- Molina Healthcare (Cincinnati, OH)
- **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... CMS and internal audit activities. This position contributes to the development of...collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory… more
- Molina Healthcare (Akron, OH)
- …to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee, ... and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and performs audits and oversight functions involving business-critical… 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 ... guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen....+ Assist in developing and refining internal SOPs and audit tools related to COB claim reviews. + Act… more
- Medical Mutual of Ohio (OH)
- …business (Commercial, Marketplace, Medicare Advantage, and Medicaid), including HEDIS audit submission, Consumer Assessment of Healthcare Providers and Systems ... fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the… more
- Molina Healthcare (Cincinnati, OH)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Crown Equipment Corporation (New Bremen, OH)
- …suppliers, service providers, brokers, and freight forwarders, to determine, maintain, and audit import claims prior to arrival and after completion. Provide ... Trade Compliance Analyst Import Location: New Bremen, OH, US, 45869...review, interpret and prepare data for US Customs import claims . Interact with suppliers outside the United States to… more
- Molina Healthcare (Cleveland, OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... change requests; retain old and new report design for audit trail purposes. + Analyze data sets and trends...support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience… more
- CVS Health (Columbus, OH)
- …opportunity to join our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health strives to continuously ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- Highmark Health (Columbus, OH)
- …work closely with the section's Accountant, Accounting Coordinators, Associate Analyst , providing, guidance, feedback, training, motivation, and support. This team ... for non-payment, Completing write-offs as appropriate, Coordinating AR issues affecting claims or inquiry processing with Membership and Billing personnel.Lead or… more