- AON (Fort Wayne, IN)
- …for benefits is governed by the applicable plan documents and policies. #LI-CC1 #LI-HYBRID #LI- REMOTE 2551890 Claims Litigation Analyst K&K Insurance is a ... Claims Litigation Analyst K&K Insurance is...choose K&K for our unique insurance products and expert claims resolution . As part of an industry-leading… more
- Elevance Health (Atlanta, GA)
- **Rating/ Claims System Analyst ** **Location:** This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of ... one of our Elevance Health PulsePoint locations. The **Rating/ Claims System Analyst ** will be responsible for...+ Documents and tracks product defects. + Coordinates problem resolution with development and/or product vendors + May implement… more
- Commonwealth Care Alliance (Boston, MA)
- …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... **Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary… 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 - ... however, this role may work remotely. The Intermediate Clinical Auditor/ Analyst is an integral part of the Quality Assurance...procedural and diagnosis codes have been used appropriately on claims . This role also acts as a SME for… more
- TEKsystems (Minneapolis, MN)
- …on meeting the January deadline. Role: Enterprise Risk Adjustment Submissions Analyst , Sr The Government Programs Enterprise Risk Adjustment Submissions Analyst ... operational work in support of Encounter Data Submissions activity. The ERA Submissions Analyst Sr performs research and analysis of submitted data, to comply with… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Senior Reimbursement-Chargemaster Analyst -Chargemaster/Projects - REMOTE ** The Senior Reimbursement and Chargemaster Analyst is ... maintaining competitive pricing. This individual is a senior level analyst who assumes a lead role and works closely...and reimbursement to ensure compliance with Federal and State claims submission regulations + Ensures the existence of accurate… more
- Prime Therapeutics (Columbus, OH)
- …drives every decision we make. **Job Posting Title** Senior Benefit Plan Configuration Analyst - Remote Preferably in California **Job Description Summary** This ... application of advanced and complex level benefit design requirements. A successful Senior Analyst will ensure a high level of quality and accuracy through benefit… more
- AssistRx (Orlando, FL)
- The Data Quality Analyst is responsible for acquiring, managing and analyzing data that will be presented to internal teams, clients and partners. The Data ... Analyst leads the onboarding of electronic data trading partners...client data submissions and communicating with them in the resolution of data quality issues. Successful applicants will have… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Business Analyst will have the responsibility to ensure that the business's need for changes to processes, policies and/or ... on cost of care savings projects is great and/or govt programs claims knowledge. **ESSENTIAL FUNCTIONS:** + Interpret business needs and issues by gathering,… more
- PeaceHealth (Vancouver, WA)
- **Description** PeaceHealth is seeking a Applications Systems Analyst for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth ... successful candidate is certified in Resolute Hospital Billing /administration. HB Claims and Remittance certification preferred. Must currently reside in WA, OR,… more
- Molina Healthcare (WI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... system and other applicable systems. + Participates in defect resolution for assigned component + Assists with development of...+ Must have experience working on SQL. + Medicare claims experience is a huge plus + Medicare Fee… more
- The Cigna Group (Seattle, WA)
- …requirements. **ESSENTIAL FUNCTIONS** + Perform efficient and effective network pharmacy claims audits to produce results consistent with departmental policies and ... base an informed, objective assessment of the accuracy and legitimacy of claims audited. + Utilizing personal knowledge of medications, prescription validity and… more
- Windstream Communications (Columbus, OH)
- …in internal investigations and support the TPA in bringing Third-Party claims to resolution . This is a full-time remote position and can sit anywhere in the ... in a world of infinite possibilities! ** ** The Risk Management Liability Analyst will act as a crucial liaison between Windstream employees, customers, and our… 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 ... of MN Medical Center East Bank Hospital, Minneapolis, MN + **Position:** Remote + **FTE:** 1.0 (80 hours per pay period) + **Shift:** day shift with no weekends… more
- Pharmacy Data Management, Inc. (OH)
- PDMI is looking for a Benefits Configuration Analyst to join our team! This role requires full knowledge of product-specific plan designs and benefit structures ... product lines related to their specific product designation. The Benefits Configuration Analyst must understand the specific products within their control and is… more
- Maryland Department of Transportation (Anne Arundel County, MD)
- Labor Relations Analyst (HR Analyst I) Salary $53,808.00 - $86,322.00 Annually Location Anne Arundel County Job Type Full Time Remote Employment ... + Description + Benefits + Questions Description Labor Relations Analyst (HR Analyst I) Grade 14 Job...Attending meetings to officially gain insight regarding employee's dispute claims based on evidence and testimony presented in grievance… more
- Integra Partners (Troy, MI)
- …member to help us turbocharge our analytical capabilities and thinking. The Business Analyst role will report to the Service Operations Director to support the ... overall development and growth of the Customer Service, Provider Claims & Appeals and Escalations departments, playing a key role in our growth and driving our… more
- Point32Health (VA)
- …of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and ... and have the judgment to seek out guidance as needed. The Analyst is responsible for the accurate coordination, efficient administration and resolution… more
- NRG Energy, Inc. (Houston, TX)
- …your career development, goals and future! **Job Summary:** The Customer Relations Analyst role is imperative to the day-to-day business functions. This role is ... customer journey to connect back relevant key metrics/measurements. The CR Analyst will lead programs that drive engagement, satisfaction, loyalty, retention, and… more
- University of Miami (Miami, FL)
- …please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . Remote Option Available The University of Miami ... an exciting opportunity for a full time Epic Senior Analyst - Resolute Professional Billing. The Epic Senior ...Support s junior staff members in the evaluation and resolution of service tickets, identification and implementation of application… more