- CVS Health (Woonsocket, RI)
- …and for successfully implementing this newly defined process. With respect to analytical research , this Claims Analyst would work with service requesters ... join and to grow with our finance operations team. This Senior Financial Analyst , Adjustment Reporting and Research position focuses on claim adjustment… more
- NJM Insurance (Trenton, NJ)
- NJM Insurance Group's Claims & Medical Services Analytics group is seeking a Claims Insights Analyst . The Claims Insights Analyst applies a strong ... through presentations, dashboards and visualizations to drive strategic decision making. The Claims Insights Analyst is a highly motivated, creative self-thinker… more
- Magellan Health Services (Albuquerque, NM)
- …5-7 years' claims experience. Minimum 1 year experience of complex claims research and/or issue resolution or analysis of reimbursement methodologies within ... The Claims Internal Resolution Analyst is responsible for coordinating the resolution of claims issues locally at the health plan by actively researching and… more
- Axis (Alpharetta, GA)
- …in the selection process. Part of AXIS Claims Shared Services, the Claims Operations Analyst is responsible for the performance, oversight, and ongoing ... improvement of Claims support activities performed within our North America ...include support around several claim financial transactions, including payment research , reporting, expense allocations, and payment validations. + Fast… more
- USAA (Chesapeake, VA)
- …candidate selected for this position will be joining the Service Team within the Claims Actuary and Analytic community, which is part of P&C Data Science. They be ... responsible for delivering insights to the Claims organization related to all things Service to better...The essence of work performed by the Decision Science Analyst involves gathering, manipulating and synthesizing data (eg, attributes,… more
- Commonwealth Care Alliance (Boston, MA)
- …not be considered at this time._** Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity & Claims will ... 011250 CCA- Claims **_This position is available to remote employees...recommendations to leadership and Executive Teams. * Conduct independent research and analysis using regulatory guidance, government data and… more
- Molina Healthcare (Grand Island, NE)
- …Nebraska Health plan SLT by providing subject matter expertise on complex claims related issues and service recovery efforts.** Analyzes complex business problems ... in all stages of project and **program oversight** development including research , design, programming, testing and implementation to ensures the released product… more
- Bank of America (Newark, DE)
- Wealth Management Fraud & Claims - Sr. Fraud Analyst Newark, Delaware;Jacksonville, Florida **To proceed with your application, you must be at least 18 years of ... be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Newark/Wealth-Management-Fraud Claims Sr-Fraud- Analyst \_25028343) **Job Description:** Merrill Wealth Management… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... successful implementation of provider engagement programs. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims from compliance against contracts, billing, and processing guidelines… more
- Amazon (Bellevue, WA)
- …of leading the world in innovative technologies and services. This Business Analyst role will help business leaders make sense of complicated insurance data ... program implementation. * Drive small to medium operational enhancement projects. * Research and implement cost reduction opportunities. About the team Logistics … more
- TEKsystems (Ewing, NJ)
- …of the servicer and/or client + Files respective investor/insurer initial and final claims based on the respective guidelines for allowable limits + Reviews MI claim ... Explanation of Benefits (EOB) or Insurer Advice of Payments (AOP) and research curtailment reasons for potential rebuttal + Files Appeal or Supplemental Claims … more
- TEKsystems (Omaha, NE)
- …of the servicer and/or client * Files respective investor/insurer initial and final claims based on the respective guidelines for allowable limits * Reviews MI claim ... Explanation of Benefits (EOB) or Insurer Advice of Payments (AOP) and research curtailment reasons for potential rebuttal * Files Appeal or Supplemental Claims … more
- Guardian Life (Pittsfield, MA)
- …for you to grow and enrich your career and future as a Business Analyst . We believe in your aspirations for purpose, leadership, and achievement in your professional ... with other business areas and outside vendors on projects relating to the research , analysis, and implementation of new technology + Ensure accurate and timely… more
- Molina Healthcare (ID)
- …ability to work independently, self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, ... for Patient Liability and Medicaid processes. **KEY RESPONSIBILITIES** * Perform research and analysis for inquiries and requests, utilizing technical tools as… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Arrangement** ; ; ;.; This is a remote position; **Responsibilities:** + Research , analyze, and process projects or correspondence for all Lines of Business.;; ... resolution.; + Consistently meets or exceeds production standards for Claims Recovery maintaining 99% financial and procedural accuracy.; +...required. + 1 to 3 years experience in Facets Claims System preferred. + In-depth knowledge of claims… more
- MetLife (Bloomfield, CT)
- …Responsibilities: * Conducts quality reviews of Americans with Disabilities Act (ADA) claims . * Identifies trends, root causes, and quality gaps from the analysis ... which to measure quality behaviors. * Assists in the research , analysis, partnering and providing feedback and recommendations for...supported. Required: * 3+ years of experience managing ADA claims . * Experience managing absence claims for… more
- Molina Healthcare (Bellevue, WA)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex claims business problems and issues using data from internal and external sources to provide insight to ... task and workflow analysis. + Interpret customer business needs in the claims space and translate them into application and operational requirements + Communicate… more
- City of New York (New York, NY)
- …Revenue is recruiting for one (1) Associate Staff Analyst to function as a Research Analyst , who will: - Manage the data manipulation of large data files ... five distinct departments: 1) Centralized Data Entry (CDE), 2) Claims & Collections (C&C), 3) Division of Financial Review...special or ad hoc projects and requests, including independent research and analyses. ASSOCIATE STAFF ANALYST -… more
- The County of Los Angeles (Los Angeles, CA)
- CHIEF RESEARCH ANALYST , BEHAVIORAL SCIENCES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4891039) Apply CHIEF RESEARCH ANALYST , ... and career-minded individuals to fill the position of Chief Research Analyst , Behavioral Sciences. To view classification...steps to view correspondence, and we will not consider claims of missing notices to be a valid reason… more
- Harvard University (Cambridge, MA)
- Details Title Research Associate/Data Analyst School Harvard School of Dental Medicine Department/Area Oral Health Policy and Epidemiology Position Description ... We are seeking a research Data Analyst in the Department of...research projects + Previous experience with health care claims (Medicare, Medicaid, and private insurance plans) strongly preferred… more