- CareFirst (Baltimore, MD)
- …and reporting tools technology. **ESSENTIAL FUNCTIONS:** + Fulfill complex regulatory reporting requirements by understanding the external request and working ... priorities. + Able to effectively provide direction to and lead technical teams. + Must be able to meet...+ Understanding of federal, state, and local legislative and regulatory processes, public policy analysis and reporting requirements. +… more
- AON (IL)
- Reinsurance Business Analyst Aon are looking to recruit an experienced Reinsurance Business Analyst to join our team in the US. This is a Hybrid position and can ... experience will not be considered for this position. The DXC SICS Application Analyst is responsible for maintaining and enhancing the DXC SICS (Swiss Insurance … more
- The Cigna Group (Bloomfield, CT)
- …better health outcomes for all. Join our ambitious and compassionate team as a Market Insight Lead Analyst / Lead Research Analyst , where your insights ... to make a real impact, this is your opportunity to grow and lead . Responsibilities + Collaborate with cross-functional teams and clients to uncover strategic… more
- The City of Rochester, MN (Rochester, MN)
- …analytical studies; prepares and assists in the preparation of financial and regulatory reports, statements, and claims for reimbursement according to prescribed ... Senior Financial Analyst - RPU Print (https://www.governmentjobs.com/careers/rochester/jobs/newprint/5147764) Apply Senior...and assign codes in accordance with state reporting and regulatory requirements. + Review documents and claims … more
- Highmark Health (Columbus, OH)
- …experiences with care delivery. The incumbent will also act as a clinical lead and expert on various workgroups, ensuring policies are grounded in strong clinical ... monitoring, review, and timely updates in response to new evidence, regulatory changes, or escalated inquiries. + **Evidence-Based Clinical Criteria Writing:**… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Description: Summary: The Payment Integrity DRG Coding & Clinical Validation Analyst position has an extensive background in acute facility-based clinical ... Essential Accountabilities: Level I . Analyzes and audits acute inpatient claims . Integrates medical chart coding principles, clinical guidelines, and objectivity in… 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 ... claims function. Make your mark in Claims ...determinations, investigations, and trial and resolution strategies. + The analyst will investigate losses, orchestrate defense strategies for healthcare… more
- University of Miami (Miami, FL)
- …of Miami Health System IT Department has an opportunity for a full-time Epic Analyst - Hospital Billing. The Epic Analyst - Hospital Billing assists Associate Epic ... to optimize the application's configuration, function, and access. The Epic Analyst facilitates day-to-day application support and resolving application issues and… more
- Boswell Engineering (South Hackensack, NJ)
- …serves as a critical hybrid function, combining the financial stewardship of a Benefits Analyst with the regulatory rigor of a Leave & Compliance Administrator. ... and New Jersey Family Leave, ensuring all interactions meet legal thresholds. + Regulatory Filings & Reporting: Lead the preparation and submission of essential… more
- Aston Carter (Salem, OR)
- Job Title: Medical Coding Analyst Job Description The Medical Coding Analyst plays a critical role in ensuring accurate medical coding and compliance with ... a subject matter expert in coding workflows, documentation standards, and regulatory requirements, contributing to quality and efficiency across the organization.… more
- Lawrence General Hospital (Lawrence, MA)
- … Analyst , Revenue Cycle Applications Analyst , or Project Lead supporting patient accounting/billing, claims , and reimbursement workflows. + Healthcare ... support future salary growth. Position Summary: As the Revenue Cycle Applications Analyst , you will assume responsibility for supporting IDM (Imaging and Document… more
- Mount Sinai Health System (New York, NY)
- …onsite occasionally at 150 E 42nd Street Corporate Offices** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the ... goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced understanding...others in the Data Science team and takes the lead role in project initiatives. **Qualifications** + BA or… more
- Safran (Gainesville, TX)
- Dispute Resolution Analyst (Temporary) **Job details** **General information** **Entity** Safran is an international high-technology group, operating in the aviation ... IT - User support technician **Job title** Dispute Resolution Analyst (Temporary) **Employment type** Temporary **Contract period** N/A **Professional category**… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and integrity of ... methodologies, risk score calculations, enrollment, submissions, medical and pharmacy claims , and provider data. Incumbent is responsible for performing analyses… more
- Zions Bancorporation (Houston, TX)
- …risk topics and mindset to actively challenge inputs (eg vendor and business claims ). + Contribute to and lead internal initiatives, including methodology ... assessment ratings against the Bank's risk methodology, and in accordance with regulatory and industry standards. + Assess the adequacy of due diligence… more
- Trinity Health (Syracuse, NY)
- …position Monday - Friday, Day Shift Schedule **Position: Clinical Risk Management Analyst ** **Mission Statement:** We, St Joseph's Health and Trinity Health, serve ... healing presence within our communities. **POSITION SUMMARY** The Clinical Risk Management Analyst is responsible for the overall patient safety and clinical risk… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Cross and Blue Shield of Minnesota Position Title: Senior Submissions Business Analyst Location: Remote Career Area: Information Technology About Blue Cross and Blue ... Submissions Team by performing data analysis, quality assurance, and regulatory submissions with a focus onaccurateandcompleteandMedicare Advantage (MA) data.You'llcollaborate… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of ... score methodology, risk score calculation, enrollment, premiums, medical and pharmacy claims , and provider data. Incumbent is responsible for performing complex… more
- Cedars-Sinai (Beverly Hills, CA)
- …care we strive for. **What will you be doing:** The Senior Financial Analyst is responsible for assisting with the development, design, maintenance, coordination and ... reports, summarizing key data, trends, and recommendations for decision-makers. + Lead complex or special assignments related to managed care financial analysis.… more
- Prime Therapeutics (Baton Rouge, LA)
- …build the future of pharmacy with us. **Job Posting Title** Principal Pricing Analyst - REMOTE **Job Description** **The Principal Pricing Analyst leads complex ... management, profit drivers and the organization's financial value statement** ** Lead the development of financial analytic pricing methodologies, models, reports… more