- Molina Healthcare (Louisville, KY)
- **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
- Molina Healthcare (Louisville, KY)
- **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… more
- Molina Healthcare (Louisville, KY)
- …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...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Elevance Health (Louisville, KY)
- **The Subrogation Analyst ** _Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our ... Elevance Health PulsePoint locations._ The **Subrogation Analyst ** is responsible for handling complex Third Party Liability, Workers? Compensation and other… more
- Molina Healthcare (Louisville, KY)
- **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 to identify early signs… more
- Molina Healthcare (Louisville, KY)
- …market-specific business rules, facilitating the accurate and timely payment of claims . Analyzes complex business problems and issues using data from ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Molina Healthcare (Louisville, KY)
- **Job Description** **Job Summary** The Analyst , Encounters is responsible for monitoring inbound and outbound encounters processes and ensuring timely, accurate, ... for Monthly Governance and Operations Reviews + Performs root cause analysis of claims and encounters data and develops recommendations based on data and industry… more
- AIG (Jeffersonville, IN)
- …through our Volunteer Time Off and Matching Grants Programs. Get to know the business General Insurance is a leading provider of insurance products and services for ... in all of AIG's specialized disciplines, such as policy issuance, premium collection, claims handling, and administration. It enables AIG to deliver business … more
- Molina Healthcare (Louisville, KY)
- …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...solutions and ability to use critical thinking to analyze claims issues. * Works with internal and external stakeholders… more
- Molina Healthcare (Louisville, KY)
- …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...+ Must have experience working on SQL. + Medicare claims experience is a huge plus + Medicare Fee… more
- Molina Healthcare (Louisville, KY)
- …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...+ Must have experience working on SQL. + Medicare claims experience is a huge plus + Medicare Fee… more
- Molina Healthcare (Louisville, KY)
- **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 (Louisville, KY)
- …from various sources to identify risks and opportunities. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and other data sources to identify early signs of trends or ... studies related to the quantification of medical interventions + Work with business owners to track key performance indicators of medical interventions + Perform… more
- Molina Healthcare (Louisville, KY)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Molina Healthcare (Louisville, KY)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more