- Molina Healthcare (Dallas, TX)
- …for accurate and timely implementation and oversight of critical information on claims databases. Synchronizes data among operational and claims systems and ... experience and knowledge to research and resolve claim/encounter issues, pended claims and facilitate system update(s) as necessary. + Works with fluctuating… more
- Amazon (Seattle, WA)
- … delivery. Key job responsibilities * Lead complex analysis efforts using healthcare data (EMR, claims , clinical quality) to inform strategic decisions ... to measure process effectiveness. This role requires strong analytical capabilities, healthcare domain knowledge, and the ability to translate complex data into… more
- MVP Health Care (Schenectady, NY)
- … healthcare quality data highly preferred + Subject matter expertise in healthcare data- claims , coding, HIE's etc. Experience with quality metrics, (NCQA ... opportunity for you if you have a passion for healthcare , innovation, and collaboration. **What's in it for you:**...that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.… more
- US Tech Solutions (IL)
- …health services and **outcomes research** and the analysis of large multi-dimensional ** healthcare claims and electronic health records** datasets. A minimum of ... 8 years is required with a Master's degree in any of the required fields. * Relevant pharmaceutical industry experience is required. * Ability to independently perform exploratory analysis of new datasets through pilot studies and feasibility assessments in… more
- CVS Health (Blue Bell, PA)
- …in health care data management and analytics + 5+ years' experience with healthcare claims data analysis + Experience working with and integrating large ... datasets from multiple sources + Experience in preparation and data management plan/ documentation + Experience with the FDA on research initiatives and data driven projects + Proficient with multi-tasking + Must be self-directed + Be able to critical think… more
- Staffing Solutions Organization (Albany, NY)
- …+ 8 years of professional experience required + Experience working with healthcare data, particularly claims , member, and provider domains required + ... Management. The individual will be responsible for the research and understanding of healthcare data and business context of various elements related to Medicaid … more
- Somatus (Mclean, VA)
- …patient safety, NCQA HEDIS quality performance, etc. + Analyze, interpret and apply healthcare payor claims data around $PMPM, Unit/1000, $$/Unit metrics to ... grow, and be the best version of themselves, including: + Subsidized, personal healthcare coverage (medical, dental vision) + Flexible Paid Time Off (PTO) +… more
- Brighton Health Plan Solutions, LLC (NC)
- About the Role The Claims Supervisor is responsible for supervising a staff of Claim Examiners and Claim Team Leads, 12-20 direct reports. The expectations include ... and training while promoting quality and superior customer service. The Claims Supervisor is accountable for identifying opportunities for enhancements and changes… more
- Cedars-Sinai (CA)
- **Job Description** The Claims Examiner is responsible for accurately and consistently adjudicating claims in accordance with policies, procedures and guidelines ... as outlined by the company policy. Process claims according to all CMS and DMHC guidelines. Investigate and complete open or pended claims . Meet production and… more
- Robert Half Accountemps (Minneapolis, MN)
- Description We are looking for a dedicated Medical Claims Analyst to join our healthcare team in Minneapolis, Minnesota. In this long-term contract position, you ... manage complex claims . * Strong communication skills to interact with healthcare providers and employees. * Attention to detail and organizational skills to… more