- Zelis (TX)
- …We are seeking a detail-oriented and technically skilled analyst to support healthcare claims repricing and data validation efforts. In this role, ... data -driven insights. Success in this role requires deep familiarity with healthcare claims data , strong SQL proficiency, and a solid understanding of… more
- Molina Healthcare (IA)
- …solution or configuration during warranty period. **KNOWLEDGE/SKILLS/ABILITIES** + Knowledge of healthcare claims and claim processing from receipt through ... functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received… more
- Molina Healthcare (Cleveland, OH)
- …+ Locate and interpret regulatory and contractual requirements + Tailors existing reports or available data to meet the needs of the claims project + Evaluates ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Providence (Renton, WA)
- …insurance codes, regulations, and our department's policies and procedures + Secure monthly claims data reports and provide quality assurance recommendations to ... claims files for quality assurance purposes + Experience working with claims data analytics + Experience in project management + Experience creating… more
- Molina Healthcare (Austin, TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- CenterLight Health System (NY)
- … and Encounter Analyst enhances the efficiency and effectiveness of the claims department by analyzing data , refining processes, and ensuring compliance with ... focus on data -driven process improvement. JOB RESPONSIBILITIES: + Analyze claims data to identify risk-adjustable conditions and uncover opportunities to… more
- TEKsystems (Minneapolis, MN)
- … Claims , RxClaims, Pharmacy benefits, Health insurance, Claims Analyst , Audit, support, analysis, workflow, claim, Healthcare , Medical Terminology Top ... Skills Details Claims , RxClaims, Pharmacy benefits, Health insurance, Claims Analyst , Audit,Support, analysis Additional Skills & Qualifications High school… more
- CenterLight Health System (NY)
- …returned monies and proper application of transaction by our TPA. + Perform in-depth claims analysis using multiple data sets, conduct root cause analysis, and ... JOB PURPOSE: The Claim Analyst will play a pivotal role in enhancing...managed care setting is strongly preferred. + Proficiency in data analytics, ie SAS, SQL. + Claims … more
- Teva Pharmaceuticals (Parsippany, NJ)
- Medicaid Claims Analyst Date: May 18, 2025 Location: Parsippany, United States, New Jersey, 07054 Company: Teva Pharmaceuticals Job Id: 60414 **Who we are** Teva ... journey of growth! **The opportunity** **Position Summary:** The Medicaid Claims Analyst is responsible for Medicaid Drug...with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and… more
- TEKsystems (Menasha, WI)
- Description As a Claims Analyst II you will be tasked...to 5pm Top Skills Details Insurance claims Claims processing Medical claims Data Entry ... & Qualifications MUST: - More than two years of claims processing experience required ( healthcare related) -...two years of claims processing experience required ( healthcare related) - Knowledge of current procedural terminology (CPT)… more
- TEKsystems (Madison, WI)
- This position is remote to Wisconsin residents only! Description As a Claims Analyst II you will be tasked with the following: - Examine and process paper ... and agreements, authorizations and other utilization management policies, etc. - Reviews claims for re-pricing. Enters eligible claim data into appropriate WRAP… more
- Healthfirst (NY)
- …of Medicare and Medicaid programs and reimbursement methodologies a plus. + Knowledge of healthcare claims processing practices in a managed care setting a plus. ... + Perform training and quality assurance on mass claim adjudications and automated data load processes. + Query and manipulate claims configuration and claim… 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 ... external investors providing opportunity for investor rebuttals. Accountable for analyzing multiple data elements in order to apply the proper decision rationale and… more
- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. **Senior Healthcare Data Analyst ** **(Location - Albany, NY)** **Summary:** The ... Data Analyst will work within the Division of ...reports in support of the intake and management of healthcare data . The ideal candidate will be… more
- Molina Healthcare (NY)
- **JOB DESCRIPTION** **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… more
- Centene Corporation (Salt Lake City, UT)
- …the applicant to use advanced analytics and apply statistical rigor to member and claims data to evaluate the impact of internal clinical programs, external ... and improve their clinical outcomes. + Interpret and analyze data from multiple sources including healthcare provider,...and analyze data from multiple sources including healthcare provider, member/patient, and third-party data +… more
- HCA Healthcare (Nashville, TN)
- …Do you have the career opportunities as a Electronic Processing Operations Analyst you want with your current employer? We have an exciting opportunity ... which is part of the nation's leading provider of healthcare services, HCA Healthcare . **Benefits** Parallon, offers...you want to work as a Electronic Processing Operations Analyst where your passion for creating positive patient interactions… more
- CDPHP (Albany, NY)
- …configuration analyst is a technical position that will focus on provider data and processes. The analyst will work with management, project managers, and ... to gain efficiencies and improve the quality of provider data that serves as the backbone of several critical...claims systems and any integrated systems. The Configuration Analyst III will be responsible for the technical oversight… more
- Centene Corporation (Austin, TX)
- …of care for members and improve their clinical outcomes. + Interpret and analyze data from multiple sources including claims , provider, member, and encounters ... and data management or 2+ years of IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/querying languages. Preferred knowledge of… more
- State of Massachusetts (Boston, MA)
- …transparency and integrity in publicly funded healthcare programs. You will review healthcare data and evaluate claims and payment data ... work experience in independent public health policy analysis, reviewing and evaluating healthcare data , healthcare program evaluation, or public health… more