- CoSourcing Partners (Chicago, IL)
- …1 month contract with possibility of extension We are seeking a seasoned Business Analyst with deep expertise in Optum Claims Editing System (CES) and ... with configuration analysts to ensure benefit structures and payment policies align with claims editing logic. Lead and support functional testing, UAT, and… more
- US LawShield (Houston, TX)
- …2 million people in their self-defense journey. US LawShield is seeking a Senior Data Analyst to join our data and analytics team. This role will be pivotal in ... or similar platforms. Conduct in-depth analyses of member engagement, retention, claims , and operational performance to identify trends, risks, and opportunities.… more
- SCOR (Charlotte, NC)
- …affiliate retrocession. This includes overseeing the processing of volumes, premiums, and claims , while maintaining a high standard of data integrity. The position ... and reduce the risk of errors. Ensuring business processes comply with regulatory requirements and internal control standards. Supporting changes that align with the… more
- EnableComp (Franklin, TN)
- …Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims , and expert human-in-the-loop integration, EnableComp provides solutions across ... for Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering… more
- Molina Healthcare (Buffalo, NY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Levi, Ray & Shoup, Inc. (Chicago, IL)
- …this opportunity is made for you! The Business Analyst will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy ... File Transfer Filters Careers Added Jul 21, 2025 Business Analyst - Claims Systems (26971) Chicago, IL...+ Ensure technical solutions align with business goals and regulatory requirements. + Collaborate with compliance teams to audit… 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...Produce provider scorecards related to Payment Integrity initiatives and lead internal and external provider meetings to review results… more
- Tucson Electric Power (Tucson, AZ)
- **Benefits Analyst - I, II, Senior or Lead ** Company **Tucson Electric Power** Location **Tucson, AZ** Requisition ID **6015** **About Us** UNS Energy ... employees,here (https://youtu.be/hpknvJPLuoc) andhere (https://youtu.be/7BECywu-Re4) . **Job Description - Benefits Analyst - I, II, Senior or Lead ** **Position… more
- Zelis (Plano, TX)
- …interests that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory Pricer ... an accurate and timely fashion. What you'll do: + Research and decipher regulatory sources such as legislative rules, state registers, waiver programs and bulletins… more
- Molina Healthcare (Provo, UT)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
- Amazon (New York, NY)
- …management through innovative software solutions. We're seeking an experienced application analyst to lead the architecture, configuration, and management of ... 95 distinct insurance programs. The solutions developed and maintained by the Application Analyst cover the full claims lifecycle, encompassing processes such as… more
- Trinity Health (Albany, NY)
- …Type:** Full time **Shift:** Day Shift **Description:** **TITLE** Risk Analyst /Specialist **DEPARTMENT:** Clinical Quality & Safety **REPORTS TO:** Risk Manager ... being faithful to who we say we are. **POSITION SUMMARY** The Risk Analyst is primarily responsible for supporting non-clinical risk management activities in both… more
- Prime Therapeutics (Eagan, MN)
- …and assumptions to define additional resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments ... Provide work plan and detailed estimate based on scope; lead scope management, prioritization and drive scope trade off...within project + Educate and advance business systems analyst practice within the Claims IT team… more
- NTT DATA North America (Merced, CA)
- …DSNP Business Analyst with specialized knowledge in Medicare and D-SNP claims processing. The ideal candidate will bring a strong understanding of CMS ... sourcing strategy NTT DATA currently seeks a DSNP Business Analyst to join our team in remote in the...scenarios. + Assess downstream implications of changes across the claims platform, ensuring regulatory and functional alignment.… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …area/out of network non-par claims . In the course of this work, the Analyst will be required to work closely with others to assemble and produce documentation ... with sound and ethical procedures, objectives and controls, a Network Services Analyst analyzes and evaluates the composition and characteristics of Health Plan… more
- Elevance Health (Cerritos, CA)
- …non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...regulatory standards and requirements. + As such, the analyst will strictly follow department guidelines and tools to… more
- CVS Health (Springfield, IL)
- …care and how provider reimbursement policies relate to the control of medical claims costs. + Full comprehension of provider contracts and the potential impact the ... regulatory /legislative environment has on reimbursement strategies. + An understanding...differentiating between inpatient and outpatient services, facility and professional claims , and impacts from population dynamics. + Underwriting, sales,… more
- Highmark Health (Albany, NY)
- …MUST BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, ... proactively identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational… more
- Kemper (St. Louis, MO)
- …promises. **About the Role:** We are seeking a detail-oriented and proactive Business Analyst with strong knowledge of the life insurance industry, regulatory ... who is equally comfortable analyzing business processes, navigating complex regulatory landscapes, and troubleshooting technical challenges. You will collaborate… more
- Vanguard (Malvern, PA)
- …that supports each other and celebrates team members' successes! As a Legal Analyst , you will leverage your analytical and communication skills to support the ... the business, under supervision by legal counsel, to provide advice on regulatory and legal developments related to Vanguard's business activities and investment… more
