- Molina Healthcare (Grand Rapids, MI)
- …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 in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
- Molina Healthcare (Grand Rapids, MI)
- …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 (Grand Rapids, MI)
- …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...methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule… more
- Molina Healthcare (Grand Rapids, MI)
- …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
- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Molina Healthcare (Grand Rapids, MI)
- …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...in contracts and benefits configuration. + Strong background in claims is required. + Experience working on Networx, QNXT… more
- Sedgwick (Grand Rapids, MI)
- …their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Sr. Data Analyst **PRIMARY PURPOSE** : To create comprehensive reporting and analysis of… more
- Molina Healthcare (Grand Rapids, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Molina Healthcare (Grand Rapids, MI)
- …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
- Corewell Health (Grand Rapids, MI)
- …issues to determine course corrections + Apply strong analytical skills and business knowledge to investigation, analysis and recommendation of solutions to problems ... or equivalent + 2 years of relevant experience in Customer Service, claims , Legal and/or enrollment/eligibility Preferred + Bachelor's Degree or equivalent + 2… more
- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Corewell Health (Grand Rapids, MI)
- …interviews, medical records audits, data mining, perform compliance audits of medical claims , fee screens and other payment mechanism to ensure accurate payment. + ... agents and vendors. Qualifications Required + Bachelor's Degree or equivalent Health, Business or statistics + 2 years of relevant experience Detection, prevention… more
- Molina Healthcare (Grand Rapids, MI)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more