- Highmark Health (Augusta, ME)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for… more
- Highmark Health (Augusta, ME)
- …SUMMARY** This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a ... product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements.… more
- Rocket Software (Augusta, ME)
- …people truly BELIEVE in what they're doing!** **Job Description Summary:** The Senior Benefit Analyst is responsible for building and delivering both global and ... country programs in line with the global total rewards philosophy. The Senior Benefits Analyst supports the design, administration, and analysis of Americas' and… more
- Public Consulting Group (Augusta, ME)
- …To learn more, visit www.publicconsultinggroup.com . The Contract Support and RCM Analyst will support both the contractual administrative tasks and the entire claim ... through claim issue research. Additional this position will assist in performing claims processing, medical record audits for all implemented agencies, and assist… more
- Otsuka America Pharmaceutical Inc. (Augusta, ME)
- …benefits . Come discover more about Otsuka and our benefit offerings; https://www.otsuka-us.com/careers-join-otsuka . **Disclaimer:** This job description is ... can too._ In this exciting role, as a Sr. Analyst within OAPI supply chain team, you will work...posted for a minimum of 5 business days. **Company benefits :** Comprehensive medical, dental, vision, prescription drug coverage, company… more
- Point32Health (ME)
- …direction of the Member Appeals and Grievance Supervisor the Appeals and Grievance Analyst is responsible per State and Federal regulations for the professional and ... authorized representative and must demonstrate superior customer service and benefit interpretation skills in all interactions. This individual prepares cases… more
- Cognizant (Augusta, ME)
- **Job Summary:** We are seeking a strong Duck Creek Functional Analyst / Business Analyst to work closely with customer Product Owners. The ideal candidate will ... teams to handle queries and understand requirements. . Experience with Billing and Claims configuration knowledge and Data Insight producer policy holder is an added… more
- Humana (Augusta, ME)
- …and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the Pricer Business and System Support team ... it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible for maintenance and support of… more
- Martin's Point Health Care (Portland, ME)
- …pharmacy benefit design, formulary management, and value-based initiatives. The analyst partners closely with pharmacy, actuarial, clinical, and finance teams to ... "Great Place to Work" since 2015. Position Summary The Senior Medical Economics Analyst - Pharmacy is responsible for performing advanced analytical work to evaluate… more
- Elevance Health (South Portland, ME)
- **Actuarial Analyst II** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing ... unless an accommodation is granted as required by law. The **Actuarial Analyst II** completes projects and performs complex actuarial studies. **How You Will… more