- Healthfirst (VA)
- …disputes/appeals and provides guidance across all areas of the company with regards to claims editing and proper coding , billing, and payment. + Researches and ... **Duties & Responsibilities** : + Conducts routine assessments of current claims edits and ensures comprehensive and defensible editing across all Healthfirst… more
- Commonwealth Care Alliance (Boston, MA)
- …Claims Essential Duties & Responsibilities: * Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and ... Medicare and Medicaid * 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims , settlement, claims auditing… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim ... submission and timely review and resolution of coding related claim denials for professional services, FQHC, MSO,...with training new staff in all aspects of the Analyst role. PHYSICAL AND SE NSORY REQUIRE M ENTS:… more
- Healthfirst (MD)
- …across all Healthfirst product lines + Participate in special projects and advanced Claims Coding activities + Proactively identifies areas of opportunity with ... industry standards across all areas of the company with regards to claims editing and proper coding , billing, and payment + Researches and provides feedback on … more
- Mount Sinai Health System (New York, NY)
- …and timely payment of claims and collection. Provides education and guidance on coding and claims management to billing and other FPA staff. Confers with ... Financial Specialists, Billing Coordinators and other FPA staff in coding and claims management. + Meets with...and other FPA staff in coding and claims management. + Meets with Chairman, department management/leadership and… more
- Geisinger (Danville, PA)
- …reports. Makes reimbursement or recovery recommendations based on appropriate coding , billed statistics, policies, industry standards and compliance with ... Health Plan departments by providing review and recommendation for correct coding , appropriate billing, and reimbursement. + Completes clinical reviews related to… more
- Healthfirst (FL)
- …a simple and easy to understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively communicate with all levels of the ... + Assist in the on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing, reference data and… more
- Molina Healthcare (UT)
- …Interfaces with the customer in developing requirements for major complex claims testing projects within Medicare, Medicaid and Marketplace; prepares system test ... business and business systems **PREFERRED EXPERIENCE:** Medicare, Medicaid and Marketplace claims knowledge Complex SQL and Excel expert knowledge SQL query and… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …the Patient Financial Services Director, the Nurse Auditor/ Revenue Integrity/ CDM Analyst is responsible for performing audits of itemized charges versus the ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising… more
- MTA (Flushing, NY)
- …- Max: $76,579 Summary MTA Bus Company is seeking a Workers' Compensation claims analyst . Responsibilities include: + Responsible for handling a full caseload ... Analyst Series (Law Department) Job ID: 9578 Business...Ensure claims files are properly documented and claims coding is correct. + Collaborate with… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan is looking for an Intermediate Clinical Auditor/ Analyst to join the Quality Assurance team! This role will work standard daylight hours, Monday - ... Steel Tower, however, this role may work remotely. The Intermediate Clinical Auditor/ Analyst is an integral part of the Quality Assurance and Operational Integrity… more
- Phoebe Ministries (Allentown, PA)
- …any claim adjustments that may be required based on Medicaid protocols to adjudicate claims . The Medicaid analyst will review, prepare, and submit responses to ... Medicaid Analyst Full-time - Allentown, PA Phoebe Ministries is...experience in related positions required. + Experience in medical claims billing/ coding ; experience with insurance follow-up processes/procedures;… more
- Fairview Health Services (St. Paul, MN)
- …is offering a great opportunity for a Revenue Intergrity Charge Description Master Analyst . Here are some key points about the position: + **Location:** University ... Job Description** **Job Summary:** The Revenue Integrity Charge Description Master Analyst serves as a liaison between organizational leadership, end-users, project… more
- Banner Health (AZ)
- …reimbursement As a Revenue Integrity Analyst you will work with a variety of claims , correcting coding or charging errors that may prevent a bill from going ... used: FinThrive, Cerner, MS4 **Desired Experience: Acute Charge Capture Analyst experience, a minimum of 2-3 years. Coding... Analyst experience, a minimum of 2-3 years. Coding certifications are a plus.** **Schedule: Monday - Friday… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Senior Billing Coordinator- Analyst MSH Adolescent Health Center FT Days** The Senior Billing Coordinator and Analyst is an experienced ... Accounts Receivable, Charge Entry, Edits and Payment Posting. The Senior Billing Coordinator- Analyst is proficient in these processes to ensure accurate and timely… more
- Idaho Division of Human Resources (Idaho Falls, ID)
- Analyst - DMS Posting Begin Date: 2024/11/06 Posting End Date: 2024/11/27 Category: Accounting and Finance Sub Category: Medical Billing & Coding Work Type: Full ... waste and abuse in the Medicaid program. As an analyst , you will play a crucial role in conducting...a crucial role in conducting preliminary investigations by reviewing claims data and medical records, reviewing provider billing practices,… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Self-insured claims experience. + Union experience a plus. + Knowledge of claims processing and medical coding a plus. + Project management experience ... About The Role MagnaCare is seeking an ERISA Benefits Analyst to Multiemployer/Labor Union ERISA medical benefits administration, documentation...document and work with IT and Operations to ensure claims are properly coded into the claims … more
- Trinity Health (Niskayuna, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Medical Billing Analyst - Cardiology Associates of Schenectady - Niskayuna, NY - Full Time** ... If you are looking for a Billing Analyst position in Albany, Full time, this could be...Medical Associates. **Responsibilities:** + Responsible to monitor and resolve Claims Workqueues; Specifically, Front End, Referrals & Authorizations, and… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Revenue Cycle Analyst - Full-time - Hybrid** If you are looking for a Revenue Cycle Analyst ... schedule 1 Work from home day a week **What you will do:** The Billing Analyst is responsible for performing a variety of clerical duties related to the efficient… more
- Flynn Restaurant Group (Independence, OH)
- **Position Description** The Risk Analyst is a member of the Flynn Risk team and assists the team on various data collection and projects. Needs to be detail ... orientated and well organized. Responsible for all departmental invoice coding , assisting with bonds, adding new locations to insurance coverage, insurance renewals,… more