- Molina Healthcare (OH)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops custom ... + Develops custom health plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and collaborates with the national… more
- Walmart (Bentonville, AR)
- …and create trust across our online and marketplace businesses. The Sr. Analyst position is responsible for reviewing internal and external item reports, conducting ... of Intellectual Property and Rights Ownership and managing related concerns and/or claims . Brand Portal familiarity is a plus. + Experience with content… more
- Wabtec Corporation (Pittsburgh, PA)
- Job Description Job Description: Risk Management Insurance Senior AnalystHow will you make a difference? As a member of the Risk Management group, you will be ... the company's insurance and risk management programs through detailed analysis, claims coordination, and policy administration. You'll work closely with internal… more
- Molina Healthcare (Racine, WI)
- **JOB DESCRIPTION** **Job Summary** Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements ... Evaluate root cause for the disputes and recommend improvements to reduce claim errors and prevent improper payments. + Provide actionable insights and… more
- CVS Health (Hartford, CT)
- …to respond, manage, and resolve escalated and complex global issues for Claims /Calls, PSS, and health plan back-office operations. The PSL role has responsibility ... to respond, manage, and resolve escalated and complex global issues for Claims /Calls, PSS, and health plan back-office operations. The Plan Sponsor Liaisons serve… more
- Raymond James Financial, Inc. (St. Petersburg, FL)
- …areas, its products, and general functions. + Assists with the monitoring of claims . + Supports colleagues with gathering the data collection and analysis associated ... Standard Office skills. . Fundamental concepts of insurance policy renewals and claims handling. + Insurance industry and terminology. . Fundamental concepts of… more
- CVS Health (PA)
- …regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education need. **Required Qualifications** ... are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or… more
- CVS Health (TX)
- …issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs. * Optimizes ... are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or… more
- CVS Health (CO)
- …and security requirements. **Required Qualifications** + 1 year minimum of claims processing experience + Experience with system testing and post go-live ... validation + QNXT Experience + Familiarity with clinical and code editing concepts and products (Example: ClaimsXten, Cotiviti PPM & CV) + Extensive knowledge of CPT, HCPCS, ICD-10 coding **Preferred Qualifications** + Prior Relevant Work Experience 3-5 years… more
- AIG (Parsippany, NJ)
- …network. Customers value AIG's strong capital position, extensive risk management and claims experience and its ability to be a market leader in critical ... lines of the insurance business. Corporate Finance - Investment Accounting The Investment Accounting group at AIG is responsible for the accounting and reporting for AIG's Invested Assets of over $95 billion a comprised primarily of fixed maturity securities… more