- TEKsystems (Minneapolis, MN)
- …caused by errors coded into the RxClaim processing system, along with claims monitoring and data validation activities. The research and remediation steps can ... and data science techniques to research and validate errors, isolate impacted claims , reprocess claims , and determine financial impact to members, health… more
- TEKsystems (Minneapolis, MN)
- … Claims , RxClaims, Pharmacy benefits, Health insurance, Claims Analyst , Audit, support, analysis, workflow, claim, Healthcare, Medical Terminology Top ... Skills Details: Claims , RxClaims, Pharmacy benefits, Health insurance, Claims Analyst , Audit, support, analysis Additional Skills & Qualifications: High… more
- Providence (MT)
- …retain the best people, we must empower them._** **Providence is calling a Senior Business Analyst - Risk, Liability & Claims who will:** + Be responsible for ... improving risk data management and reporting. **Providence welcomes 100% remote work for applicants who reside in one of...caregivers + 2+ years of experience working with healthcare claims and / or electronic medical record… more
- Commonwealth Care Alliance (Boston, MA)
- …the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing ... experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims ,… more
- Randstad US (Las Vegas, NV)
- claims analyst . + las vegas , nevada ( remote...and flexible after If you have previous experience in Medical Claims Processing or Medical ... leader in the healthcare industry, is currently hiring a Claims Analyst to work in the MST...4 PM education: High School Responsibilities + Research why medical claims are in the Pre-Payment Review… more
- Sedgwick (Columbus, OH)
- …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Performance Assurance Analyst - Property Claims (Part Time Opportunity) **PRIMARY PURPOSE** ... **:** Performs comprehensive reviews on personal and commercial lines claims of varying degree of severity (up to approximately $300,000) to ensure the highest… more
- Hackensack Meridian Health (Edison, NJ)
- … III on our Digital Technology Services team** **!** **Our openings include:** **Applications Analyst III - Epic Resolute HB/PB Claims :** Candidates need to be ... and serve as a leader of positive change. The **Applications Analyst III** gathers business requirements, conducts needs assessments, and develops functional… more
- AECOM (Sacramento, CA)
- …better world. Join us. **Job Description** **AECOM** is seeking a **Senior Forensic Claims Analyst ** to be based in **Sacramento, CA.** **JOB RESPONSIBILITIES:** ... analysis providing reasonable and realistic schedule forecasts. + Review Contractors' claims and assist with responses and potential rebuttals. + Other duties… more
- Adecco US, Inc. (Phoenix, AZ)
- We are currently looking for Claims Representatives for a Remote Opportunity. **You MUST be located within the Phoenix area and have the following ... qualifications** : + **1-2 Years Claims Processing/Reviewing Experience** + Strong Computer Skills + Works...applications/software simultaneously. + 1st day is ONSITE and then remote + Schedule times may vary from 6a -… more
- UPMC (Pittsburgh, PA)
- …revises better best practice within the department. The Intermediate Clinical Auditor Analyst reviews medical records, creates, maintains, and analyzes auditing ... working in collaboration with appropriate Health Plan departments including Quality Improvement, Claims , and Medical Directors as needed to facilitate the… more
- Prime Therapeutics (Columbus, OH)
- …producing production data for reports, scorecards, or other data using Pharmacy and/or Medical claims data to support projects and initiatives throughout the ... every decision we make. **Job Posting Title** Clinical Research Analyst , Senior - Remote **Job Description** The...code, data features, and data output using eligibility data, medical and pharmacy administrative claims . The individual… more
- Kelly Services (Niskayuna, NY)
- …here for you! We're seeking a ** Remote (CST or EST only) Global Services Fleet Analyst to work at GE Vernova** . Sound good? Take a closer look below. You owe it ... Rate/Compensation:** $30-$35/hour (depending on experience) **Shift:** Monday-Friday 8am-5pm **Location:** Remote , in CST or EST time zones only **Benefits:**… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Senior Reimbursement-Chargemaster Analyst -Chargemaster/Projects - REMOTE ** The Senior Reimbursement and Chargemaster Analyst is ... maintaining competitive pricing. This individual is a senior level analyst who assumes a lead role and works closely...and reimbursement to ensure compliance with Federal and State claims submission regulations + Ensures the existence of accurate… more
- CareFirst (Baltimore, MD)
- …new concepts that will target claim overpayment scenarios. Performs analysis on claims , provider data, enrollment data, medical policies, claim payment policies ... **Resp & Qualifications** **PURPOSE:** The Payment Integrity Analyst is responsible for conducting research and analysis and reviewing billing requirements, provider… more
- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Senior Health Informatics Analyst - Remote **Job Description Summary** Design, document, develop and ... used in addressing these issues. **Job Description** + 100% Remote + Performs exploratory data analysis and data mining...solutions to complex business problems. + Experience with healthcare medical and pharmacy claims data manipulation and… more
- University of Rochester (Rochester, NY)
- Responsibilities **Location:** Rochester Tech Park (RTP), Gates, NY - Remote options available after in-person training. Occasional onsite meetings / work at RTP are ... required. Remote location must be within 2 hours of RTP...With latitude for initiative and independent judgment, the Data Analyst I is responsible for supporting the Payment Posting/Data… more
- AssistRx (Orlando, FL)
- The Data Quality Analyst is responsible for acquiring, managing and analyzing data that will be presented to internal teams, clients and partners. The Data ... Analyst leads the onboarding of electronic data trading partners...issues. Successful applicants will have experience with Excel Pharmacy Claims experience is a huge plus Requirements + Developing… more
- The Cigna Group (Bloomfield, CT)
- …be detail oriented, self-motivated, and have excellent organization skills * Understanding of medical claims submissions is preferred * Ability to meet timeline, ... **Job Summary:** The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates… more