- Public Consulting Group (Boston, MA)
- …Education + Recovery Services **Duties and Responsibilities** + Analyzes the development of claims assigned at each level of the adjudication process. + Outlines the ... sent with applications. + Monitors and gives direction to Claims Developer regarding specific tasks on claims ....to Claims Developer regarding specific tasks on claims . + Provides monthly reporting statistics. + Ensures adherence… more
- Wolters Kluwer (Waltham, MA)
- …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 ... proficient in analyzing CMS rules as it relates to claims and processes. The candidate will be able to...grooming. **Qualifications:** + 3+ years as a Medicare/Medicaid Compliance Analyst - Revenue Cycle + 1 + years… more
- CAI (Boston, MA)
- …**Employment Type** Full time **Worksite Flexibility** Remote **Job Summary** As a Claims Processor Analyst , you will receive, investigate, and triage expedited ... case assignments. **Job Description** We are looking for a ** Claims Processor Analyst ** , you will receive,...claims **What You'll Need** Required: + At least 1 year of experience in health insurance claims… more
- Commonwealth Care Alliance (Boston, MA)
- …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... **Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary… more
- Prime Therapeutics (Boston, MA)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... and drives every decision we make. **Job Posting Title** Sr. IT Business Systems Analyst Remote **Job Description** The Business Systems Analyst (BSA) Lead IT is… more
- Prime Therapeutics (Boston, MA)
- …passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst - REMOTE **Job Description** The Business Systems Analyst (BSA) IT is ... document the requirements and technical solutions for changes to Prime's claims systems. **Responsibilities** + Ensure understanding of business requirements and IT… more
- Prime Therapeutics (Boston, MA)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Beth Israel Lahey Health (Charlestown, MA)
- …making a difference in people's lives.** **Job Description:** The Senior Financial Analyst reports directly to the Executive Director of Contracting Finance. This ... in-depth business knowledge with specialized technical and analytical skills. The analyst will be responsible for managing analyses from the conceptualization phase… more
- Prime Therapeutics (Boston, MA)
- …and drives every decision we make. **Job Posting Title** Sr Data and Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is ... experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in the implementation… more
- Cambridge Savings Bank (Waltham, MA)
- POSITION: Fraud Operations Analyst Summary: At Cambridge Savings Bank, our purpose is to have a positive impact on our customers, employees, and community's ... having a strong commitment to diversity and inclusion. The Fraud Operations Analyst is responsible for supporting operational fraud functions involved in identifying… more
- Guardian Life (Boston, MA)
- **Position Summary** The Senior Regulatory Filing Analyst is responsible for drafting, filing and securing regulatory approval of new group and retail insurance ... contract language can have on administration, marketing, sales, underwriting, pricing, claims and, ultimately, financial performance. + BS in Business Administration… more
- Elevance Health (Woburn, MA)
- **Provider Contract/CofC Analyst Sr.** **Location:** This position will work a hybrid model (remote and in-office, 1 - 2 days per week). Candidates must live ... miles of one of Elevance's Pulse Point locations. The **Provider Contract/Cost of Care Analyst Sr.** is responsible for analytical support to the Cost of Care and/or… more
- Prime Therapeutics (Boston, MA)
- …our passion and drives every decision we make. **Job Posting Title** Health Data Analyst Sr- REMOTE **Job Description** The Senior Health Data Analyst provides ... experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Basic to intermediate SAS coding skills… more
- Prime Therapeutics (Boston, MA)
- …and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Regulatory Complaints & Inquires) - Remote **Job Description** The Regulatory ... Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance programs and may lead some initiatives within their designated… more
- Atrius Health (Newton, MA)
- …health and enhance their lives. * * * * The Financial Analyst Healthcare Economics provides analytical, project management and database support. Gathers, compiles, ... . | Supports on-going analyses of financial, budgetary, or medical claims data, through forecasting, statistical analyses, trending, regression analyses, risk… more
- Harvard University (Cambridge, MA)
- …- MA - Boston Business Title:Statistical Analyst /ProgrammerSub-Unit: Salary Grade (https://hr.harvard.edu/salary-ranges#ranges) :056Time Status:Full-time Union:00 ... are preferred: + Master's degree in Statistics/Biostatistics preferred, with 1 -3 years working experience + Advanced skills/experience in statistical programming… more
- Prime Therapeutics (Boston, MA)
- …years of work experience. + Prior experience as a Business Intelligence Developer/ Analyst or Data Analyst supporting business intelligence, reporting, analytics ... that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.). + Consideration will be given… more
- Baylor Scott & White Health (Boston, MA)
- …while aligning with internal SMEs and current capacities. We have over 1 million lives across multiple blocks of business and industry-leading analytics to ... support our organization. We seek a stakeholder-facing statistical analyst that will be responsible for the extraction, analysis and interpretation of data to… more
- Prime Therapeutics (Boston, MA)
- …+ Prior experience as a Business Intelligence Developer or Data Analyst supporting business intelligence, reporting, analytics or data warehouse projects. + ... that may be in use in a Pharmacy Benefit Management setting ( Claims Processing, Prior Authorization, Telephony, Membership, etc.) + Related industry experience. +… more
- Prime Therapeutics (Boston, MA)
- …Title** Treasury Reporting Principal - Remote **Job Description** The Treasury Analyst Principal is responsible for managing, analyzing, and delivering Treasury ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more