- Highlight Health (Philadelphia, PA)
- …hard-working individual to guide and optimize the most crucial department of our business - claims analysis and resolutions. In addition to an extensive background ... a mission-driven company that protects consumer rights and controls healthcare costs exclusively for self-funded employers and their stop...are looking for a health coverage large and complex claims analysis expert - an expert who has scrutinized… more
- MetroPlusHealth (New York, NY)
- …Qualifications Bachelor's degree required A minimum of 5 years' working experience within claims in the healthcare or insurance industry Extensive knowledge of ... About NYC Health + Hospitals MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island… more
- Molina Healthcare (Long Beach, CA)
- Job Description Job Description Job Summary The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates Assists and collaborates...reporting for the assigned state Works in an agile business environment to derive meaningful information out of complex… more
- Nationwide Mutual Insurance Company (Milwaukee, WI)
- …Benefits (Stop Loss), we empower self-funded employers to take control of their healthcare costs with confidence. Backed by the strength and stability of the ... brand, our stop loss solutions offer financial protection against catastrophic claims , helping businesses manage risk while supporting employee well-being. With… more
- RxSense (Princeton, NJ)
- …Forbes' Top Startup Employers, Modern Healthcare 's Best Places to Work in Healthcare , and Inc's Best in Business and Best Workplaces. Position Summary : ... The Formulary Analyst plays a key role in the configuration, maintenance,...(PBM) 1+ year's of experience in formulary operations, pharmacy claims adjudication, or related healthcare analytics. Demonstrated… more
- Harbor, Inc. (Toledo, OH)
- …hours per week. Education/Experience/Other Requirements : Bachelors of Science in business administration, finance/accounting or other healthcare related area or ... Demonstrated understanding of grant reporting. Previous experience in a healthcare environment is desirable. Proficiency in Microsoft application suite, particularly… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... assess business impacts, and make recommendations through use of healthcare analytics, predictive modleing, etc. + Interact with various departments including;… more
- Molina Healthcare (Grand Island, NE)
- …combination of education and experience **Required Experience** + 5-7 years of business analysis experience with an emphasis in claims payment accuracy ... the Nebraska Health plan SLT by providing subject matter expertise on complex claims related issues and service recovery efforts.** Analyzes complex business … more
- Cognizant (St. Louis, MO)
- **QA Analyst Healthcare Domain - Payer & Claims Testing** This is a remote position open to any qualified applicant in the United States. We are seeking a ... highly skilled and motivated **QA Analyst Healthcare Domain - Payer & Claims Testing**...activities ensuring efficient workflow and communication. Conduct manual end-to-end business process assurance testing focusing on the Claims… more
- Levi, Ray & Shoup, Inc. (Chicago, IL)
- …Global NavigationEmployee Login (http://www2.lrs.com) File Transfer Filters Careers Added Jul 21, 2025 Business Analyst - Claims Systems (26971) Chicago, IL ... need to talk! LRS Consulting Services is seeking a Business Analyst for a long-term, hybrid onsite... will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy and… more
- Panasonic North America (De Soto, KS)
- …join a team that's changing the world? Do you have a strong background as a Claims Analyst ? Then we're looking for you! Check out the job description and apply ... make a meaningful impact on the future of energy and transportation. **Job Summary:** The Claims Analyst plays a key role in the insurance claims lifecycle… more
- Molina Healthcare (Buffalo, 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
- Kuehne+Nagel (Jersey City, NJ)
- …At Kuehne+Nagel, our work contributes to more than we imagine. **** As a Liability Claims Analyst , you will be an integral team member of the North America ... to over 30 countries worldwide since 1972. As Claim Analyst you will handle Marine Liability claims ...skills, job location, internal pay equity, and other relevant business considerations. Kuehne+Nagel reviews pay ranges regularly to ensure… more
- Molina Healthcare (Roswell, NM)
- …Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk ... adjustment to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience… more
- Molina Healthcare (Provo, UT)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Senior Financial Analyst ? At HCA Healthcare , you come first. HCA Healthcare has committed up ... members over the course of three years. **Benefits** HCA Healthcare , offers a total rewards package that supports the...difference. We are looking for a dedicated Senior Financial Analyst like you to be a part of our… more
- Cognizant (Cincinnati, OH)
- …and Digital Business Assurance in Gartner Magic Quadrant! **Senior QA Analyst - Healthcare Facets Testing** **Location: Cincinnati, OH (Hybrid)** **Required ... Cognizant Technology Solutions is looking for a **"Senior QA Analyst - Healthcare Facets Testing"** to join...of its functionalities. . Have a strong background in healthcare domains particularly in Enrollment and Claims … more
- Munson Healthcare (Traverse City, MI)
- …or GED 2 Year / Associate Degree and 2 Associates degree in Business Administration, Accounting or healthcare related field or equivalent work-related experience ... Reimbursement Analyst - Home Infusion Pharmacy Job Code: 2907...a team member to accomplish goals of the Munson Healthcare Home Infusion Pharmacy, as well as organizational goals.… more
- Beth Israel Lahey Health (Wakefield, MA)
- …including but not limited to:** + Understands the medical and pharmacy claims adjudication circle terminology, healthcare quality and EHR terminology and ... the reporting documentation repository. + Collaborates with the Medical Director(s) and business associates (eg, healthcare plan, PBM, consultants) to define the… more
- Prime Therapeutics (Eagan, MN)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization + ... It fuels our passion and drives every decision we make. **Job Posting Title** Sr. Business Systems Analyst **Job Description** The Sr. Business Systems … more
