- Fifth Third Bank, NA (Cincinnati, OH)
- …related experience. + Prior PC experience to include advanced Excel, Word and Access. Claims Analyst I At Fifth Third, we understand the importance of ... opening. GENERAL FUNCTION: Responsible for completing and filing investor/insurer claims within required guidelines in order to recoup 5/3's...of the default cycle. This results in approximately 200 claims being filed on a monthly basis and $30.0… more
- Deloitte (Cincinnati, OH)
- …who wants to work in a collaborative environment? As an experienced Epic Resolute PB Claims Analyst you will have the ability to share new ideas and collaborate ... onsite client service delivery. Work you'll do/Responsibilities As a Project Delivery Senior Analyst (PDSA) at Deloitte, you will work within an engagement team and… more
- Deloitte (Cincinnati, OH)
- …work in a collaborative environment. As an experienced Epic Resolute Hospital Billing Analyst Project Delivery Specialist, you will have the ability to share new ... ideas and collaborate on projects without the extensive demands of travel. The Project Delivery Talent Model is designed for professionals with specialized skills that align to a current client need. Team members focus on delivering services to clients,… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …ensuring compliance with Uniform Commercial Code (UCC) and Regulation E and Regulation Z claims . The Analyst uses various bank and vendor systems to research ... Third Bank. GENERAL FUNCTION: Under general supervision, the Dispute Intake Analyst provides outstanding customer service while capturing accurate customer account… more
- Molina Healthcare (Covington, KY)
- …and the Affordable Care Act (ACA). + Medical Coding certification. + Strong Medical Claims Audit knowledge To all current Molina employees: If you are interested in ... applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $77,969 - $128,519 / ANNUAL *Actual… more
- Molina Healthcare (Covington, KY)
- …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
- Elevance Health (Cincinnati, OH)
- **Grievance/Appeals Analyst II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... unless an accommodation is granted as required by law._ The **Grievance/Appeals Analyst II** is responsible for reviewing, analyzing and processing non-complex and… more
- Molina Healthcare (Cincinnati, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... of new and existing health plans. + Executes retroactive claims reports + Runs fee schedule & MRDT update...submission mailbox, submit RFCs in iServe, and notify the Analyst of completion. + Researches and reviews MRDT issues… more
- Molina Healthcare (Covington, KY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- Molina Healthcare (Covington, KY)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS… more
- Molina Healthcare (Covington, KY)
- …emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst , Data is responsible for data compilation, data management, data ... SQL, PowerBI, databricks. + Experience on ETL , healthcare specifically claims is highly preferred. **JOB QUALIFICATIONS** **Required Education** Associate degree or… more
- Molina Healthcare (Covington, KY)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Deloitte (Cincinnati, OH)
- …wants to work in a collaborative environment? As an experienced Epic Professional Billing Analyst you will have the ability to share new ideas and collaborate on ... do and the clients and industries/sectors you serve Preferred + Epic Claims certification + Analytical/ Decision Making Responsibilities + Analytical ability to… more
- Molina Healthcare (Cincinnati, OH)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- First Student (Cincinnati, OH)
- …and technology the transportation industry has to offer.** The Senior Safety Analyst is crucial for managing safety data critical to the department's operations. ... analytics models to identify trends and insights, driving continuous improvement in claims management and safety practices. + Manages all safety standard weekly,… more
- Molina Healthcare (Covington, KY)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system(s) as necessary. + Works with fluctuating volumes… more
- Molina Healthcare (Covington, KY)
- …care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of ... claim system configurations, payment policies, and audit processes. + Exceptional analytical, problem-solving, and documentation skills. + Ability to translate complex business problems into clear system requirements and process improvements. + Proficiency in… more
- Molina Healthcare (Covington, KY)
- …work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develops, implements, and uses software and systems to support… more
- Nestle (Cincinnati, OH)
- …operation of the team. **Key Responsibilities** Trade Auditing/Analysis (Deductions, Fines, Claims , Post-Audit Work) (40% of Role) + Support the Account Management ... with trade deduction analysis and reconciliation. Management of Customer post-audit claims + Collaborate with Account Managers and Sales Finance Revenue Growth… more
- Molina Healthcare (Covington, KY)
- …staff for mentoring, coaching, and analysis questions. + Reviews Health Plan analyst work products to ensure accuracy and clarity. + Reviews regulatory reporting ... or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of SQL… more