- Commonwealth Care Alliance (Boston, MA)
- …the Sr . Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr . Analyst will be responsible for developing prospective ... Integrity, Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills & Abilities (must have):** + Knowledge… more
- Molina Healthcare (Nicholasville, KY)
- …data received on claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to identify defects in ... and timely production review of issues reported within our claims intake and processing ecosystem (QNXT, Edifecs,...issues reported within our claims intake and processing ecosystem (QNXT, Edifecs, etc.). Gains understanding of solution… more
- Samsung SDS America (Santa Ana, CA)
- …("SEA") and its Loss Control Group, as well as the Samsung SDS's Management/Finance Group. Sr . Claims Analyst will work on tracking and analyzing claim data, ... services in 2012 and has now grown into a global top-level third-party logistics company. Senior Logistics Claim Analyst (" Sr . Claim Analyst ") will be… more
- ADM (Decatur, IL)
- **88365BR** **Job Title:** Sr Risk Analyst Property - Decatur, IL **Department/Function:** Risk Management **Job Description:** ** Sr Risk Analyst ... to global and regional colleagues about the overall program functioning; **Property Claims Coordination Duties:** + Provide initial guidance to all business units… more
- Zions Bancorporation (Houston, TX)
- …endless. You bring the talent; we bring the opportunity. We are looking for a Sr . Supplier Risk Analyst to join the Supply Chain Management Department. The ... and addressing control weaknesses identified through control assessments. The Sr Supplier Risk Analyst role is a...mindset to actively challenge inputs (eg vendor and business claims ). + Contribute to and lead internal initiatives, including… more
- Catholic Health Initiatives (Houston, TX)
- …offering adult and pediatric care for the Greater Houston area. **Responsibilities** Sr . Planning Analyst is responsible for coordination of planning analytics ... and internal data sources and develops related presentations to support senior -level decision-making. Provide analytical support as needed to assist Marketing and… 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 ... of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing , etc.) + Knowledge of healthcare financial terms… more
- Healthfirst (NY)
- …pharmacy team. + Monitor and analyze key data and procedures for proper claims processing and adjudication system functionality. + Perform Quality Control and ... + Provide timely support to other areas to verify and analyze claims processing cases, eligibility and other operational situations and/or issues as they relate… more
- Healthfirst (NY)
- …pivot tables, filtering and formatting. + Knowledge of healthcare financial terms and claims processing . + Basic understanding of Medicaid and Medicare programs ... core system (MHS) + Validate repricing/reprocessing projects outcome and follow up with Claims Operation teams for any fallout + Additional projects and duties as… more
- Walgreens (Deerfield, IL)
- …"An Equal Opportunity Employer, including disability/veterans". **Job ID:** 1400298BR **Title:** Senior Analyst , Liability Claims **Company Indicator:** ... of all laws and practices pertaining to the investigation, processing and settlement of Liability claims . +...the investigation, processing and settlement of Liability claims . + Develops and recommends the implementation of changes… more
- DHL Express, Inc. (Plantation, FL)
- …and Global customer contracts, contract amendments, Letters of Agreement, NDAs, Claims Waivers, specialized agreements and other documents. Review customer redlines ... **Problem Complexity:** Performs professional level work that typically requires processing and interpreting, more complex, less clearly-defined issues. Identifies… more
- Robert Half Finance & Accounting (Miami, FL)
- Description We are offering an exciting opportunity for a Senior Claims Analyst to join our team in Miami, Florida. As Senior Analyst , you will play ... minimum of 7 years of relevant experience as an Analyst . * Proficiency in Atlassian Jira is required. *...Ide and Eclipse tools is necessary. * Experience in Claims Processing and Claims audits… more
- Entergy (Little Rock, AR)
- … claims experience, litigation paralegal/secretarial work or equivalent experience. + **Associate Analyst - Claims , Sr :** 7+ years of property & casualty ... or equivalent. + Desired: Associates degree. **Minimum experience required of the position** + **Associate Analyst - Claims :** 3+ years of property & casualty… more
- Fallon Health (Worcester, MA)
- …BS - Mathematics, Finance, Economics, Management, other **Experience:** + Strong claims processing skill, understanding of medical terminology, and familiarity ... encounter submissions vendor for resolution + Work with the Senior Risk Adjustment Analyst on monthly operational...+ * Working knowledge of the provider-based healthcare industry, claims processing , provider billing or Risk Adjustment… 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 ... + Basic or advanced understanding of payment integrity, claim processing and/or revenue cycle for healthcare claims ...people who could be pretending to be recruiters or senior professionals at Zelis. Zelis is modernizing the healthcare… more
- City of Stockton, CA (Stockton, CA)
- …selection, and job analysis techniques; + General practices and procedures related to processing claims ; + Basic statistical concepts and methods; + Basic ... Human Resources Analyst II/ Senior Human Resources Analyst...City of Stockton, CA Job Type At-Will Job Number 0924-HRAnalystII/ SR Department Human Resources Opening Date 09/06/2024 Closing Date… more
- Elevance Health (Columbus, OH)
- …and other performance measurement techniques. + Oversee all activities related to claims processing . + Primary oversight and responsibility for delegated ... **Rating/ Claims System Senior Advisor** **Location:** This...claims functions performed by third party vendor, including claims processing and fulfillment. + Oversee the… more
- Hawaiian Electric (Honolulu, HI)
- Senior Digital Forensic Analyst Date:Sep 9, 2024 Location: Honolulu, Hawaii (HI), US, 96814 Company: hawaiianel We recognize our competitive advantage -- our ... serves as a subject matter expert in preserving, collecting, processing , reviewing, analyzing, and producing electronically stored information for...- Oahu Hiring Range: The hiring range for the Senior Digital Forensic Analyst [Req ID 9126]… more
- AdventHealth (Maitland, FL)
- …strongly preferred. + Managed Care, Patient Financial services, health insurance claims processing , contract management, or medical economics required + ... 3 days at the office (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …cost estimation. Many of these systems rely on core business functions (ex. claims processing , provider contracting, network management) and a complex ecosystem, ... us transform healthcare? Bring your true colors to blue. Senior Business Analyst - Cost Estimation As...and systems + Extensive experience with cost systems, data, claims processing , and benefits, including external vendor… more
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