- WelbeHealth (Baton Rouge, LA)
- …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
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Identifies claims and provider reimbursement related system problems, including claims coding and processing issues, coordinates research, audit , and ... new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well… more
- Sedgwick (Baton Rouge, LA)
- …in Financial Services & Insurance Workforce Analytics & Productivity Monitoring Analyst **PRIMARY PURPOSE OF THE ROLE:** To manage Sedgwick's Workforce Analytics ... users, coordinate with software vendors for support and enhancements, and maintain audit readiness by ensuring compliance with data governance and privacy standards.… more
- Highmark Health (Baton Rouge, LA)
- …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
- Highmark Health (Baton Rouge, LA)
- …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