- Molina Healthcare (Dallas, TX)
- …Operations teams . Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... SKILLS & ABILITIES: . 2-5 years of experience in medical claims processing, research , or a related field . Demonstrates familiarity in a variety… more
- Wolters Kluwer (Dallas, TX)
- …highly skilled Business Analyst to join the Mediregs team focusing on claims processing and the RCM process. The ideal candidate will have a strong understanding ... for our customers. **Additional Information:** https://www.wolterskluwer.com/en/solutions/mediregs **Key Responsibilities:** + Research , analyze and interpret CMS rules and claims… more
- Molina Healthcare (Dallas, TX)
- …processing issues + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... cross functionally across multiple business areas. **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing… more
- Molina Healthcare (Dallas, TX)
- …+ Must have experience in research , review and audits for adjudication rates of claims + Must be able to work in cross functional teams + Must have experience ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Elevance Health (Grand Prairie, TX)
- **Business Information Analyst Sr. - Cost of Care** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must ... 50 miles of one of Elevance's Pulse Point locations. **The Business Information Analyst Sr. - Cost of Care** is responsible for providing utilization management… more
- Molina Healthcare (Dallas, TX)
- …ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, ... and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex...Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. +… more
- Molina Healthcare (Dallas, TX)
- **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs ... to suport Molina's Prospective and Retrospective Interventions. Assist with research , development,and completion of special projects. **Knowledge/Skills/Abilities** + Assist… more
- Molina Healthcare (Dallas, TX)
- **Job Description** **Job Summary** The Sr. Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- Bank of America (Plano, TX)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, Massachusetts; ... in managing competing priorities **Desired Qualifications:** + Fraud and/or Claims background with focus on Account Takeover a plus...+ Data and Trend Analysis + Innovative Thinking + Research **_It is unlawful in Massachusetts to require or… more
- Bank of America (Plano, TX)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, Massachusetts; ... degree in a quantitative discipline such as mathematics, statistics, operations research , finance, or business ▪ Advanced analytical and quantitative skills with… more
- Citigroup (Irving, TX)
- The Loan Doc & Proc Assoc Analyst is a developing professional role. This role identifies policy and applies specialty knowledge in monitoring and assessing ... + Possible interaction with other counterparties around positions and outstanding balances/ claims + Supports an expansive and/or diverse array of products (risk… more
- Molina Healthcare (Dallas, TX)
- …other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** + Performs research and analyses on a variety of topics related to the overall ... audits, compliance, recoveries, coordination with other departments. + Consolidates research and analyses into summarized findings and may develop recommendations… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... of assigned reports, document reporting processes and procedures. + Assist with research , development and completion of special projects as requested by various… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **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 findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL… more
- Molina Healthcare (Dallas, TX)
- …+ Actively participates in all stages of project development including research , design, programming, testing and implementation to ensures the released product ... operational processes including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business… more
- Molina Healthcare (Dallas, TX)
- …analysis. + Works with internal, external and enterprise clients as needed to research , develop, and document new standard reports or processes. + Implements and ... to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent… more
- Methodist Health System (Dallas, TX)
- …manage the organization's third party payer appeals through the ability to analyze, research and successfully appeal third party claims within timely filing ... Degree or High School Diploma with (4) four years as an Account Receivable analyst in a Hospital setting. * Professional Certification through AAHAM, HFMA, or EPIC… more