- Kelsey-Seybold Clinic (Houston, TX)
- …dollar claims and present summary to management. **Job Title: Medicare Claims Analyst ** **Location: Remote** **Department:** ** Claims ** **Job Type: Full ... etc.)** **Qualifications** **Education** Required: Associate degree or 2 years Claims Payment Analyst experience in lieu of...(word and excel.) **Experience** Required: 3 years of Facility Claims Adjudication experience in a HMO,PPO, or… more
- The Cigna Group (Bloomfield, CT)
- …with AS400, MC400, McNet and RC3 systems required + 3+ years of experience with claims adjudication , claims data types and editing rules (ICD, CPT/HCPC, ... a division of the Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst ....SI testing, end to end testing and continuously improve adjudication automation and accuracy. + Partner with technology and… more
- The Cigna Group (Bloomfield, CT)
- …experience with MC400, McNet and RC3 systems Preferred + 3+ years of experience with claims adjudication , claims data types and editing rules (ICD, CPT/HCPC, ... a division of the Cigna Group is hiring a Claims System Configuration Senior Analyst . This highly...SI testing, end to end testing and continuously improve adjudication automation and accuracy. + Partner with technology and… more
- The Cigna Group (Bloomfield, CT)
- …and Change Lives?** EviCore, a division of the Cigna Group is hiring a Claims System Configuration Lead Analyst . This highly technical systems role acts as ... the Subject Matter Expert (SME) for the Claims Configuration of the eviCore Claims Systems...setups and system processes for opportunities to continually improve adjudication automation and accuracy, and update support documentation as… more
- Commonwealth Care Alliance (Boston, MA)
- …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective claims … more
- Carle (Urbana, IL)
- Claims Analyst Team A + Department: HA - Claims + Entity: Health Alliance + Job Category: Clerical/Admin + Employment Type: Full - Time + Job ID: 45246 + ... Requirements: no Email a Friend Save Save Apply Now Position Summary: The Claims Analyst accurately processes medical, dental, orthodontia and pharmacy claims… more
- DXC Technology (Troy, MI)
- …and Customer personnel involving customer products, and processing product warranty claims . Representatives provide technical support and warranty adjudication ... and colleagues at DXC.com . Responsibilities include technical troubleshooting, warranty adjudication , product support and customer support related to contacts from… more
- Allied Solutions (Plano, TX)
- …applicability of insurance coverage to certain claim types prior to the assignment to a Claims Adjuster or Analyst . The key responsibilities of this job are both ... and accurately to more senior level adjusting staff for adjudication and collection; + Adjudicate claims within the guidelines of the appropriate carrier on GAP… more
- Arkansas Children's (Little Rock, AR)
- …required attachments before being filed to payer (clean claim). 2. Expedites proper adjudication of claims by payer to maximize reimbursement and minimize older ... being adjudicated and how we might overcome lack of adjudication . 3. Reviews adjudicated claims to assure...institution that cares for children." Linda - Information Systems Analyst "We are an organization of care, love, and… more
- AIG (Atlanta, GA)
- …and professional service with empathy and efficiency. How you will create an impact The Claims Analyst III will handle and analyze general liability claims ... claims involving litigation. The position also ensures ongoing adjudication of claims within the Company standards, industry best practices and specific… more
- WellSense (Boston, MA)
- …departments to automate claims encounters functions. + Understanding of how claims payment methodologies, adjudication processing and CMS and State encounter ... Business Encounter Data Analyst WellSense Health Plan is a nonprofit health...salaries . Excellent benefits **Key** **Functions/Responsibilities:** + Understand the claims encounter data requirements in detail to ensure … more
- Commonwealth Care Alliance (Boston, MA)
- …specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication , clinical coding reviews for claims , settlement, ... the direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery Analyst... Claims Compliance, the Payment Integrity (PI) Recovery Analyst will assist in the development of a strategic… more
- TEKsystems (Palm Desert, CA)
- …at telecommute location. + Perform other duties as assigned. Skills: managed care, claims adjudication , claims resolution, claims analysis, health ... plan, provider claims , icd-10 Top Skills Details: managed care, claims adjudication , claims resolution, claims analysis,health plan,provider claims … more
- AdventHealth (Maitland, FL)
- …app provider types + Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 CPT, CPT, HCPCS II, DRG ... (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data… more
- JBS USA (Greeley, CO)
- …or mathematics, or 5 years of insurance related field. + Strong understanding of claims adjudication process and legal procedure. Claims adjuster licensure, ... **Description** Insurance Risk Analyst Purpose and Scope/General Summary: We are currently...Scope/General Summary: We are currently seeking an Insurance Risk Analyst to join our Risk Management Department. As an… more
- CVS Health (Northbrook, IL)
- …Formulary and/or Rebate knowledge beneficial + Experience with Caremark business systems, claims adjudication , formulary, drug, and client systems with an ... convenient and affordable. **Position Summary** As a Rebate Formulary Analyst , you will perform a critical role in the...emphasis on the RxClaim adjudication platform beneficial + Medicare knowledge beneficial + Ability… more
- Adecco US, Inc. (Houston, TX)
- …Part D/Pharmacy benefit, and/or PBM experience related to eligibility, benefits and/or claims adjudication . Minimum of 1 years' experience Pharmacy claim ... products, CMS guidance, the Pharmacy Benefit Manager (PBM) claim adjudication system and translate concepts into practice. . Using...practice. . Using knowledge of Medicare Part D and claims processing be able to identify unique issues and… more
- J&J Family of Companies (Raritan, NJ)
- Senior Analyst , Government Rebate Operations (GRO) - 2406214136W **Description** Johnson & Johnson Health Care Systems, part of the Johnson & Johnson family of ... companies, is recruiting for a **Senior Analyst , Government Rebate Operations (GRO)** , located in **Raritan,...on all issues relating to rebate analysis and payments, adjudication of such payments on a timely basis and… more
- Teva Pharmaceuticals (Parsippany, NJ)
- Sr. Contract Compliance Analyst Date: Sep 25, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 58352 **Who we are** ... as Revenue Accounting and Gross to Net. + Understands fundamental mechanics of claims validation, rebate systems, and outside formulary tools such as MMIT and… more
- Baptist Memorial (Memphis, TN)
- …controls designed to ensure that processes and practices lead to appropriate adjudication of claims . This role requires thorough understanding of regulatory ... and downstream revenue cycle activities that impact the adjustment processing of claims . + Conducts risk assessments to define audit priorities by evaluating… more