- Fallon Health (Worcester, MA)
- …Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high- quality , coordinated care and is continually rated among the nation's top ... health plans for member experience, service, and clinical quality . We believe our individual differences, life experiences, knowledge, self-expression, and unique… more
- Molina Healthcare (Buffalo, NY)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... management and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and developing SOPs and/or BRDs. +… more
- State of Minnesota (St. Paul, MN)
- **Working Title: T-MSIS Data Quality Analyst ** **Job Class: Agency Policy Specialist** **Agency: Human Services Dept** + **Job ID** : 89686 + **Location** : St. ... claims , encounters, and enrollment-is accurately extracted, transformed, and quality -checked to meet federal specifications and submission requirements. This role… more
- 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 ... largest US health systems with a strong reputation for quality of care and research. We have over 38,000...System. MSHP seeks a Senior Contract Compliance (Professional Billing) Analyst who will primarily be responsible for tracking, trending,… more
- MVP Health Care (Schenectady, NY)
- … data highly preferred + Subject matter expertise in healthcare data- claims , coding, HIE's etc. Experience with quality metrics, (NCQA HEDIS and NYS ... improvement. To achieve this, we're looking for a **Professional, Quality Analyst ** to join #TeamMVP. This is...opportunity for you if you have a passion for healthcare , innovation, and collaboration. **What's in it for you:**… more
- The Cigna Group (Morristown, NJ)
- …of communication with matrix partners, including but not limited to Claims Operations and Medical Management. Credentialing, Legal, Medical Economics, Compliance, ... + Creates and manages initiatives that improve total medical cost and quality . + Drives change with external provider partners by assessing clinical informatics… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …(RHIA or RHIT) or a Nursing Degree. . Three (3) years' experience in claims auditing, quality assurance, or recovery auditing, of (MS/APR) DRG coding for ... II (in addition to Level I Qualifications) . Five (5) years' experience in claims auditing, quality assurance, or recovery auditing, of (MS/APR) DRG coding for… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role ... billing-related certifications **Required Experience (must have):** + 3+ years in healthcare claims processing, provider reimbursement, or payment integrity. +… more
- Corewell Health (Grand Rapids, MI)
- …cooperation of the provider network community and internal departments. The operations analyst is responsible for the oversight of the provider enrollment data and ... issue resolution arising throughout the entire Priory Health eco system. Operation Analyst must possess strong attention to detail along with business acumen fueled… more
- Fair Haven Community Health Care (New Haven, CT)
- …clean, and reconcile data across EHR, population health tools, 340B program, and payer/ claims . + Define and implement data quality checks, lineage, and ... choices. As we grow and are able to bring high- quality health care to more areas that need access,...of ability to pay. Job purpose The Senior Data Analyst turns clinical, operational, and financial data into insights… more