• Claims Configuration Analyst

    Healthfirst (KS)
    …in a simple and easy to understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively communicate with all levels ... Assist in the setup of code sets and defining pre-authorization guidelines used in claims configuration to drive application of medical policy and accurate … more
    Healthfirst (12/25/24)
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  • Sr Claims Configuration

    Healthfirst (KS)
    …products, claims editing, reference data and their enhancements including claims configuration improvements, compliance and systems enhancements. + Follow ... the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier management. + Interpret… more
    Healthfirst (12/25/24)
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  • Senior Payment Integrity Analyst

    HealthEdge Software Inc (Topeka, KS)
    …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines of business. Payment Integrity… more
    HealthEdge Software Inc (01/15/25)
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