- WelbeHealth (Hartford, CT)
- …Health Plan Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and ... accurate pre-payment or denial of claims while meeting federal/state regulations, provider agreements terms, and/or company policies and procedures. **Essential Job… more
- Highmark Health (Hartford, CT)
- …and training materials specific to underwriting functions, ensuring clarity for audit and compliance. + Collaborate closely with underwriters to analyze existing ... 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + Experience in… more
- The Cigna Group (Bloomfield, CT)
- …Owned Life Insurance (COLI) organization is looking for a Life Insurance Account Analyst to support our collaborative team as you learn our life insurance products. ... for our Corporate Owned Universal Life Insurance clients (eg death claims , premium payments, surrenders, withdrawals, loans, lapse mailings, etc.). + Independently… more
- CVS Health (Hartford, CT)
- …every day. This is a hybrid position. **Position Summary** As a Rebate Formulary Analyst - Manufacturer Rebates you will perform a critical role in the analysis of ... Support Services as they work with clients in the development of formularies; Rebate audit team as questions arise on audits by manufacturers and clients. + Adhering… more
- Molina Healthcare (Hartford, CT)
- …in Connecticut** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost ... in response to approved change requests; retain old and new report design for audit trail purposes. + Analyze data sets and trends for anomalies, outliers, trend… more
- Highmark Health (Hartford, CT)
- …with a general understanding of data flows from various corporate systems (eg, claims , billing, lab, and Rx), to solve complex issues and problems. A comprehensive ... include but not limited to, review/editing of content submissions and best practices, audit reports, etc. The incumbent is expected to make major contributions to… more