- CareOregon (Portland, OR)
- …hired for remote positions must reside in Oregon or Washington. Job Title Medicare Encounter Data Analyst Exemption Status Exempt Department Finance Manager ... candidates residing in Oregon or Washington. Job Summary The Medicare Encounter Data Analyst leads the process...Medicare programs + Knowledge of medical and/or pharmacy claims + Knowledge of CPT, HCPCS, ICD10 coding; revenue… more
- The Cigna Group (Tucson, AZ)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director, and Other ... interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of...market financial review with senior management. + Trouble shoot claims issues for providers + Investigate member grievances within… more
- Houston Methodist (Katy, TX)
- Medicare compliance experience is preferred** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** **. ... of compliance recommendations set forth by audits from Center for Medicare /Medicaid Services (CMS), other applicable regulatory agencies, and/or Houston Methodist… more
- The Cigna Group (Nashville, TN)
- …goals, and service levels + Proficient knowledge of policies and procedures, Medicare , HIPPA and NCQA standards + Professional demeanor and the ability to ... Working knowledge of insurance industry, medical coding (CPT/HCPCS/ICD-10), and overall claims process a plus + Knowledge of National Coverage Determinations, Local… more
- Montrose Memorial Hospital (Montrose, CO)
- …PFS team to streamline workflows to maximize clean accounts. About The Career: + The Claims Analyst III must know the essential functions of denied claims ... broad knowledge of hospital billing, collections and payment application for Medicare , Medicaid and Commercial insurances + Ability to effectively communicate,… more
- The MITRE Corporation (Mclean, VA)
- …Health Agency, Hospice, Carrier, Durable Medical Equipment, Prescription Drug Event (PDE), and Medicare Advantage Encounter claims . + Degree in a data related ... a difference with us. MITRE is seeking experienced healthcare claims data analysts with the ability to develop expertise...engagement, or program implementation to support the Centers for Medicare and Medicaid Services (CMS) through all phases of… more
- General Dynamics Information Technology (Fairfax, VA)
- …economist + 3+ years of experience working with healthcare data including pharmacy claims , NDCs, and knowledge of Medicare payment policy preferred. + ... clients turn data into action as a Healthcare Statistical Analyst at GDIT. Your work will provide transformative solutions...years of experience working with healthcare data including pharmacy claims , NDCs, and knowledge of Medicare payment… more
- Providence (CA)
- …people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible for developing and ... to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of...on bid pricing outcomes + Analyzing and interpreting healthcare claims data, enrollment data, and other relevant information to… more
- Medical Mutual of Ohio (OH)
- … Supplement, and individual plans.** **Responsibilities** **Provider Reimbursement Analyst II** Under general supervision, supports assigned provider network ... Works on various projects related to the analysis of claims , clinical and financial data, with a focus on...models. . Performs other duties as assigned. **Provider Reimbursement Analyst III** Under general to limited supervision, supports assigned… more
- Medical Mutual of Ohio (OH)
- …coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Provider Analyst II** ... and performs analytical review of opportunities with provider networks. Performs claims repricing, discount analyses, etc. to support group sales efforts and… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by ... new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well… more
- General Dynamics Information Technology (Fairfax, VA)
- …economist + Five years of experience working with healthcare data including pharmacy claims , NDCs, and knowledge of Medicare payment policy preferred. + ... turn data into action as a Senior Healthcare Statistical Analyst at GDIT. Your work will provide transformative solutions... joining our team to support the Centers for Medicare and Medicaid Services. You will support a diverse… more
- Medical Mutual of Ohio (OH)
- …and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** Senior ... Employer Group Consulting Analyst Design and execute analyses and reports for clients...sources. . Track record of success with analyzing clinical, claims , pharmacy, program and other administrative data. . Intermediate… more
- WellSense (Boston, MA)
- …claim files absorbed by the data warehouse on a monthly basis. . Works with Claims Operations Analyst to provide reports to assist with identification of claim ... Internal Controls/ Operational Financial Analyst WellSense Health Plan is a nonprofit health...company serving members across Massachusetts and New Hampshire through Medicare , Individual and Family, and Medicaid plans. Founded 25… more
- Prime Therapeutics (Glen Allen, VA)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... our passion and drives every decision we make. **Job Posting Title** Lead Business Analyst **Job Description** The Business Systems Analyst (BSA) Lead IT is… more
- The Cigna Group (St. Louis, MO)
- **Product Management Lead Analyst - Centene Operations Management** **_This is a hybrid role and will require the ability to work in person._** The job profile for ... this position is Product Management Lead Analyst , which is a Band 3 Senior Contributor Career...accountabilities associated with all regulated lines of business including Medicare , Medicaid, and Marketplace (Exchange / Health Care Reform).… more
- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Analyst III Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: ... to achieve that purpose. Job Summary The Payment Integrity Analyst III is responsible for leading or assisting in...team lead on any issues identified during research or claims review. Serves as a subject matter expert and… more
- Mohawk Valley Health System (Utica, NY)
- Billing/AR Analyst - Full Time - Days Department: BILLINGS CLAIMS Job Summary The Billing Accounts Receivable Analyst is responsible for processing all ... VNA/Home Care Services claims to primary and secondary payers promptly and accurately...promote financial stability within the organization. Experience in billing Medicare , Medicaid, Commercial Insurance, HMOs, and Worker's Comp/No Fault… more
- Johns Hopkins University (Baltimore, MD)
- …across markets, organizations, populations, and technologies. The platform houses Centers for Medicare & Medicaid (CMS) health insurance claims data and is ... Hopkins Business of Health Initiative (HBHI) is seeking a **_Sr. Statistical Programmer Analyst and Data Manager_** to support health policy and economic research on… more
- Hartford HealthCare (Farmington, CT)
- …from all carriers. Biller must efficiently and accurately correct and release claims to payers, while adhering to all client, state and federal guidelines. ... RESPONSIBILITIES: * Ensures claims are submitted timely and all filing deadlines are...billing are worked daily in the electronic billing software, Medicare or other online system, Siemens, or other core… more