- CVS Health (Columbus, OH)
- …Linux OS, GCP/ AWS/ Azure * Experience working with medical and/or pharmacy claims data * Experience in healthcare industry, including health insurance, PBM ... our PBM Finance Enablement group as a Senior Reporting Analyst within our PBM Customer Reporting team. CVS Health...a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and… more
- Evolent (Columbus, OH)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...health, biology) + 1+ years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- OhioHealth (Columbus, OH)
- …in-person meeting per month in Columbus, Ohio. The Intermediate Informatics Data Analyst will support OhioHealth Pharmacy Services by analyzing and managing ... healthcare data to enhance decision-making. This role requires advanced...of Excel and PowerPoint. - Experience in Python and business intelligence tools are preferred. **Responsibilities And Duties:** Extracts… more
- Highmark Health (Columbus, OH)
- …experience within one or more Epic modules. **Preferred** + 2+ years of Healthcare Revenue Cycle experience ( Claims , Patient Access, Billing) + Epic ... supporting the Epic Resolute Professional Billing application. Responsibilities include business /systems analysis, requirements definition and documentation, system design, and… more
- Elevance Health (Mason, OH)
- …eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical editing ... to system inquiries and appeals. + Conducts research of claims systems and system edits to identify adjudication issues...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- CVS Health (Columbus, OH)
- …designs. + Completes financial forecasting and projection analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to ... on these issues. Team members collaborate closely throughout the year with market business partners in addition to the broader actuarial team. **A Brief Overview**… more
- CVS Health (Columbus, OH)
- …**Required Qualifications** + 3-5 years of data interpretation and analysis experience. + Healthcare background. + Experience with internal claims data and ... for the validation of existing fraud waste and abuse business rules and leads designed to detect aberrant billing...to determine the impact of the scheme on Aetna business . + Keep current with new and emerging fraud,… more
- Molina Healthcare (Cincinnati, OH)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
- CVS Health (Columbus, OH)
- …Experience in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting + Experience with data ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste,… more
- Highmark Health (Columbus, OH)
- …degree + 10-15 years experience in support of a Marketing function or Data Analyst role or in a business environment with responsibility for application of ... Support Analyst or equivalent training and experience in a business , specialty pharmacy, clinical pharmacy or clinical environment with direct responsibility for… more