• Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible for developing prospective ... 011250 CCA- Claims Hiring for One Year Term **_This position...claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic… more
    Commonwealth Care Alliance (08/26/25)
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  • Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, ... resolution of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on… more
    Commonwealth Care Alliance (08/31/25)
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  • Liability Analyst

    Family Dollar (Chesapeake, VA)
    …party administrator or insurance broker Strong analytical skills related to investigations, claims strategies and claim reviews Excellent written and verbal ... The Liability Analyst reports to the Liability Manager and is...and optimizing a portfolio of general and auto liability claims to reduce costs and improve outcomes. The successful… more
    Family Dollar (08/19/25)
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  • HEDIS Analyst

    Medical Mutual of Ohio (OH)
    …fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the ... initiatives to improve member health. + Orients and trains more junior-level Analyst + Participates in required trainings and performs other duties as assigned.… more
    Medical Mutual of Ohio (08/16/25)
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  • Placement Supervisor (Human Resource…

    Commonwealth of Pennsylvania (PA)
    Placement Supervisor (Human Resource Analyst 2) Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5095164) Apply  Placement Supervisor (Human ... Resource Analyst 2) Salary $59,345.00 - $90,211.00 Annually Location Dauphin...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
    Commonwealth of Pennsylvania (10/13/25)
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  • Recovery & Resolution Analyst - Remote

    Prime Therapeutics (Pierre, SD)
    …passion and drives every decision we make. **Job Posting Title** Recovery & Resolution Analyst - Remote **Job Description** The Recovery & Resolution Analyst is ... and abuse (FWA) through various mechanisms, including but not limited to: claim adjustments, future payment withholding and coordination with an external collection… more
    Prime Therapeutics (10/04/25)
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  • Analyst , Risk Management

    CVS Health (Trenton, NJ)
    …This position is accountable for successfully managing pharmacy and professional liability Risk claims . The Risk Analyst will be responsible to handle all ... aspects of claim resolution, including outreach, financial reserving, investigations, negotiations and...and resolution of primarily pre-suit druggist and professional liability claims against CVS throughout the United States. The Risk… more
    CVS Health (10/15/25)
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  • Senior Information Systems Analyst

    The County of Los Angeles (Los Angeles, CA)
    SENIOR INFORMATION SYSTEMS ANALYST /EMERGENCY APPOINTMENTS HOMELESSNESS Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4765385) Apply  SENIOR ... INFORMATION SYSTEMS ANALYST /EMERGENCY APPOINTMENTS HOMELESSNESS Salary $106,081.20 - $142,953.84 Annually Location Los Angeles County, CA Job Type Full time Job… more
    The County of Los Angeles (08/21/25)
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  • Liability Analyst

    Monro Muffler/Brake (Fairport, NY)
    claims with secondary backup functions at inputting Workers' Compensation claims . The Liability Analyst will maintain strong relationships with Monro ... Analyst will understand and professionally input and communicate claims to the Risk Management and Monro Inc. leadership...Handle sensitive information in a confidential manner. + Inputting claims following the guidelines of Monro Inc. claim more
    Monro Muffler/Brake (10/16/25)
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  • Lead Analyst , Payment Integrity - REMOTE

    Molina Healthcare (Dayton, OH)
    …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
    Molina Healthcare (09/28/25)
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