- Molina Healthcare (OH)
- …Operations teams + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...Molina. Identifies the root cause of processing errors through research and analysis, coordinates and engages with appropriate departments,… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** The Senior Business Analyst is responsible for supporting the claims processing teams by supplying regular, timely, and ... reports. As the senior level team member, this role leads efforts to ensure the claims teams and other departments have access to quality claims data through… more
- Molina Healthcare (Cleveland, OH)
- …cross functionally across multiple business areas. **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. +… more
- Elevance Health (Mason, OH)
- …and content strategy to meet financial and operational targets. The Clinical Content Analyst role will research and interpret CMS, CPT/AMA and other major ... **Clinical Content Analyst ** **Location:** This position will work a hybrid...through review, testing and finally data validation. + Develops claims editing logic and content that promotes payment accuracy… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …achieve their best possible health and quality of life. Business Systems Analyst III Provides the interface between clinical business teams (Case Management, ... Clinical Claims Review, Quality Management & STARS, Utilization Management, etc.)...as a project leader on small-scope projects. Business Systems Analyst IV Provides the interface between clinical business teams… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …Medicare Supplement, and individual plans. The Business Intelligence Programmer Analyst is responsible for transforming business requirements into BI technical ... BI project to support analytic deliverables and capabilities. The Sr. BI Programmer Analyst will have heavy interaction with our Business Analysts to ensure all… more
- Sumitomo Pharma (Columbus, OH)
- …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... assets, and in-house advanced technology capabilities, we aim to accelerate discovery, research , and development to bring novel therapies to patients sooner. For… more
- City of Columbus (Columbus, OH)
- Employee Benefits Analyst II (Vacancy) Print (https://www.governmentjobs.com/careers/columbusoh/jobs/newprint/4764157) Apply Employee Benefits Analyst II ... and programs that support consistency and streamlined administration. The Employee Benefits Analyst II will play an integral role in the delivery of effective… more
- Sumaria Systems, Inc. (Fairborn, OH)
- Management Analyst Department: SAS DAYTON, OH Office: Wright Patterson AFB, OH - SAS Location: Fairborn, OH START YOUR APPLICATION ... (https://apply.hrmdirect.com/resumedirect/ApplyOnline/Apply.aspx?req\_id=3259617&source=3259617-CJB-0) Job Title: Senior Management Analyst Job Description: Management Analyst Support Perform… more
- Lincoln Financial Group (Columbus, OH)
- …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 and develop complex innovative business solutions by creating new… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... of assigned reports, document reporting processes and procedures. + Assist with research , development and completion of special projects as requested by various… more
- Prime Therapeutics (Columbus, OH)
- …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst **Job Description** The Senior Health Data Analyst provides information, ... **Additional Qualifications** + Advanced troubleshooting skills, including in-depth client data research , which may involve research and drivers of utilization;… more
- Molina Healthcare (Columbus, OH)
- …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 (OH)
- **Knowledge/Skills/Abilities** 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
- Molina Healthcare (Columbus, OH)
- …tables through the user interface. + Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) ... and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims ...to meet deadlines and needs of user community. + Research and analyze the benefits, fee schedules + Creates… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and Identifying targeted Interventions and tracking outcome. Assist with research , development, and completion of special performance improvement projects.… more
- Molina Healthcare (OH)
- …+ Actively participates in all stages of project development including research , design, programming, testing and implementation to ensures the released product ... operational processes including but not limited to Enrollment, UM, Claims & Care Management** **Preferred License, Certification, Association** Certified Business… more
- Molina Healthcare (Cleveland, OH)
- …analysis. + Works with internal, external and enterprise clients as needed to research , develop, and document new standard reports or processes. + Implements and ... to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** **Required Education** Associate's Degree or equivalent… more