- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance **Position Summary:** The HEDIS Network Analyst will support CCA's ability to meet and surpass critical Quality ... relevant Network Providers, including those with delegated arrangements + Review YTD claims files on a monthly/quarterly basis to identify errors and address… more
- SSM Health (MO)
- …MO-REMOTE **Worker Type:** Regular **Job Highlights:** Exciting Opportunity for an Epic Systems Analyst at SSM Health! Preferred Epic certification in HB claims . ... + Acts as a resource for Epic colleagues with less experience. May lead small projects with manageable risk and resource requirements. + Analyzes, prioritizes, and… more
- Somatus (Mclean, VA)
- …the leader in value-based kidney care, has an immediate opening for an Analyst , Operations & Client Analytics to create impact among Somatus' clients and leadership ... by analyzing Somatus' healthcare claims and care management data. This position will work...and/or PowerBI, and synthesizing and presenting findings. Responsibilities + Lead ad-hoc and analytic projects in support of our… more
- SSM Health (MO)
- …Type:** Regular **Job Highlights:** SSM Health IHT is seeking a certified analyst and technically skilled team member with strong Epic Environment build experience ... must be Epic Certified in Resolute Hospital Billing (HB) and/or Hospital Claims and Remits with relevant work experience and background in hospital billing.… more
- Cardinal Health (Hagatna, GU)
- …data from multiple sources (eg, Salesforce, Trella Insights, Definitive Healthcare, claims feeds, internal CRM/ERP) to deliver clear, actionable insights that ... Ensure HIPAA/privacy safeguards and appropriate minimum necessary use of PHI/ claims . + Define and operationalize Reach (# of targeted...processes, metrics, or models + Works on or may lead complex projects of large scope + Projects may… more
- Centene Corporation (Lansing, MI)
- …needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. + Provide advanced analytical support for business operations in ... all or some of the following areas: claims , provider data, member data, clinical data, HEDIS, pharmacy, external reporting + Extract, load, model, and reconcile… more
- Centene Corporation (Austin, TX)
- …+ Develop and incorporate organizational best practices into business applications + Lead problem solving and coordination efforts between various business units + ... preferably healthcare (ie documenting business process, gathering requirements) or claims payment/analysis experience. Knowledge of managed care information systems… more
- Trinity Health (Pontiac, MI)
- …words/minute. + Work requires the ability to balance accounts and knowledge of claims processing, payments, and adjustments. + Work volume is high, and involves math ... to ensure confidentiality. Works closely with System Specialist and Surgery Revenue Lead and Finance to reconcile all revenue issues within the Surgery System.… more
- AIG (Atlanta, GA)
- …OFFICE LOCATION. THIS IS NOT A REMOTE ROLE. About the role: Senior BA Lead will work closely with business partners to gain in depth understanding of customer's ... expected standards. This role will also be responsible to lead various workshops with business partners, to derive the...required. + Experience as an underwriting assistant or in claims for insurance a plus. + Must have significant… more
- Centene Corporation (Tallahassee, FL)
- …+ Develop and incorporate organizational best practices into business applications + Lead problem solving and coordination efforts between various business units + ... Skills:** Medical Billing and Coding Appeals experience Working with claims editing, researching guidelines CPC/ CCS Certification Communication skills (written,… more