- Zelis (Morristown, NJ)
- Position Overview: The Bill Review Operations Analyst will provide daily operational support to the Expert Claims Review team, including the itemized bill ... screening, distribution, and referral processes, including ECR and ECR-EDI, DRG validation, ECR Distribution, and support for Out-of-Network report management.… more
- Independent Health (Buffalo, NY)
- …and commitment to diversity and inclusion. **Overview** The Data Innovation Analyst -Intermediate will be at the forefront of transforming data into actionable ... insights for Independent Health. The analyst will develop and maintain innovative data-driven solutions to enhance quality of care, address health disparities,… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …position is full remote with occasional time onsite.** The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed Consent ... and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a Qualifying Clinical Trial… more
- Hackensack Meridian Health (Hasbrouck Heights, NJ)
- …and serve as a leader of positive change. The **Revenue Cycle Analyst , PB** provides statistical and financial data enabling management to accurately monitor ... A day in the life of a **Revenue Cycle Analyst , PB** at Hackensack Meridian _Health_ includes: + Participates...+ Performs analytical review of denials to support Revenue Operations , Case Management, Access, and other departments as it… more
- Vanderbilt University Medical Center (Nashville, TN)
- …the operation and support of the system from the standpoint of computer operations , network operations , and/or technical support. * Coding Knowledge (Advanced): ... Ability to assign and interpret ICD-10-CM/PCS coding classification systems and MS- DRG and APR- DRG prospective payment and severity systems. * Revenue Cycle… more
- Zelis (St. Petersburg, FL)
- Position Overview: At Zelis, t he Business Analyst - Expert Claims Review (ECR) is ultimately responsible for enabling high quality user stories under our ECR ... This includes Itemized Bill Review, Clinical Chart Review, Dialysis Savings Solution and DRG Validation solutions. In this role, you will work as part of the… more
- Molina Healthcare (Nicholasville, KY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... BI, and/or Tableau and data management + Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing,… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …new processes, procedures, reports, software and the refinement of existing operations . Collaborates with multiple cross-divisional business areas and vendors to ... improve reimbursement operations , solve organizational information challenges and build an efficient,...of clinical and payment methodologies including per diems, APC, DRG , MPFS, CCI, etc. required. + Must have extensive… more
- UCLA Health (Los Angeles, CA)
- …you to maintain a high degree of knowledge in healthcare, finance, and operations , including staying current on evolving industry trends. You will: + Interface with ... pinpoint issues, achieve objectives and improve performance + Benchmark business operations relative to established best practices and internal business objectives +… more
- Banner Health (AZ)
- …coding department, including roles such as Coding Educator, Coding Quality Analyst and supervisory/management opportunities. Additionally, as part of the Revenue ... expectation is 1-2 charts an hour while maintaining a DRG accuracy rate of 95% or higher. We use...information or documentation to coding support tech, coding quality analyst or coding manager for clarification/additional information for accurate… more
- Banner Health (AZ)
- …coding department, including roles such as Coding Educator, Coding Quality Analyst , and supervisory/management opportunities. Additionally, as part of the Revenue ... role they are hired for. Our IP coding expectation is 1-2 charts while maintaining a DRG accuracy rate of 95% or higher. We use the number of accounts for specific… more
- Commonwealth Care Alliance (Boston, MA)
- …corporate reimbursement policies, and works collaboratively with the Claims Coding Analyst to ensure consistency with the Plan's claims processing system(s) + ... the scope and impact of the change on Plan operations and seek to implement changes as necessary +...Experience working with industry standard methods of payment including DRG , APC, RVU, etc. + Experience working with Medicaid,… more