- Acosta Group (Charlotte, NC)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position..., assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Claims Analyst is accountable for claims processing, research and adjudication to correctly apply benefit determination and pricing for ... claims as directed by departmental policies and procedures; follows up for resolution and processes pended claims immediately following a benefit / payment… more
- Orlando Utilities Commission (Orlando, FL)
- **OUC - The** **_Reliable_** **One** **,** is presently seeking a **Bilingual Claims Analyst (Spanish Preferred)** to join the Office of General Counsel ... understanding of relevant Florida statutes to review and analyze property and liability claims for OUC. In this role, you will investigate, negotiate, and settle … more
- The Hartford (Naperville, IL)
- Claims Analyst FL - CV08CE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working ... as we help shape the future. As a Hartford Global Specialty - Financial Lines Claims Analyst in our Employment Practices Liability ("EPL") unit, you will be… more
- State of Colorado (Denver, CO)
- Affordability Data Science Analyst (Statistical Analyst II): DORA/Division of Insurance - Hybrid Print ... Apply Affordability Data Science Analyst (Statistical Analyst II): DORA/Division of Insurance - Hybrid ...sets; + Demonstrated experience working with data sets, including claims and/or pharmacy data, in the commercial (private) and/or… more
- Mount Sinai Health System (New York, NY)
- **Job Description** Reimbursement (Supply) -Chargemaster Analyst Hybrid 150 East 42nd Stret The Reimbursement and Chargemaster Analyst is responsible for ... hospital billing, coding, and reimbursement, preferably as CDM coordinator, revenue cycle analyst or coding consultant is preferred. Nursing or clinical or materials… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key risk adjustment ... methodology, risk score calculation, ACA enrollment, premiums, medical and pharmacy claims , and provider data. Incumbent is responsible for performing complex… more
- Virtua Health (Mount Laurel, NJ)
- …optimize reimbursement within budget guidelines. Participate in ongoing coordination and resolution of revenue issues as they arise. Assists in troubleshooting and ... Financial Services staff for reporting problems and denials on individual claims . Assist in researching coding issues, provide guidance and recommend solution… more
- AIG (Atlanta, GA)
- …and professional service with empathy and efficiency. How you will create an impact The Claims Analyst III will handle and analyze general liability claims ... ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans. Determine need for and… more
- Flynn Restaurant Group (Independence, OH)
- **Position Description** The Worker's Compensation Analyst is responsible for assuring the quality and cost-effectiveness of the workers' compensation claims ... process including strategy development, analysis of risk and plans to move claims to closure. Investigates and communicates w/ operators, witnesses and third parties… more
- Elevance Health (Los Angeles, CA)
- …with various departments, when necessary, to determine root cause and appropriate resolution . + Must remediate impacted claims . **Minimum Requirements:** + ... **Provider Payment Reconsider Analyst I** **Must be located within 50 miles...lines of business and is specifically responsible for the resolution of Provider Payment Reconsideration requests. **How you will… more
- Maryland Department of Transportation (Anne Arundel County, MD)
- Labor Relations Analyst (HR Analyst I) Salary $53,808.00 - $86,322.00 Annually Location Anne Arundel County Job Type Full Time Remote Employment Flexible/ ... Hybrid Job Number 2245-MVA-EER-10/24 Department Motor Vehicle Administration Opening...+ Description + Benefits + Questions Description Labor Relations Analyst (HR Analyst I) Grade 14 Job… more
- CVS Health (Cumberland, RI)
- …to the Senior Manager of the Internal Audit Recovery Team, the Senior Analyst performs audits mainly related to retail and supports additional teams as requested. ... Collaborate with CVS internal and external partners to resolve audit claims . + Audit Reporting/Communication- Solid meeting management and oral/written communication… more
- Humana (Louisville, KY)
- …accuracy and compliance with accepted accounting policies and principles. The Accounting Analyst will assist with funding of pharmacy claims , reconciliation of ... first** We are seeking a meticulous and adaptable Accounting Analyst to join our dynamic team. This role is...in the documentation of accounting projects. This is a Hybrid position, in-office a few days a week located… more
- Johns Hopkins University (Middle River, MD)
- …standards. + Manages the collections of Out-of-State Medical Assistance claims and maintains accounts receivable balances within departmental standards. + ... payer websites, and other resources to facilitate efficient operations, issue resolution , and education. + Excellent communication and customer service skills with… more
- IBM (Washington, DC)
- …and coordinating with the IBM team on quality management issue management and resolution . + Monitoring claims processes + Analysis and reporting + Support ... the globe. You'll work with visionaries across multiple industries to improve the hybrid cloud and AI journey for the most innovative and valuable companies in… more
- Aflac (SC)
- Financial Systems Analyst I The Company: CAIC The Location: SC, US The Division: Financial Services Job Id: 6754 Salary Range: $42,000 - $98,000 Job Posting End ... you at Aflac. Worker Designation - This role is hybrid . This means you will be expected to report...system cycles for Wynsure, VUE and FSCD; ensures that claims benefits, premium refunds and commissions processed are paid… more
- Medical Mutual of Ohio (Toledo, OH)
- **_The Operations Data Analyst II position allows you the_** **_flexibility to work a hybrid schedule (on-site and at home)_** **_as long as you reside within a ... and errors that involve internal and external systems, appeals, correspondence, claims and HIPAA data, and regulatory guidance; executes complex data-related… more
- Wells Fargo (West Des Moines, IA)
- …with you. **About this role:** Wells Fargo is seeking a Quality Assurance Analyst within Consumer Collections & Servicing, part of Consumer Lending. Learn more about ... this role, you will:** + Examine and research complex programs, processes, claims , documentation, or files to ensure compliance with internal company requirements or… more
- Zelis (Morristown, NJ)
- …into OnBase (in-house system). * Perform claim look up's and identify claims associated with incoming inquiries. * Extracting multiple inquiries; separating and ... to be forwarded for further review to a coding analyst . * Send correspondence to providers as needed regarding... is not required: (ETF, Non-Accepted, Attachment Missing, Corrected Claims , and other projects as assigned). * Entering requests… more