- CVS Health (Augusta, ME)
- …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 (Augusta, ME)
- …(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 (Augusta, ME)
- … 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 (Augusta, ME)
- …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 (Augusta, ME)
- …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
- Central Maine Medical Center (Lewiston, ME)
- …and for each other every day. Central Maine Healthcare is seeking a Payment Analyst to join our Team. This is a full time 40-hour, benefits eligible position. ... rate of pay is $20.00 per hour. The Payment Analyst 's primary responsibility is to research and process payments,...years relevant experience, including knowledge of insurance billing and medical terminology What It's Like Working At CMH: We… more
- Evolent (Augusta, ME)
- …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 (Augusta, ME)
- …science, or engineering) - Preferred + Professional experience in healthcare analytics (eg medical and pharmacy claims data, membership data, or other healthcare ... Stay for the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a Senior Analyst… more
- Evolent (Augusta, ME)
- …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
- Humana (Augusta, ME)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more