- EM Key Solutions, Inc. (Washington, DC)
- …to elicit business requirements and analyze processes for technology solutions (including automated claims processing ). The Business Analyst will serve as a ... Washington, DC, USA | Contract Business Requirements Analyst This is a Remote Position EMKS/CORTEK is...and Outlook. + Knowledge and understanding of VBA pension claims (including variations for dependents) are preferred. + Experience… more
- CVS Health (Hartford, CT)
- …state timelines requirements **Required Qualifications** + 2+ years of claims processing or prior medical claim analyst experience. + Demonstrates the ... assets and resources of the Company. + Review pre-specified claims for potentially fraudulent activity and return those ...claims for potentially fraudulent activity and return those claims to the claim operations team for proper adjudication.… more
- Randstad US (Phoenix, AZ)
- claims analyst iii. + phoenix , arizona (remote)...Ability to multi-task and be agreeable to change Skills + Claims + Claims Processing + Banking ... and weekend off. Paid weekly We are looking for Claims Analyst III with a heavy finance...accuracy and productivity Contributes subject area expertise to determine processing guidelines and assess if standards have been met… 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...auditing, benefit functions, and billing functions * Knowledge of claims processing , disability claims , and… more
- Healthfirst (FL)
- …benefits, claims editing, reference data and system functionality within the claims processing system. + Analyze explanation of coverage documents to assist ... understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively...and eligibility administration systems (ie PowerMHS or any other claims processing systems). + Proficiency in medical… more
- Acosta Group (Charlotte, NC)
- …to best practices and account instructions. + Maintain a diary system and complete a claims analyst summary form timely and consistently. + Attend business unit ... **DESCRIPTION** The Sr. Casualty Risk Analyst will assist the Director of Risk Management...+ Ability to learn new systems / software for claims processing , process documentation, or other technology… more
- Commonwealth Care Alliance (Boston, MA)
- …Revenue Integrity, Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills & Abilities (must have):** ... of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective … more
- The Cigna Group (Bloomfield, CT)
- … Analyst . This highly technical systems role requires the review of our claims processing system to ensure all configurations were input correctly into the ... system per the specifications of the provider. The Claims System Configuration Senior Analyst will have in depth knowledge of the eviCore claims systems and… more
- MyFlorida (Tallahassee, FL)
- VICTIM COMPENSATION CLAIMS ANALYST - 41000485 Date: Nov 25, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify ... Office of the Attorney General Working Title: VICTIM COMPENSATION CLAIMS ANALYST - 41000485 Pay Plan: Career...clerical or administrative experience in the areas of: accounting; claims processing ; claims or benefits… more
- Molina Healthcare (MI)
- …claims projects + Assists with reducing re-work by identifying and remediating claims processing issues + Locate and interpret regulatory and contractual ... standard principles and applicable state specific policies and regulations to identify claims processing errors + Applies claims processing and technical… more
- The Cigna Group (Bloomfield, CT)
- …Lives?** EviCore, a line of business within The Cigna Group, is hiring a Claims System Configuration Lead Analyst . This **highly technical systems** role acts as ... 3+ years of experience as a subject matter expert for claims system configuration, processing , reporting, issue triage and testing - REQUIRED + Project… 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
- Armed Forces Benefit Association (Lincoln, NE)
- …to deliver total health and wellbeing to employer groups and their employees. The Claims Analyst is an operations and sales support role responsible for managing ... and Client Management teams where needed and provide group claims experience reporting for renewal processing . +...provide group claims experience reporting for renewal processing . + Adjudicate voluntary health and wellness claims… more
- New York State Civil Service (Albany, NY)
- …DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office Occupational Category ... and mentoring skills. Duties Description Primary PurposeSenior Cost Control Analyst reviews and recommends approval of construction change orders, analyzes… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also ... be responsible for analyzing claims and making decisions about their validity. The position...change to provide continuous improvements. **RESPONSIBILITIES** + Processes escalated claims , assesses the reason for the escalation, and provides… more
- Acosta Group (Irving, TX)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also ... be responsible for analyzing claims and making decisions about their validity. The position...change to provide continuous improvements. **RESPONSIBILITIES** + Process escalated claims , assesses the reason for the escalation, and provides… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also ... be responsible for analyzing claims and making decisions about their validity. The position...change to provide continuous improvements. **RESPONSIBILITIES** + Processes escalated claims , assesses the reason for the escalation, and provides… more
- Healthfirst (VA)
- **Duties & Responsibilities** : + Conducts routine assessments of current claims edits and ensures comprehensive and defensible editing across all Healthfirst ... systems and edits. + Monitors and reports on performance of current claims editing packages + Supports claims editing escalated provider disputes/appeals… more
- Molina Healthcare (WA)
- …**Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and accurate reports. As ... team member, this role leads efforts to ensure the claims teams and other departments have access to quality... teams and other departments have access to quality claims data through processes which are efficient, accurate, and… more
- Adecco US, Inc. (Phoenix, AZ)
- …the Phoenix area and have the following qualifications** : + **1-2 Years Claims Processing /Reviewing Experience** + Strong Computer Skills + Works full range ... We are currently looking for Claims Representatives for a Remote Opportunity. **You MUST...of claims , correspondence, quality assurance and escalations. + Attention to… more
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