- State of Indiana (Indianapolis, IN)
- Medicare Claims Analyst Date Posted: Jun 6, 2024 Requisition ID: 443202 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with ... an energized staff that is fully engaged with this mission. Role Overview: The Medicare Claims Analyst will serve as the primary subject matter expert for… more
- CareOregon (Portland, OR)
- …hired for remote positions must reside in Oregon or Washington. Job Title Medicare Encounter Data Analyst Exemption Status Exempt Department Finance Manager ... candidates residing in Oregon or Washington. Job Summary The Medicare Encounter Data Analyst leads the process...Medicare programs + Knowledge of medical and/or pharmacy claims + Knowledge of CPT, HCPCS, ICD10 coding; revenue… more
- Corewell Health (Grand Rapids, MI)
- …of the member appeal and fair hearing review processes for all Medicare products to thoroughly investigate appeal requests, leveraging critical thinking skills, ... Serves as a mentor/trainer to other team members. The Senior Appeals Analyst makes decisions on moderately complex issues regarding technical approach for project… more
- The Cigna Group (Tucson, AZ)
- Pima County based - Medicare Provider Performance Enablement (PPE) Senior Analyst provides broad support to Sr. Supervisor, Sr. Manager, Director, and Other ... interaction with PPE staff as well as other Cigna Medicare departments. Position is exposed to all aspects of...market financial review with senior management. + Trouble shoot claims issues for providers + Investigate member grievances within… more
- CVS Health (Phoenix, AZ)
- …health care more personal, convenient and affordable. Position Summary As a Claims Analyst , you are responsible for analyzing submitted documentation, making ... outbound calls to obtain required information, and processing Medicare Part D claims per CMS regulations....based and time sensitive environment. Additional characteristics of the Claims Analyst include: - Being able to… more
- Houston Methodist (Katy, TX)
- Medicare compliance experience is preferred** **Note: Office for this position is located at our Continuing Care Hospital:** **701 S. Fry Rd. Katy, TX 77450** **. ... of compliance recommendations set forth by audits from Center for Medicare /Medicaid Services (CMS), other applicable regulatory agencies, and/or Houston Methodist… more
- Montrose Memorial Hospital (Montrose, CO)
- …PFS team to streamline workflows to maximize clean accounts. About The Career: + The Claims Analyst III must know the essential functions of denied claims ... broad knowledge of hospital billing, collections and payment application for Medicare , Medicaid and Commercial insurances + Ability to effectively communicate,… more
- Waystar (Louisville, KY)
- **ABOUT THIS POSITION** We are looking for a Enterprise Technical Support Analyst who is passionate, curious, and joyfully optimistic. The Enterprise Technical ... Support Analyst serves as a front-line support contact for Waystar's...systems, and is connected to over 5K commercial and Medicaid/ Medicare payers. We are deeply committed to living out… more
- Providence (WA)
- …people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst , Medicare Bid who will:** + Be responsible for developing and ... to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of...on bid pricing outcomes + Analyzing and interpreting healthcare claims data, enrollment data, and other relevant information to… more
- Medical Mutual of Ohio (OH)
- … Supplement, and individual plans.** **Responsibilities** **Provider Reimbursement Analyst II** Under general supervision, supports assigned provider network ... Works on various projects related to the analysis of claims , clinical and financial data, with a focus on...models. . Performs other duties as assigned. **Provider Reimbursement Analyst III** Under general to limited supervision, supports assigned… more
- Medical Mutual of Ohio (OH)
- …coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. **Responsibilities** **Provider Analyst II** ... and performs analytical review of opportunities with provider networks. Performs claims repricing, discount analyses, etc. to support group sales efforts and… more
- The Cigna Group (Nashville, TN)
- **Cigna Medicare Part C Appeals Reviewer: Appeals Processing Analyst ** We will depend on you to communicate some of our most critical information to the correct ... individuals regarding Medicare appeals and related issues, implications and decisions. The...and related issues, implications and decisions. The Case Management Analyst reports to the Supervisor/Manager of Appeals and will… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by ... new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well… more
- Humana (Columbus, OH)
- …and operational decisions. + Forecasts financial performance in Value Based Contracts using claims data, payer reports, Medicare public use files, etc. + Tracks ... (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP). DVACO is… more
- General Dynamics Information Technology (Fairfax, VA)
- …economist + Five years of experience working with healthcare data including pharmacy claims , NDCs, and knowledge of Medicare payment policy preferred. + ... our clients turn data into action as a Statistical Analyst at GDIT. Your work will provide transformative solutions... joining our team to support the Centers for Medicare and Medicaid Services. You will support a diverse… more
- Henry Ford Health System (Troy, MI)
- … Advantage, Medicare -Medicaid Program (MMP), and Medicaid lines of business. Analyst must identify trending issues on an ongoing basis and provide root/cause ... analysis when required. The Analyst will work with HAP's medical directors, nurses, pharmacists,...following established guidelines from: The Center for Medicaid and Medicare Services (CMS), MAXIMUS Federal Services, Department of Labor… more
- The Cigna Group (St. Louis, MO)
- **Product Management Lead Analyst - Centene Operations Management** **_This is a hybrid role and will require the ability to work in person._** The job profile for ... this position is Product Management Lead Analyst , which is a Band 3 Senior Contributor Career...accountabilities associated with all regulated lines of business including Medicare , Medicaid, and Marketplace (Exchange / Health Care Reform).… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Human Resources Analyst B-C or Specialist Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4523978) Apply Human Resources Analyst B-C or ... used by all state agencies. Job Distinctions: Differs from Human Resources Analyst A by the presence of experienced level human resources responsibilities. Differs… more
- LA Care Health Plan (Los Angeles, CA)
- Payment Integrity Analyst III (ALD) Job Category: Claims Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... to achieve that purpose. Job Summary The Payment Integrity Analyst III is responsible for leading or assisting in...team lead on any issues identified during research or claims review. Serves as a subject matter expert and… more
- Johns Hopkins University (Baltimore, MD)
- …across markets, organizations, populations, and technologies. The platform houses Centers for Medicare & Medicaid (CMS) health insurance claims data and is ... Hopkins Business of Health Initiative (HBHI) is seeking a **_Sr. Statistical Programmer Analyst and Data Manager_** to support health policy and economic research on… more