- 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
- Healthfirst (NC)
- …(CPT4, ICD9 or ICD10, and HCPCS), provider contract concepts and common claims processing /resolution practices. + Experience working with and leading ... any other time management system). + Experience with Power MHS or other claims processing systems necessary. + Comprehensive knowledge of managed care industry… more
- Prime Therapeutics (Columbus, OH)
- …complex queries to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing , healthcare, and/or related field + Must be eligible to ... and drives every decision we make. **Job Posting Title** Sr . Pricing Analyst - Pharmacy Network -... - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst participates in the assessment… more
- Point32Health (MA)
- …members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of coding, ... benefit, payment, and contract interpretation in accordance to claims processing guidelines, Point32Health Medical and Payment Policies and established audit… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** The Sr Business Applications Analyst will identify business requirements and solutions related to the support of the specific business area ... working in Medicare and/or Medicaid + Knowledgeable of regulations specific to claims coding and processing , enrollment and reconciliation transaction … more
- Sedgwick (Nashville, TN)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Data Analyst Sr - Remote **PRIMARY PURPOSE** : To create comprehensive ... reporting and analysis of statistical data; to monitor data for processing and procedures issues; and to support performance initiative by providing technical… more
- Molina Healthcare (Columbus, OH)
- **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
- City of New York (New York, NY)
- …York serving in a permanent civil service title of either Accountant, Staff Analyst , or Management Auditor. To be considered for the position, please clearly mention ... up to date to allow for efficiency in the processing of payments for businesses and individuals who are...are in contract with the City, as well as claims , workers' compensation, labor law, line of duty, certificate… more
- Deloitte (Austin, TX)
- …systems, and X12 testing. This role requires a deep understanding of healthcare claims processing and the ability to update companion guides. Key ... integration and functionality of enterprise healthcare systems involving Fee-For-Service (FFS) claims and Encounters. + Conduct thorough X12 testing to ensure… more
- The Cigna Group (Bloomfield, CT)
- …Growth and Change Lives?** EviCore, a division of the Cigna Group is hiring a Claims System Configuration Senior Analyst . This highly technical systems role ... requires the review of our claims processing system to ensure all configurations...the system per the specifications of the provider. The Claims System Configuration Senior Analyst … more
- Dignity Health (Glendale, CA)
- …and internal data sources and develops related presentations to support senior -level decision-making. Provide analytical support as needed to assist Marketing and ... including Data analysis (Microsoft Excel - expert level;) Word processing - proficient level; Data Base (Power BI -...use relational data sets/ tools such as Sg2 and claims data sets; and Cost Accounting systems + Demonstrated… more
- 3M (IN)
- …reports. Key Areas of Operations Customer relationship management Order Processing Order Management and Fulfillment Collaboration with internal stakeholders (SCM, ... general guidance within customer service areas, such as customer inquiries, claims and complaints, customer training, call center(s), invoicing and order management,… more
- 3M (IN)
- …reports. Key Areas of Operations 1. Customer relationship management 2. Order Processing 3. Order Management and Fulfillment 4. Upselling and obtaining regular ... general guidance within customer service areas, such as customer inquiries, claims and complaints, customer training, Portal Management, invoicing and order… more
- Robert Half Technology (Wilkes Barre, PA)
- Description We are in search of a Senior Claims Business Analyst to become a part of our team. As a Senior Claims Business Analyst , you will be ... and expectations of the business. * Experience in Claim Administration, specifically processing and managing insurance claims . Technology Doesn't Change the… more
- OneMain Financial (Baltimore, MD)
- ** Claims Analyst / Investigator** . Excited to grow your career? We value our talented Team Members, and whenever possible strive to help one of our Team Members ... you to apply! One Team, One Vision, OneMain The Claims Analyst / Investigator has an above average...aptitude related to personal loan and credit card claim/chargeback processing , lending, collections, or fraud investigations with the ability… more
- TXNM Energy (Albuquerque, NM)
- T&D Inspector, I- Sr Location: Albuquerque, NM, United States Job ID: 6088767 Date Posted:Jan 9, 2025 **POSTING DEADLINE** This position is posted until filled. ... **DEPARTMENT** Department: Customer Ops Work Management **JOB DESCRIPTION** ** Sr . T&D Inspector** Salary Grade: G06 Minimum Midpoint Maximum $74,796 - $100,975 -… more
- The Hartford (Lake Mary, FL)
- …our team as we help shape the future. The Hartford is seeking to hire a Senior Litigation Analyst to join our Legal team. We are looking for motivated attorneys ... conduct in office Legal Bill Review audits. As a Senior Litigation Analyst you will be expected...Hartford guidelines. + Perform quality legal bill review with processing of invoice fairly with the accurate amount of… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- … correctly; any necessary changes are being modified and programmed into the claims processing system. + Assist in reviewing clients Summary Plan Description ... into an internal source document. Primary Responsibilities + The Senior Benefits Analyst 's job responsibilities include, but...experience. + Union experience a plus. + Knowledge of claims processing and medical coding a plus.… more
- Honeywell (Charlotte, NC)
- Senior Benefits Analyst - Canada & US...& 401k We are looking for an experienced, data-driven Sr . Benefits Analyst to manage our Savings, Retirement ... Canada. You will need to partner with our outsourced administrators on the processing of the most complex calculations for plans, analyzing data and interpreting… 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
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