- Banner Health (AZ)
- …data base and indices, and must be familiar with coding and abstracting software, claims processing tools, as well as common office software and electronic ... coding expertise to resolve issues and support appropriate reimbursement. Proficiency in claims software to address coding edits and claim denials utilizing multiple… more
- CVS Health (Lansing, MI)
- …identifies opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement. + Assesses impacts of new ... and projection analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost drivers and… more
- UCLA Health (Los Angeles, CA)
- …Excel + Knowledge of Tableau Reporting dashboards + Understanding of Medicare/Medi-Cal claims processing guidelines + Experience with EPIC EHR, Cirius Claim ... compliance with government regulations, reimbursement issues, etc. + Analyze hospital billing claims within the EHR and claim scrubber system + Resolve claim errors,… more
- CareFirst (Baltimore, MD)
- …setup of code sets used for configuration in benefits & pricing for claims processing , claims editing configuration set-up and maintenance. Analyzes ... business requirements and objectives towards determining the optimal configuration of the requirements. Creates complex design documents through the assessment of requirements. Assesses alternatives to different designs and chooses best solution to fit… more
- Robert Half Technology (Woodbridge, NJ)
- …reported (IBNR) calculations both based on financial and operational data (eg, claims closing ratios). * Support the development and validation of actuarial ... in SQL to extract and transform data, leveraging Python for advanced data processing and automation. * Build queries with a controls-oriented focus to ensure… 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. ... for accounts receivable processes and daily cash receipts. Accurate and timely processing of billings, receipts, and related payments. Perform analysis of assigned… more
- Molina Healthcare (Racine, WI)
- …managed care or payer environment. + In-depth knowledge of medical and hospital claims processing , including CPT/HCPCS, ICD, and modifier usage. + Strong ... requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role… more
- Centene Corporation (Jefferson City, MO)
- …+ Interprets and analyzes complex data from multiple sources including claims , provider, member, and encounters data. Proactively identifies and assesses the ... more of the following skills are desired. + Experience with Big Data; Data Processing + Experience with Data Manipulation; Data Mining + Experience with one or more… more
- BronxCare Health System (Bronx, NY)
- …collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement ... - Provides support to office operations including filing, copying, faxing, word processing and other related duties. - Collaborates with members of Department of… 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 ... experience in maintaining and operating databases, spreadsheets, presentation and word processing software, ie, Access, Excel, PowerPoint, Word, etc. * Minimum one… more