- Zelis (St. Petersburg, FL)
- Position Overview At Zelis, t he Business Analyst - Expert Claims Review (ECR) is ultimately responsible for enabling high quality user stories under our ECR ... criteria for Expert Claims Review initiatives centered around handling of medical pre- payment and post- payment claims for accurate claim payment … more
- State of Colorado (Denver, CO)
- Community Living Data & Claims Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4533291) Apply Community Living Data & Claims ... welcomes your interest in the Community Living Data & Claims Analyst position. Responsibilities in this position...HCBS claims . * Staff authority on HCBS claims relative to Payment Error Rate Management… 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
- Elkay (Milwaukee, WI)
- Freight Audit and Claims Analyst **_The Company_** Zurn Elkay Water Solutions Corporation is a thriving, values-driven company focused on doing the right things. ... Zurn Elkay Water Solutions Corporation family! **Job Description** The Freight Audit and Claims Analyst reports to the Logistics Systems & Analytics Manager and… more
- Centene Corporation (Tallahassee, FL)
- …healthcare (ie documenting business process, gathering requirements) or claims payment /analysis experience. Advanced knowledge of Microsoft Applications, ... in Florida. **Position Purpose:** Perform various analysis and interpretation to link business needs and objectives for assigned function. + Support business … more
- Crawford & Company (Lake Zurich, IL)
- …the general direction of the Claims Data Operations Manager, the Senior Claims Analyst provides a variety of critical operational support services to the ... Claim Department, its business partners and its clients related to the handling...tasks in conjunction with Finance team for any Break Payment items; maintains and monitors monthly list of clients… more
- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Analyst III Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ... net required to achieve that purpose. Job Summary The Payment Integrity Analyst III is responsible for...team lead on any issues identified during research or claims review. Serves as a subject matter expert and… more
- Amazon (New York, NY)
- …Global Risk Management and Claims team is seeking a Sr. Risk Analyst to assist with the development and management of Amazon's global insurance programs, ... review, and implementing risk management tools and techniques for new and existing business initiatives. Additionally, the Sr. Risk Analyst will manage the… more
- Public Consulting Group (Columbus, OH)
- …more, visit www.publicconsultinggroup.com . **Responsibilities** . Analyzes the development of claims assigned at each level of the adjudication process. . Outlines ... case summaries to be sent with applications. . Monitors and gives direction to Claims Developer regarding specific tasks on claims . . Provides monthly reporting… more
- Parkview North Hospital (Fort Wayne, IN)
- …the various other products offered by Signature Care. Is responsible for re-pricing and payment of claims by administering the Summary Plan Document for each ... Accuracy and quality are expected on all lines of business processed. Education Must be a high school graduate...in processing PPO, HMO, Group Major Medical, or Indemnity Claims . Prior claims processing experience on automated… more
- MTA (New York, NY)
- Senior Accounting Analyst - Electronic Payment and Refunds Job ID: 6724 Business Unit: MTA Headquarters Location: New York, NY, United States ... Revenue Management Date Posted: Apr 24, 2024 Description JOB TITLE: Senior Accounting Analyst - Electronic Payment and Refunds SALARY RANGE: $84,460 - $94,133… more
- Oriental Bank (San Juan, PR)
- The Analyst , Payment Systems (Digital Fraud Prevention) is responsible for proactively identifying and investigating suspicious or fraudulent schemes as well as ... the implementation and continuous analysis of fraud prevention rules for digital payment transactions to mitigate the risk of financial exposure without affecting… more
- Medical Mutual of Ohio (OH)
- …rate loading. . Performs other duties as assigned. **Qualifications** **Provider Reimbursement Analyst II** . Bachelor's degree in business or healthcare ... Works on various projects related to the analysis of claims , clinical and financial data, with a focus on...relational databases. . Knowledge of provider contracting. **Provider Reimbursement Analyst III** . Bachelor's degree in business … more
- Medical Mutual of Ohio (OH)
- …and consumers. . Performs other duties as assigned. **Qualifications** **Provider Analyst II** **.** **Bachelor's degree in business administration, economics, ... as well as be comfortable with management exposure.** **Senior Provider Analyst ** **.** **Bachelor's degree in business administration, economics, statistics,… more
- Sharp HealthCare (San Diego, CA)
- …internal candidates, marketplace factors, other requirements for the position, and employer business practices. **What You Will Do** Manager Claims & Insurance ... manages and supports the defense and resolution of their party liability claims against the system. Manages and supports the insurance program for the system,… more
- Zelis (Plano, TX)
- …Bill Review Senior Analyst will be responsible for analyzing hospital claims for adherence to proper billing guidelines and will work closely with Hospital ... Bill Review staff to efficiently adhere to policies and procedures for claims processing. This position will also be responsible for training and developing new team… more
- CDPHP (Albany, NY)
- …processes and rules, including benefits, pricing, enrollment, provider structure, payment and/or claims processing for each line of business . + Must have a ... of the CDPHP core claim system and integrated support systems. The Configuration Analyst II will represent various business units in the analysis, development… more
- Sacramento County (Sacramento, CA)
- Employee Benefits Analyst Level I/II Print (https://www.governmentjobs.com/careers/sacramento/jobs/newprint/4543252) Apply Employee Benefits Analyst Level I/II ... + Principles and practices of health and welfare plan administration including claims , utilization review, cost containment procedures, and managed care programs +… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About the Role We are seeking a passionate, results-oriented Senior Enterprise Business Analyst who can collaborate effectively with internal and external ... and implementation. Essential Qualifications + Minimum 6-7 years of experience as a business analyst in healthcare payer industry. + Expertise and experience in… more
- Arkansas Children's (Little Rock, AR)
- …billing requirements and software products essential to performing job duties. Analyzes claims for payment . Resolves denials. Identifies problem trends and works ... am - 5:00 pm - Hybrid Prepares accurate and complete medical claims /billings for timely submission to third-party payers. Responsible for follow-up and collection… more