- Public Consulting Group (Trenton, NJ)
- …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 (Philadelphia, PA)
- …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 (Trenton, NJ)
- …**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
- Bank of America (Pennington, NJ)
- Wealth Management Fraud & Claims - Sr. Fraud Analyst Pennington, New Jersey **Job Description:** At Bank of America, we are guided by a common purpose to help ... on retention and re-establishing client confidence. Wealth Management Fraud & Claims associates will handle inbound calls from clients, branch offices, banking… more
- Prime Therapeutics (Trenton, NJ)
- …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 (Trenton, NJ)
- …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 (Trenton, NJ)
- …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
- AmeriHealth Caritas (Philadelphia, PA)
- …Service Level Agreements. **Education/Experience:** + Bachelor's Degree preferred + Minimum of 1 year of advanced-level claims experience and auditing experience ... Review all associated documentation for completeness. Communicate with the configuration analyst , configuration team lead, tester, and requestor as required to… more
- Prime Therapeutics (Trenton, NJ)
- …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
- NJM Insurance (Trenton, NJ)
- …West Trenton Workers Compensation Department (WCC) is seeking a Sr. Business Process Analyst (based on credentials, this role can also be filled as an Associate ... or Analyst ) who supports the business process improvement, business continuity...business continuity and technology initiatives for the Workers Compensation Claims business unit. The focus of this position is… more
- CGI Technologies and Solutions, Inc. (Plymouth Meeting, PA)
- **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
- Prime Therapeutics (Trenton, NJ)
- …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 (Trenton, NJ)
- …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
- CVS Health (Blue Bell, PA)
- …support for certain financial components impacting the net cost of pharmacy claims . The colleague will: + Apply quantitative skills and analytical methods to ... drivers of financial results. \#AetnaActuary Required Qualifications + Successful completion of 1 or more Society of Actuaries Exams + Experience with Microsoft… more
- Prime Therapeutics (Trenton, NJ)
- …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
- CSL Behring (King Of Prussia, PA)
- …product(s) + Accountable for the Target Product Profile (TPP) and Target Product Claims (TPC) that form the future foundation of product labelling and other forms ... external business portfolio reporting (eg, internal product/project briefings, R&D Analyst Day, annual results communications) + Transparent risk, opportunity, and… more
- Baylor Scott & White Health (Trenton, NJ)
- …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 (Trenton, NJ)
- …+ 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 (Trenton, NJ)
- …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