- Molina Healthcare (Cincinnati, OH)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Marketplace is required. + Medical coding experience is highly preferred . **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination… more
- 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 ... task and workflow analysis. + Interpret customer business needs in the claims space and translate them into application and operational requirements + Communicate… more
- Molina Healthcare (OH)
- …background in payment integrity-either at a health plan or vendor-is strongly preferred . **Knowledge/Skills/Abilities** + Review Medicaid COB claims for correct ... **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims … more
- Baylor Scott & White Health (Columbus, OH)
- …Experience with HealthEdge HealthRules Payer claims management software strongly preferred . + Experience with benefit configuration & claim analysis strongly ... and/or level **Job Summary** **100% Remote position** The Benefit Configuration Analyst examines configuration change requests. They establish the technical scope,… more
- CVS Health (Columbus, OH)
- …Strong basic math, communication, analytical, critical-thinking, and problem-solving skills. ** Preferred Qualifications** + Claims processing experience. + ... with heart, each and every day. **Position Summary** The Dispute Repricing Analyst will be responsible for the accurate analysis and resolution of provider… more
- Highmark Health (Columbus, OH)
- …resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. This ... relationships with key internal areas, such as Customer Service Operations ( Claims , Dental Benefits, Customer Service, Membership & Billing), Provider Data… more
- Lyric (Columbus, OH)
- …support are not available for this position. **Job Summary:** The Clinical Data Analyst - Staff plays a pivotal role in advancing our products and services ... business operations leaders to develop reporting and analyze large-scale healthcare claims and clinical datasets. By leveraging advanced coding, analytic reporting,… more
- Elevance Health (Mason, OH)
- **Performance Quality Analyst I - CarelonRx PBM** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... lens, to deliver member-centered, lasting pharmacy care. The **Performance Quality Analyst I** is responsible for driving service quality excellence by evaluating… more
- Elevance Health (Mason, OH)
- **Performance Quality Analyst I - CarelonRx PBM** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... lens, to deliver member-centered, lasting pharmacy care. The **Performance Quality Analyst I** is responsible for driving service quality excellence by evaluating… more
- Elevance Health (Cincinnati, OH)
- …+ Medical economics, provider finance, healthcare analytics, and/or financial services highly preferred . + Comprehensive understanding of medical claims data. + ... **Advanced Analytics Analyst Senior - Medical Economics** **Location:** Atlanta, GA;...GA; Norfolk, VA; Indianapolis, IN; Cincinnati, OH; Chicago, IL ( preferred ). This role requires associates to be in-office 1… more