- Commonwealth Care Alliance (Boston, MA)
- …of the Sr . Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr . Analyst will be responsible for developing ... prospective claims auditing and clinical coding and reimbursement edits and necessary coding ...**Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and ... baseline compliance reviews and identifying potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders… more
- Hawaii Pacific Health (Honolulu, HI)
- …billing regulations, government billing requirements, collection laws and reimbursement procedures. As the Senior Project Analyst , your role will be to build and ... relevant experience and training, as well as internal peer equity. **Position** Project Analyst , Sr - Revenue Cycle **Location** Hawaii Pacific Health, Honolulu,… more
- CVS Health (Phoenix, AZ)
- …execution of network and mail pricing for CVS Health, a Fortune Company. The Sr . Analyst , you will ensure quality assurance for all client pricing ... role covers all delivery systems and adjudication platforms related to pharmacy claims adjudication. You will inspect the correct application of business rules,… more
- Zelis (Plano, TX)
- …and the personal interests that shape who you are. Position Overview The Sr . Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory ... good understanding of public and private healthcare payment systems, medical claims , standard claim coding , claim editing, contracting, preferred-provider… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Sr . Reporting Analyst I to join our team! Summary: Ensure accuracy and timeliness of ... all aspects of Verisk's Statistical Web Services applications. Well versed in ISO coding requirements and Strong understanding of ISO rating in multiple lines of… more
- Point32Health (Canton, MA)
- …(https://www.point32health.org/) . **Job Summary** Working under the direction of the Director or Senior Manager, the Senior Analyst will be part of ... well as finding improvements) and ad hoc requests. The Senior Network & Provider Analytics Analyst may...between payers and providers; solid knowledge of health care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs),… more
- Parkview Health (Fort Wayne, IN)
- …leads a variety of duties associated with payor contracting analytics. Acts as the senior lead analyst mentoring and guiding junior analyst co-workers. ... teach and mentor analytical co-workers. Working knowledge of clinical medical management, coding , billing, and claims processing. Strong verbal and written… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …claim edits/rejections. + Works daily Charge Reconciliation, Charge Review and other DNB/ Claims work queues specifically assigned to resolve bill holds for charge ... player. + Coaches and serves a resource for less experienced Finance Revenue Analyst . + Conducts high level decision support/analysis for various projects related to… more
- CommonSpirit Health (Englewood, CO)
- …Professional Billing Admin experience required** + **Resolute Professional Billing Claims experience required** + **Cogito Certification experience preferred** + ... and clinical needs. + Also, provides consultation for program design, coding , testing, debugging and documentation. + Understands system options and configurations… more
- Molina Healthcare (Grand Island, NE)
- …complex, often highly technical teams + Medicaid primary and Medicare preferable payer claims experience + QNXT experience + Coding experience + SQL experience ... Nebraska Health plan SLT by providing subject matter expertise on complex claims related issues and service recovery efforts.** Analyzes complex business problems… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- Position Information Posting NumberSRGV8219 Working TitleCOMPLIANCE CODING AND BILLING ANALYST Number of Vacancies1 LocationMcAllen, Texas DepartmentOffice of ... , and reimbursement processes. + Reviews, assesses and analyzes medical records, coding , billing, claims , reimbursements and workflow processes to ensure… more
- Point32Health (Canton, MA)
- …members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of coding ... , benefit, payment, and contract interpretation in accordance to claims processing guidelines, Point32Health Medical and Payment Policies and established audit… more
- Mount Sinai Health System (New York, NY)
- …Facility and Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a ** Senior Contract Manager Analyst ** will play a critical role in testing, ... within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System...the revenue cycle system. A strong background in contract coding , logic, and the ability to interpret contract terms… more
- The Cigna Group (Bloomfield, CT)
- …required, to develop and promote shared goals. The Quality Review and Audit Senior Analyst position recognizes experience in Risk Adjustment Data Validation ... and compliantly execute daily RA program operations, as identified. Participates in coding reviews of medical documentation for RA programs, as needed._ _Responsible… more
- City of New York (New York, NY)
- …the HHS-PASSPort Payment Services Unit total more than $319 million annually. The Senior Data Analyst for HHS-PASSPort Payments is responsible for running data ... on payments to contracted Human Services-directed vendors through the PASSPort portal. The Senior Data Analyst will report directly to the HHS-PASSPort Payment… more
- Rochester Regional Health (Rochester, NY)
- …records, paid claims , and national/regional benchmarks. The Quality Informatics Analyst - Senior analyzes data and trends in order to identify underlying ... Analyst - SeniorDepartment: Quality Informatics SUMMARY: The Quality Informatics Analyst - Senior is responsible for data collection, analysis, and presentation… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Senior Health Economics Analyst is responsible for identifying and delivering data-driven ... data-driven strategy recommendations in the Medicare Advantage and healthcare industry. This senior -level analyst position has the opportunity for impact and… more
- DriveTime (Tempe, AZ)
- …or in the future are not eligible for hire at this time._** In short, the Senior Analyst , Risk Pricing will use creative problem solving and leverage analysis of ... growth, customer experience, and profitability in high profile initiatives. In long, our Senior Analyst , Risk Pricing is responsible for: + Innovate on existing… more
- Cedars-Sinai (Beverly Hills, CA)
- …standard of patient care we strive for. **What will you be doing:** The Senior Financial Analyst is responsible for assisting with the development, design, ... and interpreting patient medical records using CPT and ICD10 coding systems. Technical understanding of Healthcare Data systems is...of study **Req ID** : 6681 **Working Title** : Senior Financial Analyst (Managed Care) - Hybrid… more