- Queen's Health System (Honolulu, HI)
- …business units highly desirable. * Experience with retail prescription claims or hospital billing auditing highly desirable. Equal Opportunity ... * Compliance responsibilities include monitoring and routine auditing of virtual inventory accumulation, purchasing procedures, Medicaid billing procedures, patient eligibility, new areas of service, and the overall quality of the 340B Program. * Works closely… more
- SSM Health (MO)
- …(OPA) database changes and updates. + Monitors and audits state Medicaid claims to ensure compliance. + Reconciles contract pharmacy payments against revenue posted ... by Finance. + Evaluates patient eligibility in mixed use areas and clinics in electronic medical records (EMR). + Develops and updates 340B Program reporting packets for SSM ministries. + Reviews ordering, negative and positive accumulations and unmapped items… more
- AIG (Chicago, IL)
- …American Commercial, and Specialty portfolios. + Work closely with actuarial, claims , and other functions, integrating catastrophe modelling insights into day-to-day ... business, and portfolio optimization strategies. + Carry out other modelling business activities including event response, business planning, budgeting, profit studies, portfolio optimization, reinsurance purchasing, and other exercises where catastrophe risk… more
- nVent (Anoka, MN)
- …thresholds, regional price variability recommendations, driven indexing, ship-and-debit claims impact analytic, price waterfall model, cost-to-serve analysis as ... well as AgenticAI price models. + Monitor price performance metrics and perform periodic price analysis for product lines, region, customers. + Support the pricing operations team with analytics and tools for pricing process efficiencies. + Collaborate… more
- Insight Global (Mount Laurel, NJ)
- …the organization. The team focuses on root cause analysis to ensure clean claims and accurate revenue capture. Analysts will conduct charge audits, identify workflow ... issues, monitor Epic workqueues, review medical records for compliance, and document findings thoroughly. Additional responsibilities include running reports, analyzing trends, assisting with strategic pricing and CPT updates, and collaborating with Revenue… more
- CareFirst (Baltimore, MD)
- …payor industry, insurance products, and regulation. + Knowledge of CareFirst operations, claims systems, and policies. + Microsoft Power BI and Power BI Report ... Builder. + Microsoft Excel (advanced functions, pivot tables, Power Query). + PowerPoint (advanced executive presentations). + Understanding of data visualization best practices and storytelling with data. + Strong communication and data documentation skills.… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an ... Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life… more
- Queen's Health System (Honolulu, HI)
- …safety initiatives. * Works with a multiple sources of healthcare data, ie, claims , financial and clinical data, to meet both internal and external reporting ... requirements and support new initiatives. Projects may range from simple programming and basic data manipulation/analysis to more advanced techniques. II. TYPICAL PHYSICAL DEMANDS: * Essential: finger dexterity, seeing, hearing, speaking. * Frequent: sitting,… more
- AIG (Parsippany, NJ)
- …network. Customers value AIG's strong capital position, extensive risk management and claims experience and its ability to be a market leader in critical ... lines of the insurance business. Corporate Finance - Investment Accounting The Investment Accounting group at AIG is responsible for the accounting and reporting for AIG's Invested Assets of over $95 billion a comprised primarily of fixed maturity securities… more
- Bowery Residents Committee (Manhattan, NY)
- …Highly proficient with Microsoft Office tools. + Prior knowledge of electronic claims processing would be preferred. *Vaccination preferred but not required. MAKE AN ... IMPACTAre you looking to make a positive impact on the lives of those in your community? At BRC, our staff help New Yorkers experiencing homelessness reclaim their lives by providing a hand up, offering opportunities for health and self-sufficiency, and… more
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