- ManpowerGroup (Columbia, SC)
- Our client, a leader in the healthcare industry, is seeking an Analyst , Appeals to join their team. As an Analyst , Appeals , you will be part of the ... which will align successfully in the organization. **Job Title:** Analyst , Appeals **Location:** Columbia, SC **Pay Range:**...Working knowledge of managed care and various forms of healthcare delivery systems. **What's in it for me?** +… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Senior CBO Appeals Analyst position requires an in-depth knowledge of healthcare pricing/reimbursement processes and procedures ... collaboration with the Underpayment Team manager, the Senior CBO Appeals Analyst will work to further the...to Five years of financial analysis experience in a hospital/ healthcare environment is required. Advanced knowledge of Epic, Contract… more
- Mount Sinai Health System (New York, NY)
- **Job Description** This position serves as Appeals Analyst for Central Billing Office management. Responsible for monitoring contractual allowances, analyzing ... and pursuing appeals opportunities with payors and networks, and reporting performance...education, and innovation as we work together to transform healthcare . We encourage all team members to actively participate… more
- Kelsey-Seybold Clinic (Houston, TX)
- …provider adjustments, and complete provider invoices received. **Job Title: Claims Appeals & Adjustment Analyst ** **Location: Remote** **Department:** **Claims** ... PPO, or TPA environment. Preferred: 3 years experience as Claims Payment Analyst with KSC and demonstrated ability to process complex medical claims. **License(s)**… more
- Catholic Health Services (Melville, NY)
- …are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace! Job ... Details Position Summary: Performs extensive data analytics, documents findings and recommendations to meet department and corporate goals. Builds, documents and maintains workflows related to all phases of department processes and systems. Able to act as an… more
- LA Care Health Plan (Los Angeles, CA)
- …auditing ( Appeals & Grievances, Call Center, Enrollment) in a healthcare environment required. Previous experience with Medi-Cal and Medicare in a managed ... Appeals & Grievances Regulatory Audit Readiness Specialist II...continuous process improvements. Collaborates with Customer Solution Center Business Analyst to track, trend, and analyze results of Quality… more
- CommonSpirit Health (Phoenix, AZ)
- …out in the community. **Responsibilities** **Position Summary:** The Senior Reimbursement Analyst is responsible for providing cost report preparation cost report ... appeals audit preparation and other duties related to the...and other State and Federal regulations. The Sr. Reimbursement Analyst interacts with customers and ensures value is delivered… more
- CommonSpirit Health (Phoenix, AZ)
- …our hospitals and out in the community. **Responsibilities** The **Senior Reimbursement Analyst i** s responsible for providing cost report preparation, cost report ... appeals , audit preparation and other duties related to the...and other State and Federal regulations. The Sr. Reimbursement Analyst interacts with customers and ensures value is delivered… more
- Intermountain Health (Murray, UT)
- …reimbursement, compliance initiatives, regulatory legislation, and billing practices. This analyst reviews claims and monitors provider appeals including ... **Job Description:** The Coding Analyst I for SelectHealth provides general expertise in...Retirement Income Security Act (ERISA) standards. + Logging provider appeals and sends correspondence to providers on submitted … more
- State of Colorado (Denver, CO)
- Child and Youth Medicaid System Analyst IV - Hybrid Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4857855) Apply Child and Youth Medicaid ... System Analyst IV - Hybrid Salary $70,140.00 - $112,236.00 Annually...have a more seamless connection to physical and behavioral healthcare services, which improves health outcomes, minimizes harm to… more
- The County of Los Angeles (Los Angeles, CA)
- DISASTER SERVICES ANALYST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4684863) Apply DISASTER SERVICES ANALYST Salary $87,086.16 - ... institution in Emergency Management or Homeland Security. + Experience in a healthcare , public health or an emergency medical services provider setting. +… more
- WMCHealth (Valhalla, NY)
- Payment Resolution Analyst Company: NorthEast Provider Solutions Inc. City/State: Valhalla, NY Category: Finance/Info Systems Department: Patient Accounts-WMC Health ... Internal Applicant link Job Details: Job Summary: The Payment Resolution Analyst processes all out of network insurance claims to ensure appropriate… more
- Community Health Systems (Franklin, TN)
- (Full Time, Remote) The Analyst is responsible for the maximization of reimbursement by identifying contractual variances between posted and expected reimbursement ... of payment discrepancies to internal and external departments. As a Payment compliance Analyst at PCCM/CHS Shared Service Center - Nashville, you'll play a vital… more
- Immigration and Customs Enforcement (Washington, DC)
- …(ERO), ICE Health Service Corps (IHSC), Office of Deputy Assistant Director for Healthcare Compliance, Office of Health Plan Management Unit (HPMU). This is a ... DUTIES AND RESPONSIBILITIES: Serves in the capacity of Claims Management Program Analyst Lead and subject matter expert (SME) in the oversight of program… more
- UPMC (Pittsburgh, PA)
- The Payment Accuracy Analyst is a key role responsible for supporting the Claim Editing team within UPMC Health Plan's Reimbursement Department. Functions include ... edits based on clinical, financial, and operations perspectives. The Payment Accuracy Analyst is also accountable for ongoing report analysis that identifies areas… more
- TEKsystems (Irondequoit, NY)
- Summary: Join our dynamic team as a Healthcare Billing Analyst , where you'll ensure full reimbursement for clinical services, including professional, ... policies, and phone calls. + Submit corrected claims and appeals . + Process account adjustments and refunds as needed....Data Entry + Computer Skills + Customer Service + Healthcare Experience + Medicaid Eligibility + Healthcare … more
- BrightSpring Health Services (Valdosta, GA)
- …balancing and reporting.* Maintain open communication with Billing Specialist, Cash Application Analyst and Operations.* Send cash transfer & check requests to the ... equivalent, associates degree or higher preferred.* At least 2 years healthcare billing, private insurance and/or federally funded programs, researching agings and… more
- Nuvance Health (Danbury, CT)
- …to applicable audit teams 4.Prepares, organizes, and presents all arguments and appeals to the Fiscal Intermediary, the Provider Reimbursement Review Board, NYS, OHS ... OIG. 5.Reviews Medicare audit reports to seek opportunities for adjustments or appeals . 6.Works with Medicaid auditors to clear annual audit questions. 7.Prepares… more
- Healthfirst (NY)
- …at-a-glance view of key performance indicators (KPIs), member feedback based on appeals and grievances, utilization and spend across our Healthfirst products. + ... **Preferred Qualifications:** + Experience in data analytics or consulting, preferably in the healthcare industry + 1+ years' of working experience with SQL + 1+… more
- Molina Healthcare (Long Beach, CA)
- …The **Delegation Oversight Nurse** is responsible for ensuring that Molina Healthcare 's UM delegates are compliant all applicable State, CMS, and NCQA ... requirements, as well as Molina Healthcare business needs. In addition, the Delegation Oversight Nurse...role. Productivity is important with turnaround times. Experience with Appeals , Auditing, Prior Authorization, Compliance and Quality will be… more