- 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
- Molina Healthcare (MI)
- **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- Molina Healthcare (WA)
- **JOB DESCRIPTION** **Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and ... 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… more
- AIG (Chicago, IL)
- Senior Claims Analyst , Severity Join us as a Senior Claims Analyst to grow your experience in Claims . Make your mark in Claims Our Claims ... an impact + This position will ensure high quality claim handling in the Healthcare Professional Liability ("HPL") Claims Department of General Insurance (AIG, … more
- Robert Half Accountemps (Sterling Heights, MI)
- Description We are offering a short term contract employment opportunity for a Medical Claims Analyst in STERLING HEIGHTS, Michigan. This role is in the ... healthcare benefits industry and will primarily be focused on...Minimum of three years of experience as a Medical Claims Analyst or in a similar role… 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 ... business and business systems **PREFERRED EXPERIENCE:** Medicare, Medicaid and Marketplace claims knowledge Complex SQL and Excel expert knowledge SQL query and… more
- The Cigna Group (Bloomfield, CT)
- …work independently and as a team + Strongcommunicationskills + 5+ years of healthcare claims lifecycle; configuration design, editing, claims system ... of business within The Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst ....a Claims Systems Configuration Quality Review Senior Analyst . For this **highly technical senior configuration** role, you'll… 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 ... 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… 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 ... line of business within The Cigna Group, is hiring a Claims System Configuration Lead Analyst . This **highly technical systems** role acts as the Subject Matter… 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 ... EviCore, a division of The Cigna Group is hiring a ** Claims Systems Configuration Senior Analyst .** For this senior level role, you'll be responsible to resolve… more
- Hackensack Meridian Health (Edison, NJ)
- …community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The **Applications Analyst ... Professional Billing Administration as well as Epic Resolute Hospital Billing Claims / Electronic Remittances and/or Resolute Professional Billing Claims … more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: Nov 19, 2024 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 57268 **Who we are** Teva ... healthier lives. Join us on our journey of growth! **The opportunity** The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes… more
- New York State Civil Service (Albany, NY)
- …DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office Occupational Category ... and mentoring skills. Duties Description Primary PurposeSenior Cost Control Analyst reviews and recommends approval of construction change orders, analyzes… more
- Molina Healthcare (IA)
- …for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare ... is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $21.82 - $51.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. more
- Insight Global (Philadelphia, PA)
- Job Description A large healthcare system is looking to hire a Lead Epic Claims Analyst in North Philadelphia. The role is hybrid - Monday and Friday WFH, ... https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements Epic Hospital billing and claims billing experience in support and implementations Resolute Hospital… more
- Fairview Health Services (Minneapolis, MN)
- **Overview** The Senior Application PB/HB Claims Analyst role with Epic Hospital and/or Professional billing (HB and/or PB) will provide technical expertise and ... or problem resolution. . Demonstrated working knowledge and expertise of healthcare processes and application system coordination. . Demonstrated knowledge of… more
- Elevance Health (Atlanta, GA)
- …analyzing, documenting and coordinating the resolution of escalated and/or complex claims issues that span across multiple operational areas and requires expert ... Coordinate the identification and resolution of root causes involving configuration, claims and/or contracting activities. **Requirements:** + a BA/BS degree and 5… more
- Catholic Health Services (Melville, NY)
- …are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace! Job ... Details Under minimal supervision, formulates and defines Resolute Hospital Billing/ Claims scope and objectives through research and fact-finding to develop or… 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 ... to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired +… 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 ... to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired +… more
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