- Cognizant (Columbus, OH)
- …and executing end-to-end test strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member ... About the role As a **Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing… more
- Cognizant (Columbus, OH)
- …+ Minimum one (1) year QA Experience + Minimum of two (2) year Healthcare claims processing experience + Good Spoken & Written English Good Communication ... established claims adjudication team. We are seeking highly motivated healthcare professionals with auditing experience in professional claims adjudication… more
- Cognizant (Columbus, OH)
- …WPM + 10-key + Proficient in Microsoft Office - Excel, Word, and Outlook + Healthcare claims payer processing experience (required) + Ability to work at a high ... ** Claims Process Executive (remote)** **JOB PURPOSE:** Claim Processors...workspace and location free from distractions and safety of healthcare data (required) **Salary and Other Compensation** : Applications… more
- Cognizant (Columbus, OH)
- …+ Minimum of one (3) years QA Experience + Minimum of one (5) years Healthcare claims processing experience + Good Spoken & Written English Good Communication ... established claims adjudication team. We are seeking highly motivated healthcare professionals with auditing experience in professional claims adjudication… more
- Molina Healthcare (Columbus, OH)
- …and work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (OH)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (Dayton, OH)
- …must reside in Georgia **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- Molina Healthcare (Columbus, OH)
- …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working environment ... hours will be 7am-3:30pm PST M-F** **Job Summary** Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor,… more
- Molina Healthcare (Columbus, OH)
- …and appeals experience. **Required Experience** * 7 years experience in healthcare claims review and/or member appeals and grievance processing/resolution, ... 2 years in a manager role. * Experience reviewing all types of medical claims (eg HCFA 1500, Outpatient/Inpatient UB92, Universal Claims , Stop Loss, Surgery,… more
- Evolent (Columbus, OH)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more