- CVS Health (Dover, DE)
- …including Excel and Microsoft Word **Preferred Qualifications** -2-4 years experience as a medical assistant, office assistant or claim processor -ATV, HRP, or ... day. **Position Summary** -Responsible for initial review and triage of claims tasked for review. -Determines coverage, verifies eligibility, identifies and… more
- CVS Health (Dover, DE)
- …(underwriting, sales, product development, network management). + Experience working with medical and pharmacy claims . **Education** + High school diploma ... Experience with key managed care functions including provider contracting, benefit design, medical management as well as knowledge of business functions and impact… more
- Highmark Health (Dover, DE)
- … terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... claims up to pre-determined dollar threshold. Completes pended claim letters for incomplete, invalid, or missing claim...years of prior experience processing 1st dollar health insurance claims + 3 years of experience with medical… more
- Cognizant (Dover, DE)
- …IT organization and lead changes to such specifications (with senior business analyst oversight through peer reviews); Develop an informed knowledge of the business ... + 3+years Medicare/Medicaid regulatory healthcare experience + Knowledge of claim adjudication processes and Facets platform experience preferred + Experience… more
- Cognizant (Dover, DE)
- …we're improving everyday life. **Job Title** **: Provider/Benefit Configuration Analyst ** **Location** **:** **Remote** **Job ID** **: SO# 00064116431** **Role ... code editing in the Facets environments. . Test inpatient claims with the Optum grouper to ensure accuracy and...in Facets. . Maintain a thorough understanding of standard claim payment rules for Commercial, Medicare, Medicaid, and ACA… more
- Robert Half Technology (Selbyville, DE)
- …Documents to clearly communicate project needs and expectations. * Knowledge of Claim Administration for handling insurance claims and related tasks. Technology ... Description We are offering an exciting opportunity for a Business Analyst within the IT industry, based in SELBYVILLE, Delaware. As a Business Analyst , you will… more
- Evolent (Dover, DE)
- …contribute to Evolent's broader mission. **Collaboration Opportunities:** The Senior Analyst , Performance Suite Analytics utilizes and develops analytic tools to ... impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Business Development efforts. Working in… more
- Evolent (Dover, DE)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a unique ... of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams (EAS, Specialty… more
- Evolent (Dover, DE)
- …Stay for the culture. **What You'll Be Doing:** Job Description Senior Analyst , Performance Analytics - **RBM Cardiac** product focus, utilizes and develops analytic ... impact on the organization and patient health. This role supports both Medical Cost Management activities as well as Product Development efforts. **What You'll… more
- Elevance Health (Wilmington, DE)
- **Business Information Analyst Senior -** **Tableau** **Location:** This role requires associates to be in-office 1 day per week, fostering collaboration and ... Wallingford, CT, Grand Prairie, TX or Louisville, KY. The **Business Information Analyst Senior - Tableau** is responsible for analyzing, reporting and developing… more