- CVS Health (OH)
- …are to reside within the State of Ohio + Minimum 3 years recent Healthcare Claims experience + Excellent analytical and problem-solving skills + Strong ... issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs. The Network Relations… more
- Robert Half Accountemps (Boston, MA)
- …Requirements Required Qualifications + 3-5 years of experience in auditing, compliance, or claims analysis within a healthcare setting + Proficiency in Microsoft ... Description Job Title: Medical Claims Auditor - RN Auditor Location: Massachusetts -...Job Description We are seeking a qualified Auditor with healthcare experience to support Program Integrity activities for a… more
- Texas Health Resources (Arlington, TX)
- …methodologies and their impact across different provider types, Experience with healthcare claims (Facility and Professional), knowledge of physician ... methodologies and their impact across different provider types, Experience with healthcare claims (Facility and Professional), knowledge of physician… more
- University of Utah Health (Murray, UT)
- …and patient-level data. + Ability to perform complex research and analysis of healthcare claims , enrollment, and other related data, to report on network ... program. + This role is responsible for analyzing medical claims , encounter, and risk adjustment targeting data to identify...in risk adjustment analytics within a health plan or healthcare organization. + Proficiency in SQL and data analysis… more
- Evolent (Helena, MT)
- …Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... to our culture. **What You'll Be Doing:** + Lead in-depth analyses of healthcare data - including authorizations, claims , membership, and clinical outcomes to… more
- Children's Hospital Los Angeles (Los Angeles, CA)
- …based on compliance-related issues and trends * Senior leadership experience in healthcare , risk management, claims management, insurance and/or other relevant ... is directly accountable for contributing to audit functions, business continuity, claims management, insurance, physical security, integrated risk management and all… more
- TEKsystems (Dallas, TX)
- …Must score 94% or above Preferred Experience + Experience in charge entry or claims processing + Familiarity with healthcare data and HIPAA compliance Work ... Data Operations Analyst to support our Charge Entry & Claims Submission processes. This role is ideal for someone...Oversee manual data processes related to charge entry and claims submissions + Generate weekly and monthly charge reports… more
- Conduent (Los Angeles, CA)
- …Conduent Payment Integrity Solutions performs in depth pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will ... where individuality is noticed and valued every day. **Pharmacy Claims Auditor CPhT** **Do you have a CPhT certification?**...pharmacy claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be… more
- TEKsystems (Oak Brook, IL)
- …including libraries such as pandas, NumPy, and statsmodels. * Experience working with healthcare data (eg, EHRs, claims ) and operational data (eg, staffing, ... with Python and Power BI related tools + Analyze healthcare statistics as the intent of this effort is...PI and PHI Skills Python, Sql, Data, statistical analysis, healthcare , pandas, numpy, excel Additional Skills & Qualifications *… more
- Providence (Portland, OR)
- …Health Administration, Finance, or related field. + **Experience:** 5 years in healthcare payment integrity, claims operations, or healthcare consulting. ... all Esteemed Leaders!** Are you a strategic mastermind with a passion for healthcare ? Do you thrive on navigating complex challenges and shaping the future of… more