- Public Consulting Group (Raleigh, NC)
- …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
- TriTech Enterprise Systems, Inc. (Raleigh, NC)
- …Systems, Inc, (TriTech) is seeking a 'Technical Specialist - EHR Epic Rev Cycle Analyst ' to support a Raleigh, NC project. This candidate will build the following ... Epic modules: Resolute Hospital Billing Claims and Resolute Professional Billing Claims . In...typical billing workflows Required Epic Implementation experience with at least 1 full life cycle project Required Powered by… more
- Prime Therapeutics (Raleigh, NC)
- …our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Prime Therapeutics (Raleigh, NC)
- …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 (Raleigh, NC)
- …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
- CVS Health (Raleigh, NC)
- …to GPS to rework claims after validating as overpaid **Required Qualifications** * 1 years experience working with GPS and ECHS * Knowledge of ACAS claims ... This position will be responsible for utilizing previous ACAS claims experience along with provided guidance to review and...experience along with provided guidance to review and validate claims for overpayment. The ideal candidate will be able… more
- CGI Technologies and Solutions, Inc. (Cary, NC)
- **Life Insurance Process Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Connecticut, Hartford **Alternate ... CGI is seeking a highly skilled and experienced Life Insurance Process Analyst with a strong background in Life Insurance operations. The ideal candidate… more
- UNC Health Care (Morrisville, NC)
- …impacts of proposed operational decisions throughout the UNCHC system. Responsibilities: 1 . Collaborate with Senior Leaders across affiliates to advise on regulatory ... finance, payroll, accounts payable and the Federal and State claims databases to compile the Medicare, Medicaid and Tricare...to answer and support their jobs in that the analyst supplies answers to reimbursement questions. Participate in monthly… more
- Prime Therapeutics (Raleigh, NC)
- …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 (Raleigh, NC)
- …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 (Raleigh, NC)
- …+ 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 (Raleigh, NC)
- …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