- Highmark Health (Columbus, OH)
- …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
- Fifth Third Bank, NA (Cincinnati, OH)
- …related experience. + Prior PC experience to include advanced Excel, Word and Access. Claims Analyst I At Fifth Third, we understand the importance of ... Ohio. GENERAL FUNCTION: Responsible for completing and filing investor/insurer claims within required guidelines in order to recoup 5/3's...of the default cycle. This results in approximately 200 claims being filed on a monthly basis and $30.0… more
- Cognizant (Columbus, OH)
- About the role As a **Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end test ... strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued...test plans and test cases for ETE -Health Care Claims / Membership based applications. . Perform Automation testing… more
- Molina Healthcare (Akron, OH)
- …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... that the contracts are configured correctly in QNXT. The claims are reviewed to ensure that the configured services...to detect any gaps in the correct payment of claims Make recommendations for potential revision and updates *… more
- Prime Therapeutics (Columbus, OH)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Medical Mutual of Ohio (OH)
- …fully remote opportunity. Eastern Time Zones preferred.** **Responsibilities** **HEDIS Analyst II** + Coordinates and collaborates interdepartmentally to produce the ... initiatives to improve member health. + Orients and trains more junior-level Analyst + Participates in required trainings and performs other duties as assigned.… more
- 7-Eleven (Enon, OH)
- …Compensation Analyst Apply Now (https://my7elevenhr.wd12.myworkdayjobs.com/Careers/job/SSC-Enon-OH/Workers-Compensation- Analyst \_R25\_0000008015-1/apply) Save ... 45323, United States Location Enon, Ohio Summary: The Workers' Compensation Analyst is responsible for overseeing the administration of designated Third-Party… more
- Molina Healthcare (Dayton, OH)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Prime Therapeutics (Columbus, OH)
- …passion and drives every decision we make. **Job Posting Title** Recovery & Resolution Analyst - Remote **Job Description** The Recovery & Resolution Analyst is ... coordination with an external collection agency + Evaluate audits, investigations and/or claims identified for potential recoupment to verify that results are final… more
- Baylor Scott & White Health (Columbus, OH)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more