- Fifth Third Bank, NA (Cincinnati, OH)
- …related experience. + Prior PC experience to include advanced Excel, Word and Access. Claims Analyst I At Fifth Third, we understand the importance of ... opening. GENERAL FUNCTION: Responsible for completing and filing investor/insurer claims within required guidelines in order to recoup 5/3's...of the default cycle. This results in approximately 200 claims being filed on a monthly basis and $30.0… more
- Highmark Health (Columbus, OH)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Cognizant (Columbus, OH)
- 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...test plans and test cases for ETE -Health Care Claims / Membership based applications. . Perform Automation testing… more
- Molina Healthcare (Akron, OH)
- …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... that the contracts are configured correctly in QNXT. The claims are reviewed to ensure that the configured services...to detect any gaps in the correct payment of claims Make recommendations for potential revision and updates *… more
- Prime Therapeutics (Columbus, OH)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Medical Mutual of Ohio (OH)
- …fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the ... initiatives to improve member health. + Orients and trains more junior-level Analyst + Participates in required trainings and performs other duties as assigned.… more
- 7-Eleven (Enon, OH)
- …Compensation Analyst Apply Now (https://my7elevenhr.wd12.myworkdayjobs.com/Careers/job/SSC-Enon-OH/Workers-Compensation- Analyst \_R25\_0000008015-1/apply) Save ... 45323, United States Location Enon, Ohio Summary: The Workers' Compensation Analyst is responsible for overseeing the administration of designated Third-Party… more
- Molina Healthcare (Dayton, OH)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Recovery & Resolution Analyst - Remote **Job Description** The Recovery & Resolution Analyst is ... coordination with an external collection agency + Evaluate audits, investigations and/or claims identified for potential recoupment to verify that results are final… more
- Baylor Scott & White Health (Columbus, OH)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more
- CGI Technologies and Solutions, Inc. (Columbus, OH)
- **Financial Analyst ** **Category:** Business Analysis (functional and technical) **Main location:** United States, Ohio, Columbus **Position ID:** J0825-1828 ... Description:** Under the management of the Finance Manager, the Financial Analyst carries out processing and financial administration for the assigned contracts.… more
- Marathon Petroleum Corporation (Findlay, OH)
- …Marathon Petroleum Company LP has an opportunity for a Senior Workers Compensation Analyst in Findlay, Ohio. The Workers Compensation Analyst reports to the ... KEY RESPONSIBILITIES + Manages all aspects of employee injury claims , including but not limited to timely reporting of...return to work and requesting settlement authority to resolve claims . + Ensures compliance with all state and federal… more
- Molina Healthcare (Cleveland, OH)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, accurate, ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
- Elevance Health (Cincinnati, OH)
- **Advanced Analytics Analyst Senior - Medical Economics** **Location:** Atlanta, GA; Norfolk, VA; Indianapolis, IN; Cincinnati, OH; Chicago, IL (preferred). This ... passionate about transforming American healthcare delivery. The **Advanced Analytics Analyst Senior** measures financial performance of core Carelon products… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: The Fraud Analyst I is a cross functional position within Fraud Operations. Fraud Analyst ... Domestic Collections - Responsible for processing and decisioning fraud check dispute claims . Includes working alerts, dispute cases and inbound call inquiries… more
- Molina Healthcare (OH)
- …to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee, ... and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and performs audits and oversight functions involving business-critical… more
- Prime Therapeutics (Columbus, OH)
- …and drives every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst ... and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience in the implementation of… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and ... existing lines of business and expansion into new states. The Lead Analyst , Reimbursement will be primarily responsible for implementation, maintenance, and support… more
- Highmark Health (Columbus, OH)
- …is a remote based role - looking for someone who has some claims experience and looking to become familiar with risk adjustment.** **ESSENTIAL RESPONSIBILITIES** + ... 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 1 -… more
- ClarkDietrich (West Chester, OH)
- …and benefits. Join the ClarkDietrich team by applying to the Credit & Treasury Analyst position at our West Chester, OH location. The Credit & Treasury Analyst ... coverage + Coordinate the annual insurance renewal process and support claims management + Maintain accurate records of all insurance policies, certificates,… more