- Molina Healthcare (Grand Rapids, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
- Molina Healthcare (Grand Rapids, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- Molina Healthcare (Grand Rapids, MI)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (Grand Rapids, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule… more
- Molina Healthcare (Grand Rapids, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with… more
- Molina Healthcare (Grand Rapids, MI)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...in contracts and benefits configuration. + Strong background in claims is required . + Experience working on… more
- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... organizations. + Maintains SharePoint Sites as needed. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… more
- Molina Healthcare (Grand Rapids, MI)
- …information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each ... Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network… more
- Corewell Health (Grand Rapids, MI)
- …and/or Supervisor in coordinating activities and in the development/collection of materials required to meet and demonstrate compliance to all state, federal and ... and/or Manager in coordinating activities and in the development/collection of materials required to meet and demonstrate compliance to all state, federal and… more
- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… more
- Corewell Health (Grand Rapids, MI)
- …fraud awareness for members, providers, employer groups, agents and vendors. Qualifications Required + Bachelor's Degree or equivalent Health, Business or ... interviews, medical records audits, data mining, perform compliance audits of medical claims , fee screens and other payment mechanism to ensure accurate payment. +… more
- Molina Healthcare (Grand Rapids, MI)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more