- 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
- 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 (WA)
- …The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and accurate reports. As the ... senior level team member, this role leads efforts to ensure the claims teams and other departments have access to quality claims data through processes which… more
- Pacificorp (Salt Lake City, UT)
- Insurance Analyst (Mid/ Sr . Levels) - Salt Lake City, UT - #112960 **Date:** Nov 14, 2024 **Location:** SALT LAKE CITY, UT, US, 84116 **Company:** PacifiCorp ... or programs. ** Sr . Level Responsibilities** **Additional Responsibilities of the Sr . Insurance Analyst position include the following:** * Perform… 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
- Kohler Co. (Kohler, WI)
- …+ Own & execute trade rebate program processes including enrollment, claims processing , and analysis/reporting of program performance. + Development, ... ** Sr . Market Analyst , Trade** _Work Mode:...customer-facing + Review & approve trade program co-op advertising claims **Skills/Requirements** + Requires a Bachelor's degree in marketing,… more
- National Vision (Duluth, GA)
- …priority, hard work is praised, and career growth is a reality. We are hiring for a Sr . Payroll Tax Analyst to join our growing team! This is a hybrid role ... limited to, tax overpayments and/or refunds, as well as penalty and interest claims . + Multi-State Tax Expertise: Manages payroll tax requirements across 44 states,… more
- University of Rochester (Rochester, NY)
- …regulatory requirements surrounding paired kidney and paired liver donation. + Support staff processing KPD claims and assist in resolving issues surrounding ... GENERAL PURPOSE: The Transplant Senior Finance Manager directs and plans the financial...claims payment and processing . **Cost Report:** + Acquire knowledge required to be… 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...+ Ability to learn new systems / software for claims processing , process documentation, or other technology… more
- Molina Healthcare (MI)
- **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
- American Academy of Pediatrics (Itasca, IL)
- …to affordable, high-quality pediatric care. + Analyze opportunities to ensure accurate claims processing and maximize payment for pediatric healthcare services. ... research, policy analysis, and medical liability/risk management. Reporting to the Sr Director, Child Health Financing Strategy, this role will research, develop,… more
- Molina Healthcare (KY)
- …for various departments * Complex database and data management responsibilities * Claims processing background * Basic knowledge of SQL Preferred ... all essential duties and responsibilities in order of importance)** + Analyze claims from compliance against contracts, billing, and processing guidelines +… 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
- Molina Healthcare (GA)
- …and conversion of new and existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is preferred. + ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office ... and/or construction complexity, environmental issues and other non-traditional project variables. Senior Cost Control Analyst also reviews and provides comments… 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 ... degree preferred + 3+ years of experience as a subject matter expert for claims system configuration, processing , reporting, issue triage and testing - REQUIRED… 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 ... conducts research to resolve customer initiated issues related to core systems processing ; and coordinates and manages project test resources in the development 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
- Citigroup (New Castle, DE)
- The Cash and Trade Proc Sr Analyst is an intermediate level role responsible for ensuring transactions are processed accurately and on time in coordination with ... day to day for all fraud - Counterfeit , Signature verification, Forgery Claims , Suspicious activity reporting, and Fraud wire. Will be responsible for having some… more
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