- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, ... of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid… more
- Axis (Alpharetta, GA)
- …is available upon request for candidates taking part in the selection process. ** Claims Business Analyst ** **Job Family Grouping: IT Group** **Job Family:** ... contribute to our collective success?** We are seeking a Claims Business Analyst to join our Business...your family, health and wellness programs, retirement plans, tuition reimbursement , paid vacation, and much more. Where this role… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** ** Claims Analyst ** **Location:** Trinity Health PACE Corp Michigan, Livonia, MI **Status:** Full time ... work in the office each Wednesday. **Position Purpose:** The Claims Analyst is responsible for analyzing and...adjusting, or billing experience preferred. + Experience with Medicare reimbursement rules and CMS-1500 & UB-04 claims … more
- UMB Bank (Kansas City, MO)
- **Duties & Responsibilities :** Open to hybrid or remote working schedule The Sr Card Fraud Claims Analyst will be a member of the UMB Card Operations team and ... will report directly to the Card Fraud Claims Manager. Responsibilities of this position will include supporting the Card Fraud Claims Manager in day-to-day… more
- Highmark Health (Frankfort, KY)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- New Jersey Resources (Wall Township, NJ)
- …development, and competitive pay and benefits. New Jersey Resources is seeking a Claims Analyst , responsible for the investigation and adjusting of property ... damage, bodily injury and other claims against New Jersey Resources and its affiliates (the...fitness centers. * Employee Assistance Program (EAP). * Tuition reimbursement program. * Paid time off including paid holidays.… more
- New York State Civil Service (Albany, NY)
- …DASNY - Dormitory Authority of the State of New York Title Senior Construction Claims Analyst (Cost Control) - Albany, NY or NYC Office Occupational Category ... State NY Zip Code 12208 Duties Description Primary PurposeSenior Cost Control Analyst reviews and recommends approval of construction change orders, analyzes … more
- Healthfirst (NY)
- …specifications and ensure proper system functionality and quality outcomes including claims configuration, provider set up, reimbursement methodology and core ... programs and reimbursement methodologies a plus. + Knowledge of healthcare claims processing practices in a managed care setting a plus. + Bachelor's Degree… more
- TEKsystems (Dallas, TX)
- …quality assurance or compliance filing + Must have experience in FHA Part B Claims Filing, expense reimbursement , CWOT Claims and timeline reviews for ... for expenses incurred to determine claimable vs non claimable to maximize reimbursement on behalf of the servicer and/or client + Files respective investor/insurer… more
- Carrington (Frankfort, KY)
- …amazing team and work remote from home! The Loss Claim Recovery Analysis Analyst is responsible for performing financial reconciliation on all liquidated loans and ... processes up to and including Loss Mitigation, Bankruptcy, Foreclosure, Conveyance and Claims in addition to mortgage servicing state, federal and agency guidelines… more
- Walmart (Bentonville, AR)
- …in the claim/image management system. + Handles monetary aspects of assigned claims by establishing reserves within approval level; notifying store managers of ... significant reserve increases; monitoring reserves for all open claims ; authorizing payment for approval or facilitating denial of...company discounts, Military Leave Pay, adoption and surrogacy expense reimbursement , and more. You will also… more
- Deloitte (Washington, DC)
- …who wants to work in a collaborative environment? As an experienced Epic Billing and Claims Senior Analyst you will have the ability to share new ideas and ... to understand the functional requirements. Working on Billing and Contracts Reimbursement configuration and builds by maintaining industry and client standards… more
- TEKsystems (Dallas, TX)
- …for expenses incurred to determine claimable vs non claimable to maximize reimbursement on behalf of the servicer and/or client + Files respective investor/insurer ... initial and final claims based on the respective guidelines for allowable limits...reasons for potential rebuttal + Files Appeal or Supplemental Claims ensuring all allowable advances and interest are recovered… more
- St. Luke's University Health Network (Allentown, PA)
- …of a patient's ability to pay for health care. The Claim and Denial Coding Analyst role is a Certified Medical Coder who ensures clean claim submission and timely ... queries, coding software tools and Insurance carrier medical and reimbursement policies during the claim review process. JOB DUTIES...with training new staff in all aspects of the Analyst role. PHYSICAL AND SE NSORY REQUIRE M ENTS:… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Associate Director of Professional Reimbursement Strategy, the Payment Integrity Reimbursement Policy Quality Assurance (QA) Analyst is responsible for ... with stakeholders and producing reports for the programs. The Payment Integrity Reimbursement Policy Quality Assurance (QA) Analyst would also be responsible… more
- Medtronic (Minneapolis, MN)
- …a more connected, compassionate world. **A Day in the Life** The role of Reimbursement Principal Reimbursement Analyst offers the opportunity to establish ... occlusions, peripheral embolization, deep venous disease, and superficial venous disease. The ** Reimbursement Principal Reimbursement Analyst ** will serve in… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …for you, we encourage you to apply! Job Description: Summary: The Reimbursement Configuration Analyst is responsible for utilizing system development ... test system solutions in response to high level business requirements. The Reimbursement Configuration Analyst is expected to understand requirements, develop… more
- System One (Dayton, OH)
- Job Title: Pricing and Reimbursement Analyst Type: Contract Contractor Work Model: Remote ALTA is supporting an 8-month contract opportunity working 100% remote. ... We are seeking a highly analytical and detail-oriented Medicaid Configuration Analyst with specialized expertise in Facets/NetworXPricer. This role is crucial for… more
- Humana (Denver, CO)
- …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will ... System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and… more
- Zelis (Plano, TX)
- …personal interests that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory Pricer ... systems. This position requires an in-depth knowledge of healthcare pricing/ reimbursement processes and procedures including institutional, as well as professional… more