- 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** ... healthier lives. Join us on our journey of growth! **The opportunity** The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process… more
- Phoebe Ministries (Allentown, PA)
- …claim adjustments that may be required based on Medicaid protocols to adjudicate claims . The Medicaid analyst will review, prepare, and submit responses ... Medicaid Analyst Full-time - Allentown, PA... Medicaid Analyst Full-time - Allentown, PA Phoebe Ministries is...responsible for the submission of all 180-day exception unit claims . Payments associated with Medicaid will require… more
- Sumitomo Pharma (Columbus, OH)
- …to resolve disputes and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid ... a dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
- New York State Civil Service (New York, NY)
- …clinic owner for defrauding New York State out of more than $4 Million in false Medicaid claims ; and the extradition, arrest, and arraignment of a Medicaid ... NY HELP No Agency Attorney General, Office of the Title Legal Support Analyst : Support Medicaid Fraud Investigations (6348) Occupational Category Legal Salary… more
- New York State Civil Service (New York, NY)
- …for defrauding New York state out of more than $4 Million in false Medicaid claims .Duties: * Assisting with screening and evaluating complaints of abuse and ... Agency Attorney General, Office of the Title Legal Nurse: Medical Analyst Support Medicaid Fraud Cases (6345) Occupational Category Legal Salary Grade NS… more
- Commonwealth Care Alliance (Boston, MA)
- …coding (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment ... TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible...Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims ,… more
- Elevance Health (Miami, FL)
- **Business Information Analyst Senior- Medicaid ** **Location:** This position will work a hybrid model (remote and in office 1-2 days per week). Ideal candidates ... of our Pulse Point location in Miami, FL. The **Business Information Analyst Senior- Medicaid ** is responsible for analyzing, reporting, and developing… more
- Molina Healthcare (UT)
- …Summary** Interfaces with the customer in developing requirements for major complex claims testing projects within Medicare, Medicaid and Marketplace; prepares ... a combination of applicable business and business systems **PREFERRED EXPERIENCE:** Medicare, Medicaid and Marketplace claims knowledge Complex SQL and Excel… more
- Molina Healthcare (Long Beach, CA)
- …SQL. + Must be able to conduct root cause analysis in Healthcare Porvider claims data.. + Experienced in Healthcare domain specifically Medicare, Medicaid and ... Marketplace. **JOB QUALIFICATIONS** **Required Education** HS Diploma or GED **Required Experience** 0-1 year **Preferred Education** Associate degree or equivalent combination of education and experience **Preferred Experience** 1-3 years To all current… more
- State of Georgia (Fulton County, GA)
- Investigative Auditor - Medicaid Fraud Georgia - Fulton - Atlanta (https://careers.georgia.gov/jobs/52416/other-jobs-matching/location-only) Hot ... Sign Up for Job Alerts Office of the Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL… more
- MyFlorida (Tallahassee, FL)
- …Agency's Medicaid fiscal agent; responsible for the processing of Florida Medicaid claims and multiple supporting systems; ensuring Medicaid providers ... Analyst Supervisor, AHC Administrator, and the Chief of Medicaid Fiscal Agent Operations. -Serving as a Medicaid...or similar health care work experience. -Preference given for Medicaid encounter or claims data work experience.… more
- Staffing Solutions Organization (Albany, NY)
- …understanding of database structures and business context of various elements related to Medicaid claims . Related efforts will include the production of reports ... Medicaid Program Advisor One Commerce Plaza, Albany, 99...Advisor, Albany NY** **DDSA - 1140** **Summary** The **Data Analyst ** will work within the Division of Data Services… more
- Idaho Division of Human Resources (Boise, ID)
- Business Analyst - MED Posting Begin Date: 2024/11/05 Posting End Date: 2024/12/03 Category: Business Work Type: Full Time Remote: Flexible Hybrid Location: Boise, ... HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS The Division of Medicaid has an exciting opportunity for sixbusiness analyststo join...This new system will provide the opportunity for an Analyst that enjoys being on the cutting edge of… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …the Patient Financial Services Director, the Nurse Auditor/ Revenue Integrity/ CDM Analyst is responsible for performing audits of itemized charges versus the ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising… more
- Prime Therapeutics (Glen Allen, VA)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... our passion and drives every decision we make. **Job Posting Title** Lead Business Analyst **Job Description** The Business Systems Analyst (BSA) Lead IT is… more
- Kepro (Albany, NY)
- …including coaching and mentoring and performance reviews + Strong knowledge in Medicaid Management Information System around Claims processing and related ... This is a hybrid role based in Albany NY Acentra is looking for a Business Analyst Manager to join our growing team. Job Summary: Business Analyst Manager is… more
- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Analyst III (ALD) Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... to achieve that purpose. Job Summary The Payment Integrity Analyst III is responsible for leading or assisting in...Required: Knowledge in CPT, HCPCS, ICD-9, ICD-10, Medicare, and Medicaid rules and regulations. Working knowledge of claims… more
- Elevance Health (Columbus, OH)
- …+ 4+ years of experience in the US Healthcare domain (Commercial/ Medicaid /Medicare) supporting pharmacy including claims processing and benefit administration ... **PBM Clinical/Benefit Testing Analyst III (Business Analyst III)** _Location:...Pharmacy benefit setup & validating the configuration using test claims /query testing. + Validation of Formulary, Utilization Management &… more
- VNS Health (Manhattan, NY)
- OverviewFunctions at the most senior level Business Systems Analyst role. Works directly with senior management on highly visible projects to understand business ... to meet operational, business and clinical needs. Acts as lead Business Systems Analyst on team; coordinates exchanges of knowledge and ideas, and mentors business… more
- Elevance Health (Mason, OH)
- …within SQL, SAS, Excel, or equivalent preferred. + Proficiency in analyzing Medicaid claims data preferred. + Experience analyzing and building valued ... **Provider Contract Analyst Senior** **Location:** This position will work a...to ensure data accuracy preferred. + Experience working with claims and provider contracts for the Medicaid … more