- Molina Healthcare (Jacksonville, FL)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Levi, Ray & Shoup, Inc. (Chicago, IL)
- …this opportunity is made for you! The Business Analyst will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy ... File Transfer Filters Careers Added Jul 21, 2025 Business Analyst - Claims Systems (26971) Chicago, IL...+ Ensure technical solutions align with business goals and regulatory requirements. + Collaborate with compliance teams to audit… more
- Zelis (Plano, TX)
- …the personal interests that shape who you are. Position Overview The Sr. Medicaid Regulatory Pricer Analyst will collaborate with the Zelis Regulatory Pricer ... an accurate and timely fashion. What you'll do: + Research and decipher regulatory sources such as legislative rules, state registers, waiver programs and bulletins… more
- Molina Healthcare (Layton, UT)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
- Molina Healthcare (Provo, UT)
- …**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
- Medical Mutual of Ohio (OH)
- …and other business needs. + Performs other duties as assigned. **Sr. Financials Systems Analyst ** **Job Summary:** **Performs a lead role in the preparation of ... required by state, the NAIC, and HHS. + Performs other duties as assigned. ** Lead Financials Systems Analyst ** **Job Summary:** **Performs a lead role… more
- AON (IL)
- Reinsurance Business Analyst Aon are looking to recruit an experienced Reinsurance Business Analyst to join our team in the US. This is a Hybrid position and can ... based anywhere in the US. The DXC SICS Application Analyst is responsible for maintaining and enhancing the DXC...for maintaining and enhancing the DXC SICS (Swiss Insurance Claims System) application to support business processes in reinsurance… more
- Molina Healthcare (Louisville, KY)
- …and other sources of information for quality initiatives, accreditation efforts, and regulatory mandates, and claims data coordination. + Manages small to ... **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and… more
- Medical Mutual of Ohio (OH)
- …collection. + Participates in required training and performs other duties as assigned. ** Lead HEDIS Analyst ** + Schedules, assigns, and monitors projects and ... knowledge of NCQA and CMS measurement requirements and quality rating systems. ** Lead HEDIS Analyst ** **Education and Experience:** + Bachelor's degree in… more
- Elevance Health (Walnut Creek, CA)
- …non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring ... and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize...regulatory standards and requirements. + As such, the analyst will strictly follow department guidelines and tools to… more