- Elevance Health (Indianapolis, IN)
- ** Medical Claims Data Integrity Consultant** **Location:** Atlanta, GA; Norfolk, VA; Indianapolis, IN; Chicago, IL; Louisville, KY (preferred). This role ... position is not eligible for current or future visa sponsorship._ The ** Medical Claims Data Integrity Consultant** (Business Information Developer… more
- Elevance Health (Indianapolis, IN)
- **Investigator II - Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... employment, unless an accommodation is granted as required by law._ **Carelon Payment Integrity ** is a proud member of the Elevance Health family of companies,… more
- Elevance Health (Indianapolis, IN)
- …fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days… more
- Elevance Health (Indianapolis, IN)
- …How you will make an impact: + Collects, researches, and validates bills and claims data against relevant guidelines + Assists in preparation of statistical and ... **Investigator Assistant - Payment Integrity SIU** **Location:** This role requires associates to..., is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator Assistant** will be responsible for… more
- Elevance Health (Indianapolis, IN)
- …make an impact:** + Using appropriate system tools and databases for analysis of data and review of professional and facility claims to detect fraudulent, ... **Investigator I - Payment Integrity SIU** **Location:** This role requires associates to..., is determined to recover, eliminate and prevent unnecessary medical -expense spending. The **Investigator I** will be responsible for… more
- Centene Corporation (Indianapolis, IN)
- …training, assigning work and managing performance preferred. Knowledge of Microsoft Excel, medical coding, claims processing, and data mining preferred. ... with all Federal and State Laws and Regulations related to program integrity and disclosure requirements. Develop, implement and manage strategic fraud, waste and… more
- Elevance Health (Indianapolis, IN)
- …background. **Preferred Skills, Capabilities, and Experiences:** + Healthcare experience preferred; medical claims experience a plus. + Extensive hands-on ... **Application Architect Senior - Payment Integrity ** The **Application Architect Senior** creates architectural solutions that articulate the business context,… more
- Humana (Indianapolis, IN)
- …and reporting. Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data . Maintain dashboards to communicate key ... trends to stakeholders. The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of… more
- Otsuka America Pharmaceutical Inc. (Indianapolis, IN)
- …Commercial third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data , Specialty pharma, omnichannel data , SalesForce/Veeva ... **Job Summary** The Associate Director (AD), Commercial Data Management (CDM) within Data Enablement (DE) for Business Analysis (BA) is accountable for… more
- Elevance Health (Indianapolis, IN)
- … medical guidance across multiple enterprise transformation initiatives, including: + ** Medical Cost Management** + **HealthOS and enterprise data platforms** ... payer, managed care, or healthcare leadership preferred. + Experience advising medical cost management, utilization management, payment integrity , or provider… more
- Norstella (Indianapolis, IN)
- …querying and analyzing a wide range of healthcare data sources, including claims , lab results, electronic medical records (EMR), and other real-world data ... Norstella's newest service offerings leveraging Norstella's unified Real World Data asset, a combination of claims , lab,...data into structured formats suitable for analysis, ensuring data quality and integrity throughout the process… more
- CGI Technologies and Solutions, Inc. (Indianapolis, IN)
- …migrations, and integrate testing into CI/CD pipelines. If you're passionate about data integrity , regulatory compliance, and driving quality across underwriting ... automated testing solutions to validate large volumes of policy, claims , billing, and customer data in real...testing documentation is always current. * Assist in maintaining data integrity for compliance with NAIC, HIPAA,… more
- Walmart (Indianapolis, IN)
- …area in accordance with company policies and procedures by properly handling claims and returns utilizing equipment to perform a variety of merchandising functions ... fulfillment process when necessary by processing information for thirdparty insurance claims rescanning illegible images alerting patients to inventory that is out… more
- Norstella (Indianapolis, IN)
- …the demand for Norstella's newest service offerings leveraging Norstella's unified Real World Data asset, NorstellaLinQ, a combination of claims , lab, SDOH and ... databases, ensuring data accuracy and quality. *Perform in-depth analyses on healthcare data sources, including claims , lab, EMR/EHR, and SDOH data , to… more
- Otsuka America Pharmaceutical Inc. (Indianapolis, IN)
- …lead the R&D audit program, engage with regulatory authorities, and maintain clinical data integrity . The leader will be responsible for providing a compelling ... authorities, facilitating Clinical and PV inspections and addressing any findings. + ** Data Integrity :** Ensure the accuracy, consistency, and reliability of… more
- CDM Smith (Carmel, IN)
- …claims . This role is critical in evaluating and analyzing financial data related to disaster-related claims , including property damage, business interruption, ... investigations to identify discrepancies, detect potential fraud, and ensure the integrity and fairness of claim settlements. By applying advanced accounting,… more
- Walmart (Plainfield, IN)
- …+ Supports facility with reporting and paperwork to ensure productivity and pharmaceutical integrity by entering and modifying pharmaceutical data on system and ... + Supports facility with reporting and paperwork to ensure productivity and pharmaceutical integrity by entering and modifying pharmaceutical data on system and… more
- Otsuka America Pharmaceutical Inc. (Indianapolis, IN)
- …of clinical medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management, medical writing). + An advanced understanding of ... drug development programs, including: + Understanding pharmacology of drugs and unmet medical needs. + Formulating a rationale to develop the drug in accordance… more
- Walmart (Indianapolis, IN)
- …area in accordance with company policies and procedures by properly handling claims and returns; utilizing equipment to perform a variety of merchandising functions ... fulfillment process when necessary by processing information for third-party insurance claims ; rescanning illegible images; alerting patients to inventory that is… more
- Sumitomo Pharma (Indianapolis, IN)
- …company's new and established programs. This position reports to the Chief Medical Officer. **Job Duties and Responsibilities** + Strategic thought partner including ... and operational leadership to the Marketing Brand Teams, Legal, Medical Affairs and Clinical Research in the development of...review in order to ensure the quality and scientific integrity of documents submitted to regulatory authorities + In… more