- Molina Healthcare (IA)
- …solution or configuration during warranty period. **KNOWLEDGE/SKILLS/ABILITIES** + Knowledge of healthcare claims and claim processing from receipt through ... functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received… more
- TEKsystems (Madison, WI)
- Must live and work remotely in Wisconsin Description As a Claims Analyst II you will be tasked with the following: - Examine and process paper claims and/or ... claims for payment up to $18,000.00. - Reviews claims for re-pricing. Enters eligible claim data ...Reviews claims for re-pricing. Enters eligible claim data into appropriate WRAP network re-pricing website. Overrides … more
- Molina Healthcare (Cleveland, OH)
- …+ Locate and interpret regulatory and contractual requirements + Tailors existing reports or available data to meet the needs of the claims project + Evaluates ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Providence (Renton, WA)
- …insurance codes, regulations, and our department's policies and procedures + Secure monthly claims data reports and provide quality assurance recommendations to ... claims files for quality assurance purposes + Experience working with claims data analytics + Experience in project management + Experience creating… more
- Molina Healthcare (Austin, TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** ** Claims Analyst ** **Location:** Trinity Health PACE Corp Michigan, Livonia, MI **Status:** Full time ... work in the office each Wednesday. **Position Purpose:** The Claims Analyst is responsible for analyzing and...enrollments, disenrollments, and plan changes to CMS. + Submits data to CMS to ensure compliance with all reporting… more
- CenterLight Health System (NY)
- …returned monies and proper application of transaction by our TPA. + Perform in-depth claims analysis using multiple data sets, conduct root cause analysis, and ... JOB PURPOSE: The Claim Analyst will play a pivotal role in enhancing...managed care setting is strongly preferred. + Proficiency in data analytics, ie SAS, SQL. + Claims … more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: May 15, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 61400 **Who we are** ... a difference with. **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid Drug...with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and… more
- TEKsystems (Menasha, WI)
- Description As a Claims Analyst II you will be tasked...to 5pm Top Skills Details Insurance claims Claims processing Medical claims Data Entry ... & Qualifications MUST: - More than two years of claims processing experience required ( healthcare related) -...two years of claims processing experience required ( healthcare related) - Knowledge of current procedural terminology (CPT)… more
- Healthfirst (NY)
- …of Medicare and Medicaid programs and reimbursement methodologies a plus. + Knowledge of healthcare claims processing practices in a managed care setting a plus. ... + Perform training and quality assurance on mass claim adjudications and automated data load processes. + Query and manipulate claims configuration and claim… more
- Carrington (Frankfort, KY)
- …amazing team and work remote from home! The Loss Claim Recovery Analysis Analyst is responsible for performing financial reconciliation on all liquidated loans and ... external investors providing opportunity for investor rebuttals. Accountable for analyzing multiple data elements in order to apply the proper decision rationale and… more
- Bloom Healthcare (Lakewood, CO)
- …seeking a Data Analyst , Value Based Care, to lead data analytics initiatives that support Bloom Healthcare 's population health strategies. This position ... Job Title: Data Analyst , Value Based Care Location:...Experience working with large healthcare datasets, including claims , eligibility, and encounter data + Demonstrated… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. **Senior Healthcare Data Analyst ** **(Location - Albany, NY)** **Summary:** The ... Data Analyst will work within the Division of ...reports in support of the intake and management of healthcare data . The ideal candidate will be… more
- Molina Healthcare (NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Centene Corporation (Salt Lake City, UT)
- …the applicant to use advanced analytics and apply statistical rigor to member and claims data to evaluate the impact of internal clinical programs, external ... and improve their clinical outcomes. + Interpret and analyze data from multiple sources including healthcare provider,...and analyze data from multiple sources including healthcare provider, member/patient, and third-party data +… more
- HCA Healthcare (Nashville, TN)
- …Do you have the career opportunities as a Electronic Processing Operations Analyst you want with your current employer? We have an exciting opportunity ... which is part of the nation's leading provider of healthcare services, HCA Healthcare . **Benefits** Parallon, offers...you want to work as a Electronic Processing Operations Analyst where your passion for creating positive patient interactions… more
- State of Massachusetts (Boston, MA)
- …transparency and integrity in publicly funded healthcare programs. You will review healthcare data and evaluate claims and payment data ... work experience in independent public health policy analysis, reviewing and evaluating healthcare data , healthcare program evaluation, or public health… more
- HCA Healthcare (Nashville, TN)
- …you want to join an organization that invests in you as a Senior Benefits Financial Analyst ? At HCA Healthcare , you come first. HCA Healthcare has committed ... members over the course of three years. **Benefits** HCA Healthcare , offers a total rewards package that supports the...monthly reporting scorecard for performance guarantees. + Provide premium, claims , and administrative fee data to actuarial… more
- AdventHealth (Altamonte Springs, FL)
- …close the most critical gaps in lowering the cost of care. The Analyst uses healthcare data ( claims , labs, EHR data ) analytics to gain insights into ... **Health Plan Data Analyst ** **Location:** Virtual **All the...utilizing analytical software tools and applications + Health Plan claims data knowledge This facility is an… more
- LA Care Health Plan (Los Angeles, CA)
- …Required Licenses/Certifications Preferred Statistical Analysis System (SAS) Certification Certified Healthcare Data Analyst (CHDA) Required Training ... required to achieve that purpose. Job Summary The Clinical Data Analyst III supports Healthcare ...the relationships between the field elements in encounters and claims , membership, and provider databases. This position supports the… more