- Molina Healthcare (Akron, OH)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex claims business problems and issues using data from internal and external sources to provide insight to ... locate influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for… more
- Molina Healthcare (Cincinnati, OH)
- …critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each ... database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits,… more
- System One (Dayton, OH)
- …systems and processes, including EDI and paper claims to ensure accurate data transmission and adjudication + Identify, analyst and resolve issues related to ... Title: EDI Business Implementation Analyst - 2 roles...Title: EDI Business Implementation Analyst - 2 roles are open ALTA is...+ Oversee workflows and systems for intake, imaging and data capture of paper claims ensuring timely… more
- Lyric (Columbus, OH)
- …other immigration support are not available for this position. **Job Summary:** The Clinical Data Analyst - Staff plays a pivotal role in advancing our products ... advanced coding, analytic reporting, and predictive modeling, the Clinical Data Analyst - Staff uncovers actionable insights...Work cross functionally to identify opportunities for leveraging company data to drive business solutions + Mine… more
- Molina Healthcare (OH)
- …cross-functional coordination, and shared ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** ** Business Leadership & ... Summary** Provides lead level support as a highly capable business analyst who serves as a key...the role. + Validates findings and tests assumptions through data , but leads with contextual knowledge of claims… more
- Highmark Health (Columbus, OH)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Elevance Health (Mason, OH)
- ** Business Information Analyst Senior - Provider...and analyzes business performance reports (eg for claims data , provider data , utilization ... an accommodation is granted as required by law. The ** Business Information Analyst Senior** is responsible for...is responsible for analyzing, reporting and developing recommendations on data related to complex and varied business … more
- Highmark Health (Columbus, OH)
- …+ Bachelor's Degree **EXPERIENCE** **Required** + 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or experience ... needs. May troubleshoot errors, conduct impact analyses, and/or solve data rejection. Performs business analyses in one...in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + 1 -… more
- Molina Healthcare (OH)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Prime Therapeutics (Columbus, OH)
- …with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness ... drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst... extraction, storage, manipulation, processing and analysis + Analyze claims data of varying complexity to identify… more