- Molina Healthcare (Sterling Heights, MI)
- …cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health Plans ... is a general role in which employees work with multiple types of business data. Will work cross functionally across multiple business areas.… more
- Molina Healthcare (Sterling Heights, 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 (Sterling Heights, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...in research, review and audits for adjudication rates of claims + Must be able to work in cross… more
- Molina Healthcare (Sterling Heights, MI)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
- University of Michigan (Ann Arbor, MI)
- Revenue Chrg Intgrty Analyst Apply Now **Job Summary** The Charge Integrity Analyst is responsible for a wide variety of charge-related functionality and ... a series of charge sources. Throughout the year, the analyst will assist departments with new charge build and...and Cost Center Table (BCC) + MiChart Rules (Router, Claims Manager, Revenue Guardian, etc.) + Fee Schedules +… more
- Lineage Logistics (Novi, MI)
- …a key member of the Global Insurance and Risk team, the Insurance and Risk Analyst is responsible for supporting the day to day insurance and related risk management ... Reporting:** + Collect and analyze data related to risk, claims history and insurance premiums + Own reporting process...A career at Lineage starts with learning about our business and how each team member plays a part… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- University of Michigan (Ann Arbor, MI)
- HEALTH INFORMATION MANAGEMENT ANALYST II - COMPLIANCE AND AUDITING Apply Now **Job Summary** Utilize the EPIC Release Module to locate, analyze, and produce medical ... records required to substantiate Hospital and Professional Billing claims in response to payer, auditor, and government agency requests. Process medical record… more
- Molina Healthcare (Sterling Heights, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- Lineage Logistics (Novi, MI)
- …Sourcing and Procurement team. Lineage is currently searching for a Procurement Analyst to join our growing team. Ideal candidates possess experience and/or ... education in business , supply chain management, finance or economics combined with...contractual obligations are met, supplier concerns are addressed, and claims against suppliers are resolved. + Review purchase orders… more
- Carhartt, Inc. (Dearborn, MI)
- …+ Leads gathering and preparation of insurance renewal data, including considering business changes that may impact submissions. Tracks claims submitted under ... ExemptJob Band: Professional Job SummaryThe Sr. Treasury and Risk Analyst serves as a critical role, supporting senior level...set forth by our founder, Hamilton Carhartt. We Lead Business by creating value, delivering on results, and making… more
- Molina Healthcare (Sterling Heights, MI)
- **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and related financial data like risk...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- Molina Healthcare (Sterling Heights, MI)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- Molina Healthcare (Sterling Heights, MI)
- **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides ... as directed by the Enrollment team . Partners with the vendor to analyze business and vendor performance problems and issues using data from internal and external… more
- Molina Healthcare (Sterling Heights, MI)
- …used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables ... departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods… more
- Exotic Automation & Supply (New Hudson, MI)
- …in the Pricing system. + Maintenance and submission of customer rebates and subsidy claims to Suppliers. + Input/Upload of Supplier Price Updates from price files. + ... or requested. Knowledge, Skills and Abilities Required: + Bachelor's degree in business or related area (will consider equivalent job experience). + Two years… more
- Molina Healthcare (Sterling Heights, MI)
- …analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment ... findings and may develop recommendations to solve problems and issues related to business operations. + Follows team coding standards for report design. Works to… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more