- PROMEDICAL, LLC (Lexington, MA)
- Complex Claims Analyst Healthcare Billing PROMEDICAL is seeking a Complex Claims Analyst . This position is responsible for the initial ... unpaid or denied workers compensation & motor vehicle medical claims . Analyst will ensure that claims...insurance carriers have the necessary information to adjudicate. A healthcare revenue cycle background in medical billing or insurance… more
- Medline Industries LP (Libertyville, IL)
- …Expertise in SAP and Vistex Pricing configuration and enhancement of complex pricing scenarios. Expertise in Agreements, Contracts, Claims , Reconciliation ... in EDI 832, 867 integration with Vendors Demonstrated experience in designing complex SAP SD/OTC/Vistex business processes and completing complex projects.… more
- LA Care Health Plan (Los Angeles, CA)
- Claims Compliance Data Validation Analyst II Job Category: Claims Department: Claims Data and Support Services Location: Los Angeles, CA, US, 90017 ... net required to achieve that purpose. Job Summary The Claims Compliance Data Validation Analyst II supports...stated knowledge, experience and/ or skills. Experience working with complex and high dollar claims . Must have… more
- Elevance Health (Norfolk, VA)
- …you a check, or ask you for payment as part of consideration for employment. **Rating/ Claims System Analyst ** + Job Family: IFT > IT Bus Systems Solutions ... Date:May 06, 2024 + Reference: JR111007 **Location:** + VA, NORFOLK **Description** **Rating/ Claims System Analyst ** **Location:** This position will work a… more
- Geisinger (Danville, PA)
- Job Summary Reviews and resolves complex claims issues, using established state and federal guidelines, departmental policies and procedures to ensure that work ... departments and facilitates the exchange of information between the grievances, claims processing and provider relations systems. Follows up with providers, internal… more
- Providence (CA)
- …of WA, OR, MT, CA, AK and or TX **Providence is seeking an Epic Applications Analyst - AP Claims , who will:** + Demonstrate full use and application of standard ... related to technical discipline and provide solution to a variety of moderately complex problems. + Manage small and moderately complex projects, establish and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare ? Bring your true colors to blue. The Senior Claims Testing Analyst is responsible for reviewing business requirements, developing, and ... executing comprehensive test plans, analysis of reporting, performing claims quality review, mentoring associates and ensuring department goals are met in a… more
- Health Plans, Inc. (Dallas, TX)
- …Experience + Understanding of claims processing systems + 2+ years of healthcare claims processing (PPO and Medicare/RBP) + Detailed understanding of PPO ... Employers Health Network, LLC (EHN ) creates community-based healthcare networks and a unique governance model to form a true partnership between self-funded… more
- MD Anderson Cancer Center (Houston, TX)
- The Principal EHR Systems Analyst is a primary support contact for the assigned application and communicates directly with the Manager to discuss design decisions. ... all key decisions are implemented across the application. The Principal EHR Systems Analyst will be responsible for coordinating and communicating with the end users… more
- TEKsystems (Bakersfield, CA)
- … industry. This candidate MUST have experience with Jiva Integrations. Must Haves: Healthcare experience Claims Operations or application vendor experience: 3 + ... business requirements and configuration within the core systems. The Configuration Analyst III elicits complex business requirements through group meetings,… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …and present clinical observations and insights from the analysis of data from healthcare claims + Be responsible for standard and ad-hoc extracts/reports across ... initiatives' success. With strong communication and organizational skills, the claims data analyst assists leadership and team...+ At least one year of experience as a healthcare data analyst and experience at a… more
- HCA Healthcare (Denver, CO)
- …The Division Denial Prevention Data Analyst is responsible for performing complex financial analysis of patient claims , specifically related to denial and ... Are you passionate about the patient experience? At HCA Healthcare , we are committed to caring for patients with...family! Jump-start your career as a Denial Prevention Data Analyst today with HealthOne. **Benefits** HealthOne, offers a total… more
- Healthfirst (New York, NY)
- …3 days per week located at 100 Church Street, NYC. + As a Senior Healthcare Analyst within Medical Economics, you will manage projects from analysis to ... and deliver impactful business recommendations. As a Senior Medical Economics Analyst , you'll map out and construct detailed analyses, confront challenging and… more
- Hartford HealthCare (Newington, CT)
- …moment matters. And this is *yourmoment.* **Job:** **Administrative* **Organization:** **Hartford HealthCare Corp.* **Title:** *Revenue Cycle Business Analyst / ... Work where every moment matters. Every day, over 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every… more
- Medical Mutual of Ohio (OH)
- …and limited oversight. . Performs other duties as assigned. **Lead Provider Analyst ** Primary point of analytical support for complex and cross-functional ... Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Provider Analyst II** Provides analytical support during contract negotiation process.… more
- University of Pennsylvania (Philadelphia, PA)
- …and advanced techniques to merge different datasets and create analysis files from complex databases. Statistical Analyst B will use advanced statistical methods ... The University offers a competitive benefits package that includes excellent healthcare and tuition benefits for employees and their families, generous retirement… more
- Elevance Health (Woodland Hills, CA)
- …check, or ask you for payment as part of consideration for employment. **Grievances and Appeals Analyst I** + Job Family: CLM > Claims Support + Type: Full time ... + CA, WOODLAND HILLS + NV, LAS VEGAS **Description** **Title: Grievance/Appeals Analyst I** **Location:** This position will work a hybrid model (remote and… more
- Elevance Health (Norfolk, VA)
- …you a check, or ask you for payment as part of consideration for employment. **Grievance/Appeals Analyst I** + Job Family: CLM > Claims Support + Type: Full time ... **Location:** + VA, Norfolk + KY, Lexington **Description** **Title: Grievance/Appeals Analyst I** **Location:** This position will work a hybrid model (remote… more
- Insight Global (Richmond, VA)
- …in .NET and SQL to understand its functionality and implications within health plan claims systems (they are on qnxt) -Serve as a bridge between technical teams and ... business stakeholders, translating complex technical concepts into easily understandable language for non-technical...prior experience working with health plans and knowledge of claims systems (qnxt or facets) We are a company… more
- AdventHealth (Maitland, FL)
- …knowledge of healthcare managed care contracts and healthcare administrative claims data + Employs existing complex models and implements them on new ... from the various financial systems and interface tools + Performs analysis of complex and varied healthcare data including financial modeling and risk… more