- Stanford Health Care (Palo Alto, CA)
- …**This is a Stanford Health Care job.** **A Brief Overview** Clinical Government Audit Analyst and Appeal Specialist II plays a critical role in the Revenue Cycle ... well as excellent analytical and communication skills. The Clinical Government Audit Analyst and Appeals Specialist II will collaborate with clinical staff, coding… more
- GCI Communication Corp (Anchorage, AK)
- …matrix (HRBP, Benefits, Payroll, IT). + Document the issue, steps taken, and resolution ; close with confirmation. Claims Administration + Intake and date-stamp ... employee records, assisting with HR help desk inquiries, and coordinating claims , reporting, and administrative processes that ensure compliance, consistency, and… more
- UPMC (Pittsburgh, PA)
- UPMC is hiring an Expert Senior Systems Analyst to join their highly accomplished team. This position is specifically for the Hospital Billing Claims Bridges EHR ... APPLY NOW!! Work Location: Hybrid: This position is predominately ' remote work' with the exception of the mandatory onsite...Act as a mentor for all level staff in resolution of Level 2 and Level 3 issues. Manage… more
- Molina Healthcare (Columbus, GA)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Molina Healthcare (Sterling Heights, MI)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... system and other applicable systems. + Participates in defect resolution for assigned component + Assists with development of...of new and existing health plans. + Executes retroactive claims reports + Runs fee schedule & MRDT update… more
- Beth Israel Lahey Health (Charlestown, MA)
- …Cycle Denial Analyst is charged with coordinating the analysis and effective resolution of denied claims with the purpose of reducing overall denials and ... **Job Description:** **Essential Responsibilities:** Responsible for prioritizing and managing to resolution denied claims with third party payers. Research,… more
- CareFirst (Baltimore, MD)
- …setup of code sets used for configuration in benefits & pricing for claims processing, claims editing configuration set-up and maintenance. Analyzes business ... to day operational support, including product configuration error handling and issue resolution by analyzing back-end logs + Participates in government and industry… more
- NTT DATA North America (Oklahoma City, OK)
- …organization, apply now. We are currently seeking a HC and Insurance Operations Analyst to join our team. **Posisition:** ** Claims Case Manager** **This position ... or legally required benefits.** **Role Overview:** We are seeking a dedicated Claims Case Manager to provide comprehensive claim servicing to our insurance… more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this ... Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Healthcare Analyst Senior Location: Hybrid | Eagan, Minnesota Career Area: Data Analytics & ... make a difference, join us. The Impact You Will Have The Senior Healthcare Analyst is responsible for contributing to and supporting the strategic needs of the… more
- Commonwealth Care Alliance (Boston, MA)
- …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... 011250 CCA- Claims Hiring for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …considered. * 3 years of relevant health plan or provider office medical coding/ claims and/or Business Analyst experience in a healthcare setting applicable to ... Blue Cross and Blue Shield of Minnesota Position Title: Healthcare Coding Analyst Location: Hybrid | Eagan, Minnesota Career Area: Customer Service/Operations About… more
- Humana (Nashville, TN)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** This is not a remote work from home position Monday - Friday, Day Shift Schedule **Position: ... Clinical Risk Management Analyst ** **Mission Statement:** We, St Joseph's Health and Trinity...and oral communication skills, strong interpersonal, motivational and conflict resolution skills. + Strong management and administrative skills. +… more
- NYU Rory Meyers College of Nursing (New York, NY)
- Position Summary Manage claims adjudication by identifying contractual variances between posted and expected reimbursement for Article 28, Managed Care, Commercial ... and be part of the team that works towards resolution and improvement of the revenue cycle processes. Directly...Contact payer to resolve appeals and final solution to claims . Collaborate with the Director of Insurance Strategy in… more
- Highmark Health (Tallahassee, FL)
- …business/systems analysis, requirements definition and documentation, system design, and problem resolution . The analyst communicates with system end-users to ... Epic modules. **Preferred** + 2+ years of Healthcare Revenue Cycle experience ( Claims , Patient Access, Billing) + Epic Certification in Resolute Hospital Billing… more
- Molina Healthcare (UT)
- …and validate provider complaints and payment disputes, ensuring accurate and timely resolution in line with policy and contractual guidelines. + Partner with ... payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. +...potential problems. + Ability to work independently in a remote environment. + Ability to work with those in… more
- AIG (Atlanta, GA)
- …ROLE REQUIRES 4 DAYS PER WEEK IN OUR ATLANTA OFFICE LOCATION. THIS IS NOT A REMOTE ROLE. About the role: Senior BA Lead will work closely with business partners to ... required. + Experience as an underwriting assistant or in claims for insurance a plus. + Must have significant...multi-tasking. + Must be pro-active with issue identification and resolution . + Strong ability to perform analysis of medium… more
- Koniag Government Services (Vienna, VA)
- …the appropriate solver team. + Receiving and troubleshooting calls from international and remote users for issue resolution . + Escalating issues to the customer ... peripherals to include assessing system health, replacing components and submitting warranty claims with the vendor. **Requirements** + Shall have four years of… more
- CareFirst (Baltimore, MD)
- …day to day business technical support of systems and sub systems supporting claims , service, and membership within the organization in order to allow CareFirst to ... resources for benefit configuration, support of systems and sub systems supporting claims , service, and membership within the organization in order to allow… more
