- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for ... 011250 CCA- Claims Hiring for One Year Term **_This position...Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+… more
- Molina Healthcare (Jacksonville, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Savers | Value Village (Bellevue, WA)
- **Description** Job Title: Claims Analyst (Remote, USA) Pay Range: $52,014 - $73,860 Savers Benefits Geographic & job eligibility rules may apply Healthcare ... to supplement our offerings. What you'll be working on: The Claims Analyst supports Saver's risk mitigation strategy by conducting initial investigation and… more
- Levi, Ray & Shoup, Inc. (Chicago, IL)
- …The Business Analyst will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy and first-pass resolution rates. + Gather ... File Transfer Filters Careers Added Jul 21, 2025 Business Analyst - Claims Systems (26971) Chicago, IL...years relevant IT experience overall. + Experience in the Healthcare industry domain, including and especially Claims … more
- Prime Therapeutics (Austin, TX)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Claims Analyst - JUDI Ops Support - Remote **Job Description** The Claims ... Analyst is responsible for serving as a Claims Operations subject matter expert on system functionality which...processing or project lifecycle, or related roles in the healthcare or PBM industry + Must be eligible to… more
- Catholic Health (Buffalo, NY)
- …and technology method of transformation. Supports the organizations Revenue Cycle claims and remittance process. Identifies and implements EPIC and/or 3rd Party ... technical mechanics to support the work. A level II Analyst does so at a intermediate complexity and competency,...of job experience in a computer science, business or healthcare field + Associates: minimum four (4) years of… more
- WellSpan Health (York, PA)
- …providers, managers, and staff in departments to ensure correct coding of claims . + Maintains current knowledge of payer/insurance policies, rules and regulations, ... and federal guidelines. + Demonstrates initiative and resourcefulness by communicating results of claims review activity to PCS and PFS Leadership. + Serves as point… more
- Montrose Memorial Hospital (Montrose, CO)
- …sick and holiday pay. About Montrose Regional Health: + As the leading healthcare in the Uncompahgre Valley, MRH offers patients personalized and professional ... healthcare backed by the latest technology experience, and partnership,...23-specialties and sub- specialties. We are the hospital, the healthcare resource, and the employer of choice in our… more
- Molina Healthcare (NY)
- …Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk ... to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired +… more
- Molina Healthcare (Grand Island, NE)
- …advanced skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and ... to provide analytic support for finance, pricing and actuarial functions. + Healthcare Analyst I experience desired. + PowerBI, Excel, Power Pivot, VBA, Macros,… more
- Molina Healthcare (Columbus, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired +… more
- Molina Healthcare (Cincinnati, OH)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives ... solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. *… more
- Molina Healthcare (Louisville, KY)
- **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 relevant… more
- Molina Healthcare (MI)
- …and work PST hours. **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 relevant… more
- Molina Healthcare (Provo, UT)
- …trends, payment integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement ... Provides lead level support as a highly capable business analyst who serves as a key strategic partner in...operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to… more
- Molina Healthcare (Layton, 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
- 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 general supervision of the Manager, Clinical Analytics, the Health Care Analyst is responsible for providing high quality analyses that answer questions about… more
- The Cigna Group (Bloomfield, CT)
- The Quality Review & Audit Senior Analyst (" Analyst ") exhibits expertise in evaluating complex medical documentation for diagnosis code accuracy and compliance ... (RA) program and Risk Adjustment Data Validation (RADV) audits. The Senior Analyst is responsible for all aspects of auditing medical documentation for diagnostic… more
- Catholic Health (Buffalo, NY)
- …Exempt from Overtime: Exempt: Yes Work Schedule: Days Hours: 8-4 Summary: The Healthcare Analyst III will be responsible for compiling, formatting, maintaining ... and analyzing health care electronic medical record and claims data in order to track and trend health...and utilization objectives and NCQA accreditation requirements. Additionally, the Healthcare Analyst III will be responsible for… more
- Evolent (Helena, MT)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
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