- Molina Healthcare (Columbus, OH)
- …Maintains 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, prior authorizations, fee schedules, and other business requirements.… more
- Medical Mutual of Ohio (OH)
- …site for meetings in Brooklyn, OH monthly; Ohio residents preferred. **Financials Systems Analyst III** **Job Summary:** **Under general supervision, updates and ... needs. + Performs other duties as assigned. **Sr. Financials Systems Analyst ** **Job Summary:** **Performs a lead...and runs queries to generate monthly reports for premium, claims and enrollment to be used by several operating… more
- Motion Recruitment Partners (Dublin, OH)
- Senior Systems Analyst - Remote Dublin, OH **Hybrid** Contract $51.07/hr - $51.07/hr Our client is looking for a Senior Systems Analyst on an 11-month ... OH. Join over 20,000 employees at this global company specializing in technology-enabled claims and risk management solutions. You will be part of a culture that… 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
- Medical Mutual of Ohio (OH)
- …Advanced knowledge of NCQA and CMS measurement requirements and quality rating systems . **Lead HEDIS Analyst ** **Education and Experience:** + Bachelor's degree ... including HEDIS audit submission, Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS). Supports data capture and… more
- Prime Therapeutics (Columbus, OH)
- …and Medicaid Services rules and regulations + 1 year of experience working with claims systems Every employee must understand, comply with and attest to the ... Analyst - JUDI Ops Team - Remote **Job Description** The Claims Technical Analyst is responsible for serving as the claims analysis resource for… more
- CGI Technologies and Solutions, Inc. (Columbus, OH)
- **Financial Analyst ** **Category:** Finance **Main location:** United States, Ohio, Columbus **Position ID:** J0825-1828 **Employment Type:** Full Time **Position ... Description:** Under the management of the Finance Manager, the Financial Analyst carries out processing and financial administration for the assigned contracts.… more
- Fifth Third Bank, NA (Cincinnati, OH)
- …Discover a career in banking at Fifth Third Bank. GENERAL FUNCTION: The Fraud Analyst I is a cross functional position within Fraud Operations. Fraud Analyst ... Responsible for analyzing and decisioning alerts on fraud detection systems to determine what actions need to be taken...- Responsible for processing and decisioning fraud check dispute claims . Includes working alerts, dispute cases and inbound… more
- Elevance Health (Mason, OH)
- …ASC X12 837 EDI experience. + Intermediate Microsoft Excel experience. + Facets systems knowledge considered a plus. + Claims and/or Encounters experience ... **Business Information Analyst Senior - Medicaid Encounters Data** The **Business...+ Develop and analyze business performance reports (eg, for claims data, provider data, utilization data) and provides notations… more
- Intermountain Health (Columbus, OH)
- **Job Description:** The Revenue Cycle Analyst is responsible for tracking revenue performance metrics across the organization and mitigating root causes ... trends, and recommend changes to care site and revenue cycle leadership. The analyst should also be able to lead committee meetings and present their findings… more