- Ford Motor Company (Frankfort, KY)
- ** Claims Lead Analyst ** We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves and build a better world -- ... is a hybrid role.** **What you'll do ** Lead development efforts for claims /returns modernization, ensuring current and future business requirements are met with… more
- Molina Healthcare (Louisville, KY)
- …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... remediation plans and fixes, overall progress, and status of impacted claims **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or equivalent… more
- Molina Healthcare (Louisville, KY)
- **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 (Louisville, KY)
- …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 research, review and audits for adjudication rates of claims + Must be able to work in cross… more
- Molina Healthcare (Louisville, KY)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
- Prime Therapeutics (Frankfort, KY)
- …flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm + Constantly required to sit, use hands ... our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides… more
- Sumitomo Pharma (Frankfort, KY)
- …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 (Frankfort, KY)
- …flexible schedule which may include weekends, holidays, or shifts outside of Prime's core business hours of 9:00am-3:00pm + Constantly required to sit, use hands ... every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- Prime Therapeutics (Frankfort, KY)
- …Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting the business in decision making and ... operations efforts by providing data, reporting and business intelligence services. This role is responsible for acting...education and/or relevant work experience; HS diploma or GED required + 5 years of work experience in data… more
- Molina Healthcare (Louisville, KY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
- Sedgwick (Louisville, KY)
- …years of related experience or equivalent combination of education and experience required . Experience in multi-line claims management processes and system ... of LLMs + RESTFUL APIs + Knowledge of third party administration and claims management business and technology + Oral and written communication skills… more
- Evolent (Frankfort, KY)
- …creativity, accountability, and a growth mindset as we solve complex business problems. **Collaboration Opportunities:** The Senior Analyst , Client Analytics ... reports with complex regulatory/clinical requirements for healthcare lines of business - ** Required ** + 2+ years of...SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - ** Required ** +… more
- Molina Healthcare (Louisville, KY)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Education** Bachelor's Degree or equivalent combination of education and experience ** Required Experience** + 5-7 years of business or experience system… more
- Molina Healthcare (Louisville, KY)
- …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 (Louisville, KY)
- …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 (Louisville, KY)
- …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...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- HealthEdge Software Inc (Frankfort, KY)
- …root-cause issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The ... implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior… more
- Sedgwick (Louisville, KY)
- …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 Workforce Planning Analyst **Our teams connect! We collaborate onsite and have a hybrid work… more
- Evolent (Frankfort, KY)
- …selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ... Analytics team offers candidates the opportunity to work with key business , analytics, product, and operational leaders to deliver client-specific analytical… more
- Molina Healthcare (Louisville, KY)
- …systems to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or ... used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables… more