- Robert Half Accountemps (Raleigh, NC)
- Description We are looking for a detail-oriented Medical Claims Analyst to join our team in Raleigh, North Carolina. This long-term contract position is ... ideal for someone with extensive experience in medical claims processing and a strong ability to manage repetitive clerical tasks effectively. The role requires… more
- Cognizant (Raleigh, NC)
- About the role As a **Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end test ... strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality Engineering team and… more
- Norstella (Raleigh, NC)
- Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States Date Posted: Oct 27, 2025 Employment Type: Full Time Job ID: R-1548 **Description** At ... to extract meaningful insights from **real-world data (RWD)** sources, including ** claims , laboratory results, billing codes, and electronic health records (EHRs)**… more
- Baylor Scott & White Health (Raleigh, NC)
- …2 Years of Experience in Healthcare Analytics + 2 years working with ACA and Medical Claims , MMR, MOR, MAO-002, MAO-004 and RAPs/EDS data + Experience with ... + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight...outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter… more
- Prime Therapeutics (Raleigh, NC)
- …with data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... decision we make. **Job Posting Title** Data & Reporting Analyst - REMOTE **Job Description** The Data & Reporting... - REMOTE **Job Description** The Data & Reporting Analyst is responsible for supporting the business in decision… more
- Humana (Raleigh, NC)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- City of Durham (Durham, NC)
- Business Services Analyst , Sr. Print (https://www.governmentjobs.com/careers/durhamnc/jobs/newprint/5114446) Apply Business Services Analyst , Sr. Salary ... - $84,000 Hours/Schedule/Shift: 8:00am - 5:00pm The Sr. Business Services Analyst is devoted to providing advanced-journey level management analysis and oversight;… more
- CVS Health (Raleigh, NC)
- …R, Alteryx, Trifacta, Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and… 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
- NTT DATA North America (Raleigh, NC)
- …an overall sourcing strategy. NTT DATA Services currently seeks a **QA Data Analyst ** to join our team in **NC, Remote.** **Role Responsibilities** + Write advanced ... validation, and reconciliation between sources and outputs. + Work with claims (institutional, professional, dental, pharmacy) and clinical data sources (lab,… more
- CVS Health (Raleigh, NC)
- …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning ... the negotiation role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role as a negotiator,… more
- Brink's (Raleigh, NC)
- …we provide equal opportunity to participate and grow. Job Summary: The Risk Analyst is responsible for performing research and analytical work for the safety, ... + MBR and QBR presentations and data collection + Claims Dashboard and reporting by SLAs and exposures +...employment with Brink's US We provide a competitive salary, medical , dental, vision and life insurance plans. In addition,… more
- Evolent (Raleigh, NC)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from ... innovative analytics solutions that drive decision-making for clients by performing medical economics analyses to determine cost and utilization drivers. Showcase… more
- Sedgwick (Raleigh, NC)
- …INCLUDE** + Ensures software scalability and data integrity throughout all claims -related applications. + Ensures software compatibility and alignment with overall ... client programs involving numerous interfaces or system modifications. + Manages analyst /programmers as needed. + Reviews software change requests to identify… more
- Public Consulting Group (Raleigh, NC)
- …methodologies to ensure transparency and repeatability. + Develop and implement claims -based quality metrics to assess the performance of Medicaid programs. + ... Analyze large datasets of Medicaid claims to identify trends, patterns, and insights..Collaborate with healthcare providers, policymakers, and other stakeholders to… more
- Elevance Health (Durham, NC)
- …healthcare analytics, and/or financial services highly preferred. + Comprehensive understanding of medical claims data. + Intermediate to Advanced expertise with ... American healthcare delivery. The **Senior Health Economist (** Advanced Analytics Analyst Senior) measures financial performance of core Carelon products leveraging… more
- Public Consulting Group (Raleigh, NC)
- …Third Party Administrator Services + Enhance Health and Public Safety Services + Claims Processing Services and Solutions + Consulting and Advisory Services + Cost ... + Provides leadership, management, and direction to the Quality Assurance Analyst team. + Leads and manages department providing oversight on operations,… more