- Highmark Health (Providence, RI)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Highmark Health (Providence, RI)
- …SUMMARY** This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a ... product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements.… more
- Rocket Software (Providence, RI)
- …people truly BELIEVE in what they're doing!** **Job Description Summary:** The Senior Benefit Analyst is responsible for building and delivering both global and ... country programs in line with the global total rewards philosophy. The Senior Benefits Analyst supports the design, administration, and analysis of Americas' and… more
- Center For Health Information And Analysis (Boston, MA)
- …be a driving force in health policy impact! We are seeking a Research Analyst to contribute to our growing research projects within the dynamic Strategy and Research ... team. The Research Analyst will work closely with the research team and...tasks for large datasets such as the All Payer Claims Database (APCD), hospital discharge data (Case Mix), and… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- …initiatives. . Working knowledge of healthcare payer systems and processes ( benefits , claims , enrollment, provider data, UM/PA). . Experience writing ... **Senior Business System Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Massachusetts, Canton **Position… more
- Public Consulting Group (Providence, RI)
- …To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative tasks and the entire claim ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- CVS Health (Woonsocket, RI)
- …with heart, each and every day. **Job Purpose and Summary:** The Call Center Analyst (Level 107) role has evolved beyond traditional call center functions to become ... trends, identify systemic issues, and drive operational improvements. The analyst leverages advanced tools-including Excel (with formulas and pivot...- 30% + Managing a work queue and closing claims - 20% + Taking calls - 10% +… more
- Zurich NA (Boston, MA)
- TPA Operations Sr. Performance Analyst 125087 At Zurich North America Claims we acknowledge that work life-balance and flexibility are a priority when it comes ... Designed with our employees' needs in mind, the ZNA Claims hybrid work model emphasizes flexibility, allowing claims...for specific initiatives. + Lead the production of periodic benefit follow-ups for key initiatives within the relevant region… more
- WTW (Boston, MA)
- …to the language. **Other:** Keep abreast of laws and regulations impacting employee benefits , claims procedures, and notice requirements by using our legal ... are seeking an organized and detail-oriented Retirement Plan Compliance Analyst to join our team. As a compliance ...also eligible for an annual short-term incentive bonus. **Company Benefits ** WTW provides a competitive benefit package… more
- Otsuka America Pharmaceutical Inc. (Providence, RI)
- …benefits . Come discover more about Otsuka and our benefit offerings; https://www.otsuka-us.com/careers-join-otsuka . **Disclaimer:** This job description is ... can too._ In this exciting role, as a Sr. Analyst within OAPI supply chain team, you will work...posted for a minimum of 5 business days. **Company benefits :** Comprehensive medical, dental, vision, prescription drug coverage, company… more
- Point32Health (Canton, MA)
- …of the Member Appeals and Grievance Supervisor the Member Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and ... authorized representative and must demonstrate superior customer service and benefit interpretation skills in all interactions. This individual prepares cases… more
- Point32Health (Canton, MA)
- …motivated individuals to join our organization as an Analytics & Triage Fraud Analyst within our Special Investigations Unit ("SIU"). The Analytics & Triage Fraud ... Analyst is an essential team member of the SIU,...capability building and ad hoc requests of monthly provider claims files, including communication with external stakeholders + Support… more
- Cognizant (Providence, RI)
- **Job Summary:** We are seeking a strong Duck Creek Functional Analyst / Business Analyst to work closely with customer Product Owners. The ideal candidate will ... teams to handle queries and understand requirements. . Experience with Billing and Claims configuration knowledge and Data Insight producer policy holder is an added… more
- Humana (Providence, RI)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- Prime Therapeutics (Providence, RI)
- …pricing or financial analysis to include 5 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field** **3 ... build the future of pharmacy with us. **Job Posting Title** Principal Pricing Analyst - REMOTE **Job Description** **The Principal Pricing Analyst leads complex… more
- Bank of America (Boston, MA)
- Fraud Analytics and Innovation Lead Analyst - Fraud Strategy Jacksonville, Florida;Plano, Texas; Richmond, Virginia; Sun City West, Arizona; Boston, Massachusetts; ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Jacksonville/Fraud-Analytics-and-Innovation-Lead- Analyst Fraud-Strategy\_25042825-2) **Job Description:** At Bank of America, we… more
- Humana (Providence, RI)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Norstella (Providence, RI)
- Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States Date Posted: Nov 20, 2025 Employment Type: Full Time Job ID: R-1548 **Description** At ... to extract meaningful insights from **real-world data (RWD)** sources, including ** claims , laboratory results, billing codes, and electronic health records (EHRs)**… more
- Cognizant (Providence, RI)
- **Health Payer Business Analyst , Senior Consulting Manager** **About the Role:** As a Sr. Consulting Manager you will make an impact by driving client engagement, ... firms * Strong background in Healthcare industry, including health plans, claims , and provider operations * Project management and people management experience… more
- CVS Health (Woonsocket, RI)
- …do it all with heart, each and every day. **Position Summary** The Senior Analyst , Account Management will serve as a fully dedicated advocate to senior employees ... Serve as the main point of contact for senior leaders working closely with the Benefits team to ensure a seamless and high-quality Aetna experience. + Serve as a… more