2% from a year ago

Risk Management Analyst in Battle Creek, MI
Risk Management Analysts help corporations to control or minimize the impact of risks.
February 04, 2020