- Centene Corporation (Raleigh, NC)
- …area of compliance ; in particular HIPAA, and state regulations. Experience with Medicare claims , specifically Medical Claims Part C and Provider Network, ... workplace flexibility. **Position Purpose:** Assist in maintaining Centene Corporation's Compliance Program; guide special projects; provide regulatory interpretation; perform… more
- Humana (Raleigh, NC)
- **Become a part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... closely with IT, the pricing software vendor, CIS BSS, claims operations, and other business teams involved in the...+ Creating and executing comprehensive test plans + Ongoing Medicare Pricer maintenance, quality assurance, and compliance … more
- Prime Therapeutics (Raleigh, NC)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... Pharmacy Benefit Management (PBM) or healthcare experience with understanding of Medicare , Medicaid, the Exchanges along with regulatory compliance requirements… more
- UNC Health Care (Chapel Hill, NC)
- …well-being of the unique communities we serve. Summary: The Revenue Integrity Analyst is responsible for researching and resolving complex carrier/payor claim edits, ... coding denials. Works with departments on charging and coding issues. Possess claims coding, reimbursement, and billing skills to review and analyze charges and… more
- Cognizant (Raleigh, NC)
- …on optimal configuration decisions in collaboration with business teams. + Ensure compliance with Medicaid and Medicare program requirements. **Work model:** We ... **Sr QNXT Config Analyst ** **Job ID:** \#00066084291 **Location:** Remote **Work Model:**...configuration and optimization of QNXT systems to support healthcare claims processing and reimbursement. You will be a valued… more
- Humana (Raleigh, NC)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more