- CGI Technologies and Solutions, Inc. (Atlanta, GA)
- ** HealthCare Claims Intelligence Engineer** **Category:** Analytics and Emerging Digital Technologies **Main location:** United States, Georgia, Atlanta ... (ML), data analysis, Business Intelligence and Data Visualizations to streamline the claims processing, Payment Integrity and healthcare analytics systems. This… more
- CenterWell (Topeka, KS)
- …caring community and help us put health first** As an **Accounts Receivable Specialist/ Healthcare Claims Denials Specialist** , you will: + Ensure the ... High School Diploma or the equivalent + Minimum of two years medical claims processing experience + Knowledge of healthcare collection procedures and… more
- Guidehouse (San Antonio, TX)
- …/ business setting. **What Would Be Nice To Have** **:** + Has active understanding of healthcare claims appeal process + UB-04 / CMS 1500 background + PC skills ... You Will Need** **:** + High School Diploma/GED or 3 years of relevant healthcare and/or business experience in lieu of High School Diploma/GED. + 0-2+ years… more
- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within a world-class ... create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims Department of General… more
- Guidehouse (Lewisville, TX)
- …billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the meeting of both ... Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides...GED. + 0-2+ years working within the following sectors: healthcare , insurance, business, finance or customer service. + Working… more
- System One (Reston, VA)
- Job Title: Domain Architect - Healthcare Claims Location: Remote - EST/CST ONLY (onsite required once per quarter / 4 times per year ) Role Type: 12+ months ... optimization by introducing capabilities (inclusive of all functions) for their Healthcare Claims domain of responsibility utilizing in-depth knowledge and… more
- Commonwealth Care Alliance (Boston, MA)
- CCA- Claims Essential Duties & Responsibilities: * Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and ... on edits implemented. * Utilize data to examine large claims data sets to provide analysis and reports on...job. Required Experience (must have): * 7+ years of Healthcare experience, specific to Medicare and Medicaid * 7+… more
- Guidehouse (San Antonio, TX)
- …GED. + 0-2+ year's experience in office, business, operations, customer service or healthcare field. **What Would Be Nice To Have** **:** + Knowledge and utilization ... of desktop applications to include Word and Excel is essential for job responsibilities. + Ability to initiate and follow through on projects and work independently with minimal supervision. + For insurance specific clients: 1+ year medical provider experience… more
- The Cigna Group (Bloomfield, CT)
- …with all MS office products including PowerPoint - REQUIRED + 5+ years of healthcare claims life cycle experience, emphasis in claims system requirements ... of business within The Cigna Group, is hiring a Claims System Configuration Lead Analyst. This **highly technical systems**...Matter Expert (SME) for the Configuration of the eviCore Claims Systems and the suite of eviCore Claim Products.… more
- The Cigna Group (Bloomfield, CT)
- …work independently and as a team + Strongcommunicationskills + 5+ years of healthcare claims lifecycle; configuration design, editing, claims system ... EviCore, a line of business within The Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst. For this **highly technical senior… more
- The Cigna Group (Bloomfield, CT)
- …to succeed:** + High School Diploma or GED Required + 5+ years of healthcare claims lifecycle; configuration design, editing, claims system requirements, and ... Improve Lives? Do you have **advanced** **technology skills with Claims Systems Configuration,** SQL querying, MS Access, Excel and...a division of The Cigna Group is hiring a ** Claims Systems Configuration Senior Analyst.** For this senior level… more
- The Cigna Group (Bloomfield, CT)
- …School Diploma or GED required, bachelor's degree preferred + **5+ years of healthcare claims lifecycle; configuration design, editing, claims system ... a division of the Cigna Group is hiring a Claims System Configuration Senior Analyst. This highly technical systems...highly technical systems role requires the review of our claims processing system to ensure all configurations were input… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Advantage, Medicare Supplement, and individual plans. Processes routine to moderately complex healthcare claims and responds to inquiries from third party ... knowledge or experience._** **Responsibilities** . Processes routine to moderately complex healthcare claims and/or adjustments while providing customer service… more
- Insight Global (St. Petersburg, FL)
- …. Skills and Requirements - 3 years of experience in healthcare claims - Microsoft Office Suite- PowerPoint, word, outlook, ... Job Description A client of Insight Global is looking for a Regulated Claims Settlement Coordinator to site remotely. The role involves preparing and presenting the… more
- Molina Healthcare (KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and contract data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Molina Healthcare (KY)
- **Knowledge/Skills/Abilities** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (NM)
- …work during EST hours **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Henry Ford Health System (Troy, MI)
- …with industry professionals, enabling you to develop valuable skills in the healthcare and insurance sector. In addition to helping your assigned department meet ... PROGRAM DUTIES/RESPONSIBILITIES: + Conduct comprehensive research on industry trends, healthcare policies, and emerging technologies. Analyze data and prepare… more
- AIG (Chicago, IL)
- …an impact + This position will ensure high quality claim handling in the Healthcare Professional Liability ("HPL") Claims Department of General Insurance (AIG, ... Senior Claims Analyst, Severity Join us as a Senior...The analyst will investigate losses, orchestrate defense strategies for healthcare provider insureds, conduct independent assessments as to exposures… more
- Healthfirst (NY)
- …sum product, array formulas). + Knowledge of SQL, Medicaid/Medicare programs, Healthcare Claims and/or reimbursement preferred. Minimum Qualifications: + ... sum product, array formulas). + Knowledge of SQL, Medicaid/Medicare programs, Healthcare Claims and/or reimbursement preferred. Preferred Qualifications: +… more
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