- Commonwealth Care Alliance (Boston, MA)
- …of the Sr . Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr . Analyst will be responsible for developing ... prospective claims auditing and clinical coding and reimbursement edits and necessary coding ...**Essential Duties & Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement… more
- Healthfirst (NY)
- …AMB Surgery, DME, vaccination Ambulance fee schedules + Prior experience with multiple claims scrubbers to ensure coding guidelines are followed + Prior ... codes (ICD-10) represent patient services, treatments, copays, and coinsurance + Verify coding accuracy to support compliant billing and prevent claim denials and… more
- AdventHealth (Maitland, FL)
- …days at the office (Altamonte Springs, FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating ... care contracts and proposals, analyze fee schedules, and determine contract compliance. The Senior Medical Economics analyst must have attention to detail and… more
- Philadelphia Insurance Companies (Bala Cynwyd, PA)
- …member of Ward's Top 50 and rated A++ by AM Best. We are looking for a Sr . Reporting Analyst I to join our team! Summary: Ensure accuracy and timeliness of ... all aspects of Verisk's Statistical Web Services applications. Well versed in ISO coding requirements and Strong understanding of ISO rating in multiple lines of… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Clinical Center of Excellence, Health Plan, ... tools to monitor trend drivers and provide recommendations to senior leaders on UM and CM improvements. Responsible for...and manage information from large data sources + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... creating tools to monitor trend drivers and provide recommendations to senior leaders for affordability opportunities. Responsible for conducting complex analyses of… more
- AIG (Parsippany, NJ)
- …we are reimagining the way we help customers to manage risk. Join us as a Senior Loss Sensitive Analyst to play your part in that transformation. It's an ... limited to completing security calculations, premium reconciliations, program adjustments, prep- coding , and other projects. + Compile and organize relevant coverage… more
- University of Texas Rio Grande Valley (Mcallen, TX)
- Position Information Posting NumberSRGV8219 Working TitleCOMPLIANCE CODING AND BILLING ANALYST Number of Vacancies1 LocationMcAllen, Texas DepartmentOffice of ... , and reimbursement processes. + Reviews, assesses and analyzes medical records, coding , billing, claims , reimbursements and workflow processes to ensure… more
- Mount Sinai Health System (New York, NY)
- …Facility and Ancillary Contracts across the Mount Sinai Health System. MSHP seeks a ** Senior Contract Manager Analyst ** will play a critical role in testing, ... within MSHP team + Opportunity to work directly with senior leaders from across the Mount Sinai Health System...the revenue cycle system. A strong background in contract coding , logic, and the ability to interpret contract terms… more
- AdventHealth (Maitland, FL)
- …- Hybrid - Altamonte Springs, FL** **The role you'll contribute:** The Senior Compliance Analyst applies technical, analytical, and problem-solving skills to ... sources of data to support executive decision-making regarding contract violations. The Senior Compliance Analyst will have expertise in Commercial and… more