- Healthfirst (NE)
- …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 of the ... + Assist in the on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing, reference data and… more
- Healthfirst (NE)
- …the development and configuration of new business, member benefits and products, claims editing, reference data and their enhancements including claims ... enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier… more
- Healthfirst (NE)
- …terms, prepare fee schedules and accurately document file changes into the claims processing system + Research and identify published updates to payment ... methodologies, fee schedules and claims editing policies from Medicare, Medicaid, and third-party sources....the on-going audit of configurations for new and existing claims business rules within the claims processing… more
- Molina Healthcare (NE)
- **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 (NE)
- **JOB DESCRIPTION** **Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and ... team member, this role leads efforts to ensure the claims teams and other departments have access to quality... teams and other departments have access to quality claims data through processes which are efficient, accurate, and… more
- Molina Healthcare (Grand Island, NE)
- …**Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Identifies and ... interprets trends and patterns in datasets to locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and… more
- Molina Healthcare (Lincoln, NE)
- …**KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing requirements (1500 and UB04), provider and benefit ... configuration, and other claim reimbursement drivers + Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements. + Reviews, researches, analyzes and evaluates all… more
- Sumitomo Pharma (Lincoln, NE)
- …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
- Prime Therapeutics (Lincoln, NE)
- …complex work efforts + Desire and ability to educate and advance the business systems analyst practice within the Claims IT team and across the organization + ... passion and drives every decision we make. **Job Posting Title** IT Business Systems Analyst Sr **Job Description** The Business Systems Analyst (BSA) Senior IT… more
- Prime Therapeutics (Lincoln, NE)
- …passion and drives every decision we make. **Job Posting Title** Senior Pricing Analyst **Job Description** The Senior Pricing Analyst participates in the ... 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
- Intermountain Health (Lincoln, NE)
- **Job Description:** As a Business Systems Analyst , you will work closely with the business areas to identify and understand their needs and requirements. The major ... to major projects. Requirements may be specific to healthcare insurance products, claims , sales activities or other service-related processes; all in support of… more
- Lincoln Financial Group (Lincoln, NE)
- …73933 **Role at a Glance** Lincoln National Corporation seeks an Analyst , Application Development in Radnor, PA to consult/analyze and deliver assignments/projects ... for Group Protection IT Claims of application development responsibility. Act as a resource...process. Maintain legacy and emerging developments/trends for Group Protection Claims , assess impact, and collaborate with management to incorporate… more
- Molina Healthcare (NE)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... executive decision-making + Mine and manage information from large data sources. + Analyze claims and other data sources to identify early signs of trends or other… more
- Evolent (Lincoln, NE)
- …as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics role will be serving key internal (Evolent Account ... + 2+ years of SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - **Required** + 2+ years of experience using Microsoft… more
- Molina Healthcare (Grand Island, NE)
- …Description** Who you are : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise and cloud based ETL/BI ... You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You...QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards… more
- Molina Healthcare (NE)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience...functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and… more
- Prime Therapeutics (Lincoln, NE)
- …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information, ... experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, and/or financial data + Basic to intermediate SAS coding skills… more
- Kanaan Communications, LLC (Omaha, NE)
- …telecommunications industry. We are currently hiring an individual to fill our Safety Analyst role reporting to our Omaha, NE location. Connecting you to great ... gym memberships, pet insurance, and much more! The Safety Analyst is responsible for the following areas of safety...Assists with investigating and administering property and utility damage claims in a timely and professional manner + Conducts… more
- PNC (Brock, NE)
- …have an opportunity to contribute to the company's success. As a Loan Support Analyst Senior within PNC's Midland organization, you will be based in office within ... Midland footprint of Kansas City, Dallas, or Birmingham. As a Loan Support Analyst Senior in PNC Midland's Insurance department, you will be responsible for… more
- Molina Healthcare (NE)
- **Knowledge/Skills/Abilities** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience...functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and… more