- Molina Healthcare (Chandler, AZ)
- …Operations teams . Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... SKILLS & ABILITIES: . 2-5 years of experience in medical claims processing, research , or a related field . Demonstrates familiarity in a variety… more
- CAI (Phoenix, AZ)
- …claims and appeals in compliance with regulatory standards, while performing claims research , authorization lookups, and maintaining case assignments. **Job ... claims and appeals in compliance with regulatory standards, while performing claims research , authorization lookups, and maintaining case assignments. This is… more
- Bank of America (Phoenix, AZ)
- Sr Claims Analyst (Debit Fraud Claims ) Phoenix, Arizona **Job Description:** **Class Start Date: 04/07/2025** **Work Schedule: Monday - Friday (8:00 AM to ... claims and escalations including in-depth analysis for fraud and non-fraud claims , handling complex decisions based on analytical research , established… more
- Molina Healthcare (Chandler, AZ)
- …processing issues + Interprets, communicates, and presents, clear in-depth analysis of claims research results, root cause analysis, remediation plans and fixes, ... cross functionally across multiple business areas. **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing… more
- Molina Healthcare (Chandler, AZ)
- …+ Must have experience in research , review and audits for adjudication rates of claims + Must be able to work in cross functional teams + Must have experience ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Sumitomo Pharma (Phoenix, AZ)
- …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
- Evolent (Phoenix, AZ)
- …Stay for the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a Senior Analyst ... with a quantitative major (eg actuarial, statistics, biostatistics, operations research , mathematics, economics) or healthcare major (health administration, epidemiology,… more
- Molina Healthcare (Chandler, AZ)
- …ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, ... and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex...Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. +… more
- Prime Therapeutics (Phoenix, AZ)
- …our passion and drives every decision we make. **Job Posting Title** Health Data Analyst Sr- REMOTE **Job Description** The Senior Health Data Analyst provides ... **Additional Qualifications** + Advanced troubleshooting skills, including in-depth client data research , which may involve research and drivers of utilization;… more
- Prime Therapeutics (Phoenix, AZ)
- …program manuals are effectively followed and/or maintained. Works independently to research and resolve regulatory inquiries/complaints related to claims , ... and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Regulatory Complaints & Inquires) - Remote **Job Description** The Regulatory… more
- Bank of America (Phoenix, AZ)
- Sr. Fraud Analyst - Fraud Detection, Account Takeover Phoenix, Arizona **Job Description:** At Bank of America, we are guided by a common purpose to help make ... transaction characteristics of greater complexity, performing functions related to research , and resolving fraudulent activity and service support. **Responsibilities:**… more
- Molina Healthcare (Chandler, AZ)
- **Job Description** **Job Summary** The Sr Analyst , Risk Adjustment - Predicitve Analytics role supports Molina's Risk Adjustment Predictive Analytics team. Designs ... to suport Molina's Prospective and Retrospective Interventions. Assist with research , development,and completion of special projects. **Knowledge/Skills/Abilities** + Assist… more
- Molina Healthcare (Chandler, AZ)
- **Job Description** **Job Summary** The Sr. 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
- U-Haul (Phoenix, AZ)
- …in the life insurance industry. Oxford Life is seeking a talented Actuarial Analyst for the Actuarial Department of Oxford. This position reports to the Valuation ... to ensure the company's financial position to meet client claims . - Determine the financial soundness of each line...scheme. - Keep a close eye to the new research and developments that have arisen in the actuarial… more
- Bank of America (Phoenix, AZ)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, Massachusetts; ... in managing competing priorities **Desired Qualifications:** + Fraud and/or Claims background with focus on Account Takeover a plus...+ Data and Trend Analysis + Innovative Thinking + Research **_It is unlawful in Massachusetts to require or… more
- Bank of America (Phoenix, AZ)
- Fraud Analytics and Innovation Senior Analyst Newark, Delaware;Plano, Texas; Richmond, Virginia; Fort Worth, Texas; New York, New York; Boston, Massachusetts; ... degree in a quantitative discipline such as mathematics, statistics, operations research , finance, or business ▪ Advanced analytical and quantitative skills with… more
- Highmark Health (Phoenix, AZ)
- …subject matter expert in strategy development for new strategic programs. + Research claims processing problems, perform initial problem identification and ... effectively to explain technical benefits, application of medical policy, and claims processing capabilities and functionality. + Work independently or a team… more
- Molina Healthcare (Chandler, AZ)
- …other end users for operational and strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** + Performs research and analyses on a variety of topics related to the overall ... audits, compliance, recoveries, coordination with other departments. + Consolidates research and analyses into summarized findings and may develop recommendations… more
- Molina Healthcare (Chandler, AZ)
- **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
- Molina Healthcare (Chandler, AZ)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develop ad-hoc reports using SQL programming, SQL… more