- Mount Sinai Health System (New York, NY)
- …processes, and related regulations. ? Familiarity with contract terms, NYS regulations, claims processing , and healthcare reimbursement models. ? Experience in ... * Analyze contract language to ensure proper interpretation and application of terms during claims processing . * Ensure that all contract terms are being adhered… more
- Elevance Health (Louisville, KY)
- …**Microsoft Office Suite** (Excel, Word, Outlook) preferred. + Experience in **medical claims processing ** workflows and systems preferred. + Experience in ... to verify the accuracy of billed services and ensure claims were submitted and processed appropriately. The analyst... claims were submitted and processed appropriately. The analyst will assess the validity of each recovery request,… more
- Highmark Health (Harrisburg, PA)
- …on SOX remediation and Regulatory and legal guidelines. In addition, the Analyst will identify potential areas of processing vulnerability through procedure ... ESSENTIAL RESPONSIBILITIES: 1. Ensure the consistent, accurate, efficient, and appropriate processing of adjustments and/or duplicate claims through an audit… more
- Allied Solutions (Plano, TX)
- …Loss, GAP, CPI and others as assigned. This position will involve the initial processing and investigation of 20-40 claims per day. This position ensures that ... coverage to certain claim types prior to the assignment to a Claims Adjuster or Analyst . The key responsibilities of this job are both administrative and… more
- CGI Technologies and Solutions, Inc. (Canton, MA)
- …teams. . Provide subject matter expertise (SME) on payer workflows such as claims processing , member onboarding, provider data management, care management, and ... **Senior Business System Analyst - Healthcare** **Category:** Business Analysis (functional and technical) **Main location:** United States, Massachusetts, Canton… more
- Molina Healthcare (Rio Rancho, NM)
- …Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to ... JOB DESCRIPTION Job Summary Provides lead level analyst support for configuration information management activities. Responsible...updates/changes within a claims processing system. + Advanced experience validating… more
- Molina Healthcare (St. Petersburg, FL)
- …combination of relevant education and experience. * Advanced experience using a claims processing system. * Advanced experienced verifying documentation related ... JOB DESCRIPTION Job Summary Provides senior level analyst support for configuration information management activities. Responsible...to updates/changes within a claims processing system. * Advanced experience validating… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …in healthcare contract variance analysis, including an in-depth knowledge of healthcare claims processing -OR- * An approved equivalent combination of education ... **_SUMMARY_** We are currently seeking a *PFS Contract Variance Analyst Senior** *to join our Denials Analysis team. This...* Excellent problem solving skills * Knowledge of EPIC claims processing systems and electronic health records… more
- LA Care Health Plan (Los Angeles, CA)
- …Advanced understanding of managed care operations (including but not limited to, claims processing ; provider contracting, network and data management; complex ... Core Systems Configuration Analyst III Job Category: Administrative, HR, Business Professionals...application of the Division of Financial Responsibility (DoFR) to claims processing . Strong communication, analytical, organizational, and… more
- AIG (Lenexa, KS)
- …by third party contractors or by internal claim handling teams associated with the processing of commercial or personal line claims . + Generate monthly reports ... to manage risk. Join us as a Claim Governance Analyst to play your part in that transformation. It's...valued member of the team. Make your mark in Claims . Our Claims teams are the proven… more