- Molina Healthcare (Yonkers, NY)
- …cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health Plans ... is a general role in which employees work with multiple types of business data. Will work cross functionally across multiple business areas.… more
- Molina Healthcare (Yonkers, NY)
- …Description** Who you are : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise and cloud based ETL/BI ... You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You...QA role within our Agile team is a Senior Analyst position dedicated to ensuring the highest quality standards… more
- Molina Healthcare (Yonkers, NY)
- …during EST hours **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive… more
- Molina Healthcare (Yonkers, NY)
- …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 existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is… more
- Molina Healthcare (Yonkers, NY)
- …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
- Nuvance Health (Danbury, CT)
- …claim submission for designated groups of accounts by payer.Insures that all claims are compliant with State and Federal billing regulations and contractual ... Confirmation of electronic and hard-copy billing of any delinquent claims . Rebilling & follow-up of all delinquent claims...impose an undue hardship on the operation or our business . If you believe you require such assistance to… more
- Nuvance Health (Danbury, CT)
- …submission for designated groups of accounts by payer. Insures that all claims are compliant with State and Federal billing regulations and contractual obligations. ... Confirmation of electronic and hard-copy billing of any delinquent claims . Rebilling & follow-up of all delinquent claims...impose an undue hardship on the operation or our business . If you believe you require such assistance to… more
- New York State Civil Service (White Plains, NY)
- …following areas of function:* Investigates suspicious activity and can work on the Claims , Premium Audit, Provider Fraud, and/or Data Analytics team on a variety of ... and performance. Preferred Qualifications:* Knowledge in use of IBM i2 Analyst Notebook * Intermediate or Advanced Microsoft software (Excel/PowerPoint)* Desire to… more
- Molina Healthcare (Yonkers, NY)
- …meet data analysis and database development needs. + Reviews, evaluates, and improved business logic and data sources. + Resource to staff for mentoring, coaching, ... and analysis questions. + Reviews Medical Economics analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting requirements and Health Plan… more