- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Clinical Auditor/ Analyst Intermediate! The Clinical Auditor/ Analyst Intermediate is an integral part of the ... and revises better best practice within the department. The Clinical Auditor/ Analyst Intermediate creates, maintains and analyzes auditing reports related to their… more
- Highmark Health (Harrisburg, PA)
- …the consistent, accurate, efficient, and appropriate processing of adjustments and/or duplicate claims through an audit sampling review process. 2. Develop ... **Company :** Highmark Inc. **Job Description :** GENERAL OVERVIEW: The Quality analyst is responsible for compiling and analyzing data relevant to the handling of… more
- AmeriHealth Caritas (Philadelphia, PA)
- …services. Discover more about us at www.amerihealthcaritas.com . **Responsibilities:** Audit and analyze all Facets configuration changes completed by the ... Review all associated documentation for completeness. Communicate with the configuration analyst , configuration team lead, tester, and requestor as required to… more
- Evolent (Harrisburg, PA)
- …contribute to Evolent's broader mission. **Collaboration Opportunities:** The Senior Analyst , Performance Suite Analytics utilizes and develops analytic tools to ... in the Performance Suite where Evolent does not pay claims . + Support the design of data transfer protocols...cross-functionally to identify the root cause. + Apply post-pay audit and payment integrity methods and techniques to ensure… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …them to achieve their goals. Our talented team delivers actuarial, audit , corporate communications, financial and investment, human capital services, information ... must show a commitment to ongoing professional development as a Business Analyst within the insurance industry. This role requires close collaboration with business… more
- WTW (Philadelphia, PA)
- …**The Role** We are seeking an organized and detail-oriented Retirement Plan Compliance Analyst to join our team. As a compliance analyst you will ... with ERISA regulations and other applicable federal laws. Adhere to audit protocol to ensure accuracy of documentation. **Document Production/Management:** Adhere to… more
- Highmark Health (Harrisburg, PA)
- …and training materials specific to underwriting functions, ensuring clarity for audit and compliance. + Collaborate closely with underwriters to analyze existing ... 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or...role or experience in a related operational area (eg claims , billing, customer service, etc.) **Preferred** + Experience in… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …them to achieve their goals. Our talented team delivers actuarial, audit , corporate communications, financial and investment, human capital services, information ... maintenance, large account pricing, and product development. The Actuarial Analyst needs to be able to work with internal...Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii,… more
- UPMC (Pittsburgh, PA)
- …with third-party vendors engaged in specialty-specific support (eg, documentation consultants, audit firms), helping to align their efforts with clinical and ... and basic revenue cycle principles (documentation, coding, billing, authorizations, and claims processes) + Strong problem-solving and analytical skills, work across… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …them to achieve their goals. Our talented team delivers actuarial, audit , corporate communications, financial and investment, human capital services, information ... the Philadelphia Insurance Companies, Tokio Marine America, Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance Company of Hawaii, Ltd.) is an… more