- Molina Healthcare (Buffalo, NY)
- …DESCRIPTION** **Job Summary** Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains ... critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they… more
- Molina Healthcare (Cincinnati, OH)
- …of business rules as they apply to each database. Validate accuracy of configuration and ensure adherence to business and system requirements of customers as it ... Responsible for work load assignment to auditors. Train and coach new employees . Provide clear and concise results and comments to leaders about focal and and… more
- Sharp HealthCare (San Diego, CA)
- …claims, provider , billing, capitation, financial and structural. The Systems Analyst -EDI Mgmt will work to streamline processes, create efficiencies and complete ... Do** Under the direction of the Manager of EDI Management, the Systems Analyst -EDI Mgmt will use technical and analytic skills to complete monitoring, reviewing,… more
- Commonwealth Care Alliance (Boston, MA)
- …to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements ... issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare,… more