- Transdev (Lombard, IL)
- …Responsibilities: + Primary support for key internal topic of insurance and insured claims estimates + Work with actuary and risk department to support valuation of ... significant estimates related to insured claims + Create and maintain pricing model related to...global company, Transdev is a leader in mobility with operations in 19 countries, proudly operated by 110,000 team… more
- UCLA Health (Los Angeles, CA)
- …You will: + Analyze complex financial data + Identify trends in revenue cycle operations + Summarize data and present reports to leadership + Serve as liaison with ... compliance with government regulations, reimbursement issues, etc. + Analyze hospital billing claims within the EHR and claim scrubber system + Resolve claim errors,… more
- Highmark Health (Columbus, OH)
- …Utilize robust, data-driven insights from complex healthcare datasets (eg, claims , clinical, utilization, pharmaceutical) to inform policy development, identify ... liaison between the Medical Policy department, other internal departments (eg, Operations , Provider Relations, Clinical Programs), and external vendors to ensure… more
- Queen's Health System (Honolulu, HI)
- …* In addition to the educational requirement, three (3) years pharmacy operations , business operations or finance experience, preferably in a comparable ... other similar medical record system highly desirable. * Experience in PBM operations , sales, PBM implementation, or within various business units highly desirable. *… more
- SSM Health (MO)
- …Type:** Regular **Job Highlights:** **Qualifications** : Experienced with 340B program operations and audits and Advanced 340B Operations Certificate within ... (OPA) database changes and updates. + Monitors and audits state Medicaid claims to ensure compliance. + Reconciles contract pharmacy payments against revenue posted… more
- Geisinger (Danville, PA)
- Job Summary Performs analytics, reporting, Billing/Enrollment Operations support, Finance Operations support, system configuration, processing of TPA capitation ... system, including the areas of billing, accounts receivable, capitation payable, claims payable, weekly check processing, new product development, and the… more
- AIG (Chicago, IL)
- …and Portfolio Management. + Lead the quarterly portfolio roll-up and reporting operations for select North American Commercial, and Specialty portfolios. + Work ... closely with actuarial, claims , and other functions, integrating catastrophe modelling insights into...an exciting time to join us - across our operations , we are thinking in new and innovative ways… more
- nVent (Anoka, MN)
- …thresholds, regional price variability recommendations, driven indexing, ship-and-debit claims impact analytic, price waterfall model, cost-to-serve analysis as ... for product lines, region, customers. + Support the pricing operations team with analytics and tools for pricing process...**WE HAVE:** + A dynamic global reach with diverse operations around the world that will stretch your abilities,… more
- Insight Global (Mount Laurel, NJ)
- …is hiring two Revenue Integrity Analysts to join Virtua's Revenue Cycle Operations team, which supports hospitals, hospice, home health, professional services, and ... the organization. The team focuses on root cause analysis to ensure clean claims and accurate revenue capture. Analysts will conduct charge audits, identify workflow… more
- CareFirst (Baltimore, MD)
- …the healthcare payor industry, insurance products, and regulation. + Knowledge of CareFirst operations , claims systems, and policies. + Microsoft Power BI and ... multiple tasks simultaneously that may include staff support relating to current operations . Applies a depth of knowledge, skills, and abilities to research and… more