- Molina Healthcare (Lexington, KY)
- …maintenance of critical information on claims databases, synchronizing operational and claims systems data and application of business rules as they apply ... * Loads and maintains contracts, benefit and/or reference table information into the claims payment system and other applicable systems . * Participates in defect… more
- Molina Healthcare (Lexington, KY)
- **JOB DESCRIPTION** **Job Summary** Provides senior level analyst support for medical economics analysis activities, including extracting, analyzing and synthesizing ... * Extracts and compiles data and information from various systems to support executive decision-making. * Mines and manages...and manages information from large data sources. * Analyzes claims and other data sources to identify early signs… more
- Molina Healthcare (KY)
- …care and develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably. Performs research, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary)… more
- Molina Healthcare (Owensboro, KY)
- …care and develop payment strategies that give incentives to providers and healthcare systems that deliver better health, more affordably. Performs research, ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary)… more
- Molina Healthcare (KY)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... or reference table information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component + Assists with… more
- Elevance Health (Louisville, KY)
- …Skills, Capabilities, and Experiences:** + **2-4 years** of experience in healthcare claims analysis, payment integrity, or related field strongly preferred. ... healthcare providers to verify the accuracy of billed services and ensure claims were submitted and processed appropriately. The analyst will assess the… more
- Highmark Health (Frankfort, KY)
- …you will play a critical part in supporting United Concordia's dental claims operations by investigating and resolving system issues, managing a dynamic backlog ... team effectiveness. This is an opportunity to make a direct impact on claims processing efficiency and member satisfaction while working alongside a dedicated and… more
- Molina Healthcare (Bowling Green, KY)
- …not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with ... care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of… more
- Prime Therapeutics (Frankfort, KY)
- …us. **Job Posting Title** IT Analyst **Job Description** The IT Business Systems Analyst is responsible for solving moderately complex system problems and ... and document the requirements and technical solutions for changes to Prime's claims systems . **Responsibilities** + Ensure understanding of business requirements… more
- Baylor Scott & White Health (Frankfort, KY)
- …ODS, or other reporting environment in a work environment. + Knowledge of healthcare and health insurance claims processing domains. + Ability to write ... **JOB SUMMARY** The Sr. Data Governance Analyst plays a key role in advancing BSWH...governance tools, monitor KPIs, and operationalize data standards across systems . + Stay updated on industry trends and best… more