- Commonwealth Care Alliance (Boston, MA)
- …the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... claims auditing and clinical coding and reimbursement edits and necessary coding ...Degree Required Experience (must have): + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+… more
- Zelis (St. Petersburg, FL)
- …understanding of payment integrity, claim processing and/or revenue cycle for healthcare claims + Understanding of medical coding and medical claims + ... Position Overview: At Zelis, t he Business Analyst - Expert Claims Review (ECR)...in accordance with Company policies. Zelis is modernizing the healthcare financial experience by providing a connected platform that… more
- Kelsey-Seybold Clinic (Houston, TX)
- …dollar claims and present summary to management. **Job Title: Medicare Claims Analyst ** **Location: Remote** **Department:** ** Claims ** **Job Type: Full ... certifications, etc.)** **Qualifications** **Education** Required: Associate degree or 2 years Claims Payment Analyst experience in lieu of education Preferred:… more
- Carle (Urbana, IL)
- Claims Analyst Team A + Department: HA - Claims + Entity: Health Alliance + Job Category: Clerical/Admin + Employment Type: Full - Time + Job ID: 45246 + ... Requirements: no Email a Friend Save Save Apply Now Position Summary: The Claims Analyst accurately processes medical, dental, orthodontia and pharmacy claims… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, the Payment Integrity (PI) Recovery Analyst will assist in ... drive incremental value year over year. The PI Recovery Analyst will employ use of analytics, trends, competitor benchmarking,...and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for … more
- Molina Healthcare (Nicholasville, KY)
- … 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...related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health… more
- The Walt Disney Company (Lake Buena Vista, FL)
- **The** **US Healthcare Analyst ** **is responsible for providing analytical insights and management for healthcare programs and initiatives. This position ... data maintenance and programming dashboards and reports** **Working knowledge of medical claims coding processes** **Experience with financial processes used in… more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director, and Other ... including but not limited to Health Services, Medical Economics, Sales and Coding in order to develop solutions for strategic business needs. + Understands,… more
- LogixHealth (Bedford, MA)
- …revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting ... On-Site in Bedford, MA $500 Signing Bonus This Role: As a Reimbursement Analyst at LogixHealth, you will work with the department management teams to provide… more
- The Cigna Group (Houston, TX)
- …with other internal departments, including but not limited to Health Services, Finance, Claims , and Coding in order to develop solutions for strategic business ... monitors and reports on key program performance metrics, such as utilization, coding , and STARs/quality performance + Perform root cause analyses and resolution… more
- The Cigna Group (Huntsville, AL)
- …with other internal departments, including but not limited to Health Services, Finance, Claims , and Coding in order to develop solutions for strategic business ... Huntsville, AL This role will work with a subdivision within Cigna Healthcare called CareAllies, a Management Company that works side-by-side with providers and… more
- UPMC (Pittsburgh, PA)
- …of relevant experience OR equivalent combination of education & work within healthcare payers/ claims payment processing will be considered + Current certified ... UPMC Health Plan is hiring a full-time Payment Accuracy Analyst to support the Hospital Reimbursement team. This role will work in a hybrid structure, with most time… more
- Molina Healthcare (Lexington, KY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... of configuration solutions and ability to use critical thinking to analyze claims issues. * Works with internal and external stakeholders to understand business… more
- Molina Healthcare (Louisville, KY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... requirements and converting these terms to configuration parameters. + Handles coding , updating and maintaining benefit plans, provider contracts, fee schedules and… more
- Elevance Health (Columbus, OH)
- … processing. + Responsible for monitoring Medicare changes as they relate to claims payment and methodologies, benefits and coding and billing. + Develop ... **Rating/ Claims System Senior Advisor** **Location:** This position will...of study and a minimum of 8 years systems analyst or business analyst experience; or any… more
- WellSense (Boston, MA)
- Business Encounter Data Analyst WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through ... no matter their circumstances. **Job Summary:** The Business Encounter Data Analyst is responsible for compiling and analyzing encounter data and understanding… more
- The Mount Sinai Health System (New York, NY)
- …DRG Appeals Analyst - CDI Liaison is responsible for analyzing medical records, claims data, and coding on all diagnoses and procedures (both medical and ... Clinical Modification (ICD-9-CM American Medical Association Current Procedural Terminology (CPT-4) Coding system; and Healthcare Common Procedure Coding … more
- Kelly Services (Houston, TX)
- …easy. That's where **Kelly(R)** comes in. We're seeking a **Medical Claims Analyst ** to work at a premier healthcare organization in **Houston, TX 77092** ... your life. **What's a typical day as a Medical Claims Analyst ? You'll be:** * Maintaining workflow...Have an understanding of medical terminology, CPT/HCPCS and ICD-9/ICD-10 Coding , and billing forms (HCFA/UB04). * Have a strong… more
- AdventHealth (Maitland, FL)
- …various sources using knowledge of healthcare managed care contracts and healthcare administrative claims data + Employs existing complex models and ... the full spectrum of app provider types + Applies detailed understanding of medical coding systems affecting the adjudication of claims to include ICD-9/10 CPT,… more
- Trinity Health (Niskayuna, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Medical Billing Analyst - Cardiology Associates of Schenectady - Niskayuna, NY - Full Time** ... If you are looking for a Billing Analyst position in Albany, Full time, this could be...Medical Associates. **Responsibilities:** + Responsible to monitor and resolve Claims Workqueues; Specifically, Front End, Referrals & Authorizations, and… more