- Healthfirst (UT)
- …in a simple and easy to understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively communicate with all levels ... Assist in the setup of code sets and defining pre-authorization guidelines used in claims configuration to drive application of medical policy and accurate … more
- Healthfirst (UT)
- …products, claims editing, reference data and their enhancements including claims configuration improvements, compliance and systems enhancements. + Follow ... the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier management. + Interpret… more
- Healthfirst (UT)
- … business rules within the claims processing system. + Identify claims configuration and contract implementation defects and improve departmental performance ... specifications and ensure proper system functionality and quality outcomes including claims configuration , provider set up, reimbursement methodology and core… more
- Molina Healthcare (West Valley City, UT)
- …areas. **KNOWLEDGE/SKILLS/ABILITIES** + Provides research and analytics associated with medical claims processing requirements (1500 and UB04), provider and benefit ... configuration , and other claim reimbursement drivers + Recognizes, identifies and documents changes to existing business processes and identifies new opportunities… more
- Molina Healthcare (Layton, UT)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... **KNOWLEDGE/SKILLS/ABILITIES** + Analyze and interpret data to determine appropriate configuration changes. + Accurately interprets specific state and/or federal… more
- Intermountain Health (Murray, UT)
- **Job Description:** As a Business Systems Analyst , you will work closely with the business areas to identify and understand their needs and requirements. The major ... to major projects. Requirements may be specific to healthcare insurance products, claims , sales activities or other service-related processes; all in support of… more
- Molina Healthcare (Salt Lake City, UT)
- …and conversion of new and existing health plans. + Must have experience on claims processing system, benefit configuration . + SQL knowledge is preferred. + ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Molina Healthcare (Provo, UT)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... and other business requirements. **KNOWLEDGE/SKILLS/ABILITIES** + Trains staff on configuration functionality, enhancements, and updates. + Works with internal and… more
- HealthEdge Software Inc (Salt Lake City, UT)
- …implementing proprietary healthcare edits that drive cost savings and accuracy in claims processing. The successful candidate will be responsible for taking a senior ... level role in analyzing claims data, as well as translating contract terms, policies,...features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines of business. Payment Integrity… more
- Evolent (Salt Lake City, UT)
- …a deep understanding of end user outputs, platform development & configuration , multisystem functional requirements, business rules, and leverage that knowledge to ... + 5-8+ years of IT and / or business experience in an HMO / PPO Claims , Medicaid, Medicare and / or managed care healthcare environment + Knowledge of the Affordable… more