- Wolters Kluwer (Dallas, TX)
- …Location:_** Riverwoods, IL (USA) **About the Role:** We are seeking a highly skilled Business Analyst to join the Mediregs team focusing on claims ... contribute to software maintenance and final acceptance testing. The Business Analyst works closely with a cross-functional...tools (eg, SQL, Excel, Tableau). + Recent experience with healthcare claims software (eg, Epic, Cerner, or… more
- Molina Healthcare (TX)
- **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… more
- Molina Healthcare (San Antonio, TX)
- …cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health Plans ... is a general role in which employees work with multiple types of business data. Will work cross functionally across multiple business areas.… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Guidehouse (Lewisville, TX)
- …experience in lieu of Diploma / GED. + 1-3+ year's experience in within business , operations, customer service or healthcare fields. **What Would Be Nice to ... **Clearance Required** **:** None **What You Will Do** **:** The **Billing Analyst ** is expected to perform specific billing processes, follow-up, account analysis… more
- Molina Healthcare (TX)
- **Knowledge/Skills/Abilities** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... costs to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc. + Analysis and forecasting of trends in… more
- Molina Healthcare (TX)
- …self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to ... **Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the… more
- Molina Healthcare (Fort Worth, TX)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms ... **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… more
- Evolent (Austin, TX)
- …reimbursement structures associated with Commercial, Medicare, and Medicaid lines of business . Healthcare claims : specifically, differences between ... **Required** + 2+ years of SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - **Required** + 2+ years of experience… more
- Molina Healthcare (San Antonio, TX)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Molina Healthcare (Dallas, TX)
- …both verbally and written. + You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You pay attention to ... 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… more
- Molina Healthcare (Austin, TX)
- …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 (TX)
- …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 existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is… more
- Molina Healthcare (TX)
- …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
- Molina Healthcare (Fort Worth, TX)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- Molina Healthcare (TX)
- …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
- Elevance Health (Grand Prairie, TX)
- …preferred. + Scaled Agile Framework Training strongly preferred. + 5+ years of claims editing experience with healthcare payers and/or claims editing ... **Clinical Content Analyst ** **Location:** This position will work a hybrid...CMS, CPT/AMA and other major payer policies based on healthcare correct coding and regulatory requirements. **How you will… more
- Evolent (Austin, TX)
- …Excel, SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data + Using analytical tools to integrate various data ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...SQL or SAS is preferred + 2-5 years of healthcare -related experience is preferred **Technical Requirements:** We require that… more