- Acosta Group (Jacksonville, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position...for change to provide continuous improvements. This is a Hybrid role. The Hybrid schedule for all… more
- Acosta Group (Charlotte, NC)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position..., assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.… more
- Fallon Health (Worcester, MA)
- …the Risk Adjustment Analyst (RAA) will be to function as the Claims SME for the Risk Adjustment & Analytics Department. The RAAimplements data analytic reports, ... as appropriate. **Responsibilities** **Primary Job Responsibilities:** + Analyze, prioritize & support resolution of Claims / Encounter data errors by triaging to… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Claims Analyst is accountable for claims processing, research and adjudication to correctly apply benefit determination and pricing for ... claims as directed by departmental policies and procedures; follows up for resolution and processes pended claims immediately following a benefit / payment… more
- Kelly Services (Mason, OH)
- …a great, new opportunity. Join the Kelly(R) Professional & Industrial team as a Claims Testing Analyst with a world-class equipment and services company that ... workers. Pay Rate: $29.45 per hour Location: Mason OH Hybrid Role Responsibilities: Validate base data in the test...so let's get to work. Apply to be a Claims Testing Analyst today! As part of… more
- State of Colorado (Denver, CO)
- Insurance Analyst (Rate/Financial Analyst II): DORA/Division of Insurance - Hybrid Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4638928) Apply Insurance Analyst (Rate/Financial Analyst II): DORA/Division of Insurance - Hybrid … more
- The Mount Sinai Health System (New York, NY)
- **JOB DESCRIPTION** Reimbursement (Supply) -Chargemaster Analyst Hybrid 150 East 42nd Stret The Reimbursement and Chargemaster Analyst is responsible for ... Analyzes charges and reimbursement to ensure compliance with Federal and State claims submission regulations + Ensures the existence of accurate charging processes +… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key risk adjustment ... methodology, risk score calculation, ACA enrollment, premiums, medical and pharmacy claims , and provider data. Incumbent is responsible for performing complex… more
- Henry Ford Health System (Troy, MI)
- …Medicare Advantage, Medicare-Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide ... root/cause analysis when required. The Analyst will work with HAP's medical directors, nurses, pharmacists, Legal department, and other subject matter experts to… more
- The Cigna Group (Bloomfield, CT)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director, and Other ... Coordinated Care Organization (financial understanding, provider network building, conflict/issue resolution , contracting, claim payment, meetings, training, etc.). **RESPONSIBILITIES:** +… more