- TEKsystems (Honolulu, HI)
- The Claims Analyst will oversee claims processing operations, ensuring accuracy, efficiency, and compliance with regulatory requirements. This role requires ... a strong understanding of claims systems, management capabilities, and a drive for process...management capabilities, and a drive for process improvement. The Analyst will manage both onshore and offshore vendor relationships… more
- Carrington (Honolulu, HI)
- Come join our amazing team and work remote from home! The Loss Claim Recovery Analysis Analyst is responsible for performing financial reconciliation on all ... + Reconcile all loan advances once the GSE or Government Mortgage Insured "expense" claim has been paid. + Maintain updates in LoanServ and input the assign and… more
- Cognizant (Honolulu, HI)
- …IT organization and lead changes to such specifications (with senior business analyst oversight through peer reviews); Develop an informed knowledge of the business ... + 3+years Medicare/Medicaid regulatory healthcare experience + Knowledge of claim adjudication processes and Facets platform experience preferred + Experience… more
- Highmark Health (Honolulu, HI)
- …Must Be Able to Read and Comprehend Spanish Medical Terminology The Quality analyst is responsible for compiling and analyzing data relevant to the handling of ... all types of complex adjusted claims ; conducting reviews of all organizational or functional activities...remediation and Regulatory and legal guidelines. In addition, the Analyst will identify potential areas of processing vulnerability through… more
- Cognizant (Honolulu, HI)
- **About the role** As a QNXT Config Analyst , you will make an impact by conducting requirements using QNXT configuration. You will be a valued member of the ... team to add PBPs. + Troubleshoot and remediate/workaround for claim pend issues. + QNXT Configuration for different State...do back-end queries and validate Config setup to match claim processing. + Ability to advise Client on decision… more
- TEKsystems (Honolulu, HI)
- A healthcare company in Hawaii is seeking a Healthcare Business Analyst to ensure successful integration of their application working in healthcare claims ... candidate needs to understand healthcare operations, particularly with Medicare and Medicare claims , and will serve as a key liaison between internal stakeholders.… more
- United States Fleet Forces Command (Honolulu, HI)
- …this flyer. Responsibilities You will serve as a Precision Strike Weaponeering Analyst , N2 Intelligence Division of Cruise Missile Support Activity Pacific (CMSA ... experience must demonstrate the following: Experience maintaining certification as a Weaponeering Analyst Experience in the Completion of CPS and CTM training JQR's… more
- Evolent (Honolulu, HI)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique ... of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams (EAS, Specialty… more
- Evolent (Honolulu, HI)
- …Stay for the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a Senior Analyst ... Preferred + Professional experience in healthcare analytics (eg medical and pharmacy claims data, membership data, or other healthcare data) - Preferred +… more
- Highmark Health (Honolulu, HI)
- …Degree **EXPERIENCE** **Required** + 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or experience in a related operational ... area (eg claims , billing, customer service, etc.) **Preferred** + 1 - 3 years in the Health Insurance Industry **LICENSES OR CERTIFICATIONS** **Required** + None… more
- Cognizant (Honolulu, HI)
- …we're improving everyday life. **Job Title** **:** **FACETS Configuration Analyst ** **Location** **:** **Remote** **Job ID** **: SO#** **00064187821** **Role ... Assurance:** o Conduct unit and integration testing of configurations to ensure accurate claims adjudication. o Collaborate with QA teams to develop test cases and… more
- Evolent (Honolulu, HI)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Analyst , Client Analytics** Integrate and analyze claims and enrollment data from ... multiple sources using SAS and SQL programs. Import and load data from disparate sources to facilitate reporting for multiple health plans. Build new client relationships to understand analytical and reporting needs. Create actionable, innovative analytics… more
- Hawaii Pacific Health (Honolulu, HI)
- …the managed care services department including referral management, patient steerage, and claims auditing. Under the general direction of the Department Director or ... relevant experience and training, as well as internal peer equity. **Position** Analyst - Analytics Managed Care **Location** Hawaii Pacific Health, Honolulu, HI |… more
- Evolent (Honolulu, HI)
- …fostering expertise and cooperation. + Extract, manage, and analyze claims and operational data using industry-standard metrics. **Qualifications Required and ... public health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider, clinical vendor, managed care,… more
- Evolent (Honolulu, HI)
- …SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data * Using analytical tools to integrate various data sources to ... lines of business and health care data including medical, pharmacy and ancillary claims data, membership data, clinical operational data (UM & CM), or other… more
- Evolent (Honolulu, HI)
- …SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data + Working on a strategic analytics team using data to identify ... more years of experience within a healthcare analytics role, working with Claims , Membership, or Authorization Data, and consulting both internal and external… more
- Highmark Health (Honolulu, HI)
- …5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project leadership ... in a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + None **LICENSES or CERTIFICATIONS** **Required** + None… more
- Highmark Health (Honolulu, HI)
- …quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of ... participation percentage, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered and to set… more