- Molina Healthcare (WA)
- **JOB DESCRIPTION** **Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and ... reports. As the senior level team member, this role leads efforts to ensure the claims teams and other departments have access to quality claims data through… more
- Commonwealth Care Alliance (Boston, MA)
- CCA- Claims Essential Duties & Responsibilities: * Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and ... on edits implemented. * Utilize data to examine large claims data sets to provide analysis and reports on...savings based on provider billing trends * Liaison between business partners and vendors; bringing and interpreting business… more
- Molina Healthcare (MI)
- **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 be initiated through provider inquiries or… more
- Molina Healthcare (UT)
- … and business systems **PREFERRED EXPERIENCE:** Medicare, Medicaid and Marketplace claims knowledge Complex SQL and Excel expert knowledge SQL query and coding ... Interfaces with the customer in developing requirements for major complex claims testing projects within Medicare, Medicaid and Marketplace; prepares system test… more
- Robert Half Accountemps (Sterling Heights, MI)
- Description We are offering a short term contract employment opportunity for a Medical Claims Analyst in STERLING HEIGHTS, Michigan. This role is in the ... Minimum of three years of experience as a Medical Claims Analyst or in a similar role... regulations and medical terminologies * Bachelor's degree in healthcare administration, business , or a related field… more
- Molina Healthcare (IA)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- The Cigna Group (Bloomfield, CT)
- …EviCore, a line of business within The Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst . For this **highly technical senior ... input correctly per the specifications of the provider. The Claims Configuration Quality Review Senior Analyst will...as a team + Strongcommunicationskills + 5+ years of healthcare claims lifecycle; configuration design, editing, … more
- The Cigna Group (Bloomfield, CT)
- …School Diploma or GED required, bachelor's degree preferred + **5+ years of healthcare claims lifecycle; configuration design, editing, claims system ... a division of the Cigna Group is hiring a Claims System Configuration Senior Analyst . This highly...and act as a subject matter expert (SME) to business and IT for eviCore claims product… more
- The Cigna Group (Bloomfield, CT)
- …EviCore, a line of business within The Cigna Group, is hiring a Claims System Configuration Lead Analyst . This **highly technical systems** role acts as the ... initiatives. You'll be the subject matter expert to the business and IT for eviCore claims product...products including PowerPoint - REQUIRED + 5+ years of healthcare claims life cycle experience, emphasis in… more
- The Cigna Group (Bloomfield, CT)
- …to succeed:** + High School Diploma or GED Required + 5+ years of healthcare claims lifecycle; configuration design, editing, claims system requirements, and ... a division of The Cigna Group is hiring a ** Claims Systems Configuration Senior Analyst .** For this...act as a subject matter expert (SME) to the business and IT for eviCore claims product… more
- Hackensack Meridian Health (Edison, NJ)
- …healthcare and serve as a leader of positive change. The **Applications Analyst III** gathers business requirements, conducts needs assessments, and develops ... specifications and build to ensure that developed information technology solutions support business objectives. This level works with little or no supervision and… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Nov 19, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 57268 **Who we are** Teva ... healthier lives. Join us on our journey of growth! **The opportunity** The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes… more
- Fairview Health Services (Minneapolis, MN)
- **Overview** The Senior Application PB/HB Claims Analyst role with Epic Hospital and/or Professional billing (HB and/or PB) will provide technical expertise and ... application area. Job functions include configuring applications by translating the business requirements into software specifications. This position is eligible for… more
- Elevance Health (Atlanta, GA)
- …analyzing, documenting and coordinating the resolution of escalated and/or complex claims issues that span across multiple operational areas and requires expert ... Coordinate the identification and resolution of root causes involving configuration, claims and/or contracting activities. **Requirements:** + a BA/BS degree and 5… 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 Under minimal supervision, formulates and defines Resolute Hospital Billing/ Claims scope and objectives through research and fact-finding to develop or… more
- Molina Healthcare (KY)
- **Knowledge/Skills/Abilities** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Molina Healthcare (NM)
- …work during EST hours **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Molina Healthcare (KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and contract data regarding network ... assess business impacts, and make recommendations through use of healthcare analytics, predictive modleing, etc. + Interact with various departments including;… more
- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within a world-class ... How you will create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims Department… more
- Capgemini (Bridgewater, NJ)
- Healthcare Business Analyst Choosing Capgemini means choosing a company where you will be empowered to shape your career in the way you'd like, where you'll ... Newark, NJ** **Job Description** Capgemini is seeking a Senior Business system analyst with Healthcare ...Product, Data models & architecture (Preferred) or any other claims processing system like NASCO. + Experience with using… more
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