- Acosta Group (Jacksonville, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position...for change to provide continuous improvements. This is a Hybrid role. The Hybrid schedule for all… more
- Acosta Group (Irving, TX)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position..., assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.… more
- Fallon Health (Worcester, MA)
- …the Risk Adjustment Analyst (RAA) will be to function as the Claims SME for the Risk Adjustment & Analytics Department. The RAAimplements data analytic reports, ... as appropriate. **Responsibilities** **Primary Job Responsibilities:** + Analyze, prioritize & support resolution of Claims / Encounter data errors by triaging to… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Claims Analyst is accountable for claims processing, research and adjudication to correctly apply benefit determination and pricing for ... claims as directed by departmental policies and procedures; follows up for resolution and processes pended claims immediately following a benefit / payment… more
- State of Colorado (Denver, CO)
- Insurance Analyst (Rate/Financial Analyst II): DORA/Division of Insurance - Hybrid Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4638928) Apply Insurance Analyst (Rate/Financial Analyst II): DORA/Division of Insurance - Hybrid … more
- Mount Sinai Health System (New York, NY)
- **Job Description** Reimbursement (Supply) -Chargemaster Analyst Hybrid 150 East 42nd Stret The Reimbursement and Chargemaster Analyst is responsible for ... hospital billing, coding, and reimbursement, preferably as CDM coordinator, revenue cycle analyst or coding consultant is preferred. Nursing or clinical or materials… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key risk adjustment ... methodology, risk score calculation, ACA enrollment, premiums, medical and pharmacy claims , and provider data. Incumbent is responsible for performing complex… more
- Henry Ford Health System (Troy, MI)
- …Medicare Advantage, Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide ... root/cause analysis when required. The Analyst will work with HAP's medical directors, nurses, pharmacists, Legal department, and other subject matter experts to… more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director, and Other ... Coordinated Care Organization (financial understanding, provider network building, conflict/issue resolution , contracting, claim payment, meetings, training, etc.). **RESPONSIBILITIES:** +… more
- The Cigna Group (Houston, TX)
- …utilization, coding, and STARs/quality performance + Perform root cause analyses and resolution related to provider concerns, grievances, claims and care ... with other internal departments, including but not limited to Health Services, Finance, Claims , and Coding in order to develop solutions for strategic business needs… more
- The Cigna Group (Huntsville, AL)
- …utilization, coding, and STARs/quality performance. + Perform root cause analyses and resolution related to provider concerns, grievances, claims and care ... other internal departments, including but not limited to Health Services, Finance, Claims , and Coding in order to develop solutions for strategic business needs.… more
- Virtua Health (Mount Laurel, NJ)
- …optimize reimbursement within budget guidelines. Participate in ongoing coordination and resolution of revenue issues as they arise. Assists in troubleshooting and ... Financial Services staff for reporting problems and denials on individual claims . Assist in researching coding issues, provide guidance and recommend solution… more
- AIG (Atlanta, GA)
- …and professional service with empathy and efficiency. How you will create an impact The Claims Analyst III will handle and analyze general liability claims ... ensure proactive claims handling aimed at the prompt and cost-effective resolution of claims through well-developed action plans. Determine need for and… more
- CVS Health (Cumberland, RI)
- …to the Senior Manager of the Internal Audit Recovery Team, the Senior Analyst performs audits mainly related to retail and supports additional teams as requested. ... Collaborate with CVS internal and external partners to resolve audit claims . + Audit Reporting/Communication- Solid meeting management and oral/written communication… more
- University of Michigan (Ann Arbor, MI)
- Clinical Info Analyst Assoc Apply Now **Job Summary** We, the staff and faculty within the Department of Ophthalmology & Visual Sciences and Kellogg Eye Center are ... guidelines + Adhere to appropriate billing workque and submission claims + Manage claim denials and required follow up...Identify and track reoccurring operational problems and participate in resolution + Required to have knowledge and adhere to… more
- Aflac (SC)
- Financial Systems Analyst I The Company: CAIC The Location: SC, US The Division: Financial Services Job Id: 6754 Salary Range: $42,000 - $98,000 Job Posting End ... you at Aflac. Worker Designation - This role is hybrid . This means you will be expected to report...system cycles for Wynsure, VUE and FSCD; ensures that claims benefits, premium refunds and commissions processed are paid… more
- Medical Mutual of Ohio (Toledo, OH)
- **_The Operations Data Analyst II position allows you the_** **_flexibility to work a hybrid schedule (on-site and at home)_** **_as long as you reside within a ... and errors that involve internal and external systems, appeals, correspondence, claims and HIPAA data, and regulatory guidance; executes complex data-related… more
- Wells Fargo (San Antonio, TX)
- …begins with you. **About this role:** Wells Fargo is seeking a Quality Assurance Analyst in the Lending Fulfillment Customer Service team as part of the Commercial ... this role, you will:** + Examine and research complex programs, processes, claims , documentation, or files to ensure compliance with internal company requirements or… more
- University of Michigan (Ann Arbor, MI)
- …submission, error correction and insurance collections. + Initiate and process claims and other forms within prescribed guidelines; screening for accuracy, ... action when necessary, ensuring compliance. + Work across teams to ensure resolution (ie registration, refund team, payment posting, etc.). + Apply payments to… more
- State of Colorado (Denver, CO)
- …UNTIL MONDAY , OCTOBER 8, 2024 AT 5PM. This position will have remote and hybrid workplace options available but will still be required to report to the listed ... hearing officer, trial judge, and/or substantial experience litigating cases or claims in specifically identified federal, state, or local government administrative… more
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