- Commonwealth Care Alliance (Boston, MA)
- …Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and ... Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role...reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject… more
- Highmark Health (Boston, MA)
- …efficient working relationships with key internal areas, such as Customer Service Operations ( Claims , Dental Benefits, Customer Service, Membership & Billing), ... resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. This… more
- Humana (Boston, MA)
- …They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations , claims operations , and other business teams involved in the ... and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral… more
- Highmark Health (Boston, MA)
- …recommends process improvements for efficiencies. May provide guidance to Associate level employees. **ESSENTIAL RESPONSIBILITIES** + Intake operational objectives ... improvement meetings and/or discussions. + Analyze the functions and operations of a business area/function and identify problem areas....3 - 5 years of experience in a Business Analyst or Business Process Analyst role or… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …The role also includes the development and communication of market segment medical claims expense trends with the aim to provide insights that inform pricing, ... business partners outside of Finance, spanning multiple layers of the organization from analyst to SVP, including Sales & Segmentation, Pharmacy, ET, and Health Care… more