- Molina Healthcare (Omaha, NE)
- …and conversion of new and existing health plans. + Must have experience in Contracts configuration in QNXT or Networx + Experience in DOFR (division of ... and other business requirements. **KNOWLEDGE/SKILLS/ABILITIES** + Loads and maintain contract , benefit or reference table information into the claim payment… more
- Molina Healthcare (Racine, WI)
- …and other business requirements. **KNOWLEDGE/SKILLS/ABILITIES** + Loads and maintain contract , benefit or reference table information into the claim payment ... scripts + Pre and post validation of fee schedule, contract , and complex retro reports. + Manages all MRDT...submission mailbox, submit RFCs in iServe, and notify the Analyst of completion. + Researches and reviews MRDT issues… more
- Molina Healthcare (Orem, UT)
- …and design standards. *Conducts peer review of other analysts (internal and contract staff) to ensure standards and quality. *Recommends, schedules and performs ... implementing application changes. **Preferred Education** Master's Degree **Preferred Experience** QNXT knowledge. SharePoint, MS Project experience. To all current… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr . Analyst plays a critical role in ensuring accurate, compliant, and ... of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr . Analyst serves as a subject matter expert on Medicaid… more