- 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 ... Bank. 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
- Molina Healthcare (Covington, KY)
- JOB DESCRIPTION Job Summary Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory ... with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing through resolution. **Essential Job Duties** * Serves as … more
- Molina Healthcare (Covington, KY)
- JOB DESCRIPTION Job Summary Provides lead level analyst support for configuration information management activities. Responsible for accurate and timely ... implementation and maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules… more
- ClarkDietrich (West Chester, OH)
- …and benefits. Join the ClarkDietrich team by applying to the Credit & Treasury Analyst position at our West Chester, OH location. The Credit & Treasury Analyst ... coverage + Coordinate the annual insurance renewal process and support claims management + Maintain accurate records of all insurance policies, certificates,… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Provides senior level analyst support for medical economics analysis activities, including extracting, analyzing and synthesizing ... decision-making. * Mines and manages information from large data sources. * Analyzes claims and other data sources to identify early signs of trends or other… 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
- Elevance Health (Cincinnati, OH)
- **Actuarial Analyst II** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law. The **Actuarial Analyst II** completes projects and performs complex actuarial studies. **How You Will… 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)
- **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
- 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
- First Student (Cincinnati, OH)
- …transportation industry has to offer.** Serves as the third party liability claims administrator (GLICRS) and the technical examiner for the workers compensation ... for financial data integrity purposes, state regulators for self- insurance purposes, claims vendors for financial data integrity purposes, and RMIS vendors for RMIS… more
- Molina Healthcare (Covington, KY)
- …in Connecticut** **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** + Develop ad-hoc reports using SQL programming, SQL Server… 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)
- …Analysis_ * Uses a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. * Applies understanding of ... health care regulations, managed care claims workflows, and provider reimbursement models to shape payment...**Required Qualifications** * At least 5 years of business analyst experience in a managed care organization (MCO), and… more