- Molina Healthcare (Grand Rapids, MI)
- …trends or discrepancies related to over- or underpayment. + Utilize QNXT to research claims history, provider contract setup, and benefits configuration. + Work ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Molina Healthcare (Grand Rapids, MI)
- **Job Description** **Job Summary** The Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. ... The analyst will support existing lines of business and expansion...Technical Configuration and Configuration Information Management. **Job Duties** + Research , review, and decipher state-specific Medicaid and Medicare reimbursement… more
- Molina Healthcare (Grand Rapids, MI)
- …around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research , analysis and modeling of complex healthcare claims data, ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...provides insights needed to support strategic investment decisions + Research and develop reports and analyses for senior management… more
- Veralto (Grand Rapids, MI)
- …growth. Reporting to the Import Export Compliance Manager, the Trade/Logistics Analyst , is responsible for identifying and implementing strategies to minimize tariff ... tariff classification accuracy. We are seeking a detail-oriented and analytical Logistics Analyst to support our global trade compliance and supply chain teams. This… more
- Corewell Health (Grand Rapids, MI)
- Job Summary Responsible for the analysis, research and completion of complex member appeal investigations. Effectively administer all steps of the member appeal and ... (external medical records, internal documentation from enterprise-wide systems including: claims payments, billing and enrollment, care management, medical, pharmacy… more
- Molina Healthcare (Grand Rapids, MI)
- …+ Actively participates in all stages of project development including research , design, programming, testing and implementation to ensures the released product ... technical teams + Appeals & Grievance, healthcare services, or claims background **Preferred License, Certification, Association** Certified Business Analysis… more
- Corewell Health (Grand Rapids, MI)
- …collects and documents findings for management review. Investigation may include research , interviews, data analysis, and substantive desk or onsite medical record ... interviews, medical records audits, data mining, perform compliance audits of medical claims , fee screens and other payment mechanism to ensure accurate payment. +… more