- Independent Living Systems (Miami, FL)
- We are seeking a Senior Business Analyst to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community ... maximizing independence for all vulnerable populations. About the Role: The Senior Business Analyst in Health Care Services plays a pivotal role in bridging the gap… more
- Commonwealth Care Alliance (Boston, MA)
- …coding (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment ... TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible...Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for claims ,… more
- Humana (Hartford, CT)
- **Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, ... resolution of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on … more
- Elevance Health (Grand Prairie, TX)
- **Business Information Analyst Senior - Medicaid Encounters Data** The **Business Information Analyst Senior** is responsible for analyzing and validating ... plus. + Claims and/or Encounters experience preferred. + Experience with Medicaid data preferred. Please be advised that Elevance Health only accepts resumes for… more
- Zelis (Plano, TX)
- …and the personal interests that shape who you are. Position Overview The Sr. Medicaid Regulatory Pricer Analyst will collaborate with the Zelis Regulatory Pricer ... communicating rules, regulations, and procedures pertaining to public and private Medicaid payment systems. This position requires an in-depth knowledge of… 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...care reimbursement, public health care programs and reimbursement methodologies ( Medicaid and Medicare) * Ability to work cross functionally… more
- Molina Healthcare (KY)
- …**Job Summary** **Job Summary** Responsible for comprehensive contract review and target claims audit review. This includes but not limited to deep dive, contract ... review and targeted claims audits related to accurate and timely implementations and...regulations with different lines of business such as Medicare, Medicaid , Marketplace, Dual Coverages / COB. + 2+ years… more
- Molina Healthcare (Grand Island, NE)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... on researching, presenting and documenting is required, + Experience with Medicare, Medicaid and Marketplace is required. + Medical coding experience is highly… more
- Montrose Memorial Hospital (Montrose, CO)
- …knowledge of hospital billing, collections and payment application for Medicare, Medicaid and Commercial insurances + Ability to effectively communicate, verbally, ... and non-verbally, in a clear, concise manner, both orally and in writing. What We Offer: + Mentoring + Continuing Education + 401 K Retirement Plan with employer match + Multiple health options to selection from + Ability to earn an additional $5.00 per hour… more
- Molina Healthcare (Provo, UT)
- …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
- Molina Healthcare (Layton, UT)
- …at a health plan or vendor-is strongly preferred. **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct secondary pricing logic and compliance ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Idaho Division of Human Resources (Boise, ID)
- …ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE TO BE CONSIDERED. The Division of Medicaid has an exciting opportunity for oneBusiness Analyst to join the Bureau of ... Business Analyst - MED Posting Begin Date: 2025/09/11 Posting...plan, coordinate, develop and implement required changes within the Medicaid Enterprise Systems to support administrative needs and the… more
- NTT DATA North America (Little Rock, AR)
- …* Analyze and document business, technical, and user requirements related to Medicaid Claims Adjudication and other functional areas. * Collaborate with ... apply now. We are currently seeking a Senior Business Analyst to join our team in Little Rock, Arkansas...implementation projects * Minimum of 6years of experience in Medicaid Claims Adjudication, including understanding of … more
- AdventHealth (Maitland, FL)
- …: Maitland, FL **The role you will contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving skills to identify, quantify, and ... to support executive decision-making regarding contract violations. The Senior Compliance Analyst will have expertise in Commercial and Governmental (Medicare, … more
- State of Colorado (Denver, CO)
- OCL Projects, PCSP Waiver Logic and Enrollment Analyst Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5041514) Apply OCL Projects, PCSP ... Waiver Logic and Enrollment Analyst Salary $71,544.00 - $94,872.00 Annually Location Denver Metro,...Financing (HCPF) oversees and operates Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus (CHP+), and other… more
- Medical Mutual of Ohio (OH)
- …for all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid ), including HEDIS audit submission, Consumer Assessment of Healthcare Providers ... fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the… more
- Mount Sinai Health System (New York, NY)
- …compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP's subject matter experts ... Sinai Health System. MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who will primarily be responsible for tracking, trending, and analyzing… more
- Elevance Health (Winston Salem, NC)
- **Business Information Analyst Senior** **Locations:** This role requires associates to be in-office **1-2** days per week, fostering collaboration and connectivity, ... eligible for current or future VISA sponsorship._ The **Business Information Analyst Senoir** is responsible for analyzing, reporting and developing recommendations… more
- University of Michigan (Ann Arbor, MI)
- BUSINESS INTELLIGENCE ANALYST - CDI Apply Now **Job Summary** **BASIC FUNCTION AND RESPONSIBILITY** The Clinical Information Analyst provides advanced technical ... numerous types of data, both modeled and disparate, this analyst will produce relevant, timely analytics for presentation to...and integrating data from disparate sources (ie Cost and claims or clinical data in the electronic health record)… more
