- Elevance Health (Indianapolis, IN)
- ** Medical Claims Data Integrity Consultant** **Location:** Atlanta, GA; Norfolk, VA; Indianapolis, IN; Chicago, IL; Louisville, KY (preferred). This role ... position is not eligible for current or future visa sponsorship._ The ** Medical Claims Data Integrity Consultant** (Business Information Developer… more
- Elevance Health (Indianapolis, IN)
- …fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment. Researches new healthcare-related ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days… more
- Centene Corporation (Indianapolis, IN)
- …training, assigning work and managing performance preferred. Knowledge of Microsoft Excel, medical coding, claims processing, and data mining preferred. ... with all Federal and State Laws and Regulations related to program integrity and disclosure requirements. Develop, implement and manage strategic fraud, waste and… more
- Elevance Health (Indianapolis, IN)
- …background. **Preferred Skills, Capabilities, and Experiences:** + Healthcare experience preferred; medical claims experience a plus. + Extensive hands-on ... **Application Architect Senior - Payment Integrity ** The **Application Architect Senior** creates architectural solutions that articulate the business context,… more
- Humana (Indianapolis, IN)
- …and reporting. Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data . Maintain dashboards to communicate key ... trends to stakeholders. The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of… more
- Otsuka America Pharmaceutical Inc. (Indianapolis, IN)
- …Commercial third-party data assets, including Xponent Plantrak, DDD, HCOS, Claims Data , Specialty pharma, omnichannel data , SalesForce/Veeva ... **Job Summary** The Associate Director (AD), Commercial Data Management (CDM) within Data Enablement (DE) for Business Analysis (BA) is accountable for… more
- Elevance Health (Indianapolis, IN)
- …scaling, and maintaining platforms for: + Medical Cost Management ( claims review, payment integrity , utilization management, risk adjustment). + Cost ... or healthcare technology company. + Experience in AI/ML, advanced analytics, and data platforms specific to medical cost optimization. + Strong knowledge… more
- USAA (Indianapolis, IN)
- …families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity , loyalty and service - define how we treat each other and our members. ... responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate… more
- Elevance Health (Indianapolis, IN)
- … medical guidance across multiple enterprise transformation initiatives, including: + ** Medical Cost Management** + **HealthOS and enterprise data platforms** ... payer, managed care, or healthcare leadership preferred. + Experience advising medical cost management, utilization management, payment integrity , or provider… more
- Elevance Health (Indianapolis, IN)
- …management input and dollar volume of provider. + Analyzes data to select claims to be reviewed, conducts reviews using medical charts, medical notes, ... within 50 miles of one of our Elevance Health PulsePoint locations._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon… more