., Telemetry, Medical/Surgical, OB or L&D, Geriatrics and Orthopedics Knowledge of worker's compensation claims process...Description : The Payment Integrity Analyst is responsible for accurately reviewing pre and post pay claim audits...
benchmark. Reporting to the Senior Manager of Data Analytics, the Analyst will support the development of methodologies... payer-reported data on health care costs and utilization, claims data, discharge data, and survey data; Developing...
or a related major preferred. A minimum of 3 years of experience as an analyst (data, financial business or related... the National Research Corporationâs Consumer Choice Award 19 years in a row for providing the highest-quality medical...
include the following, but are not limited to: Analyze claims and remittance data and present findings to departmental...Position Summary At Stony Brook Medicine the Revenue Cycle Analyst will provide operational support and analytical...
include the following, but are not limited to: Analyze claims and remittance data and present findings to departmental...Position Summary At Stony Brook Medicine the Revenue Cycle Analyst will provide operational support and analytical...
include the following, but are not limited to: Analyze claims and remittance data and present findings to departmental...Position Summary At Stony Brook Medicine the Revenue Cycle Analyst will provide operational support and analytical...
supporting inbound/outbound claims/encounters/enrollment data using a variety of data sources in a dynamic and fast paced... where necessary. Knowledge of Health Care (Medicare/Medicaid, Members, Providers, Claims, etc.) - 5+ years of experience...
Responsibilities Perform daily audits on client data for completeness and accuracy of coding utilizing both coding... training to Become familiar with claims payment policy and processing – specifically CMS, Medicaid regulations, AAOS, ICD-10...
. Recommend solutions based on data analysis to increase quality and/or improve existing processes. Conduct User Acceptance... of Healthcare Claims/Enrollment and Horizon operating model. May require knowledge of ETL/SQL. Strong Computer Skills-Microsoft...
supporting inbound/outbound claims/encounters/enrollment data using a variety of data sources in a dynamic and fast paced... where necessary. Knowledge of Health Care (Medicare/Medicaid, Members, Providers, Claims, etc.) - 5+ years of experience...
years of experience in medical/pharmacy claims processing or benefit coordination within a managed care environment...Job Description: Assembles, extrapolates, and analyzes pharmaceutical usage data in order to calculate rebates...
, tracking and data quality for a variety of programs and will be a key partner in identifying risks, communicating updates..., coordinates claims, file handling and oversight and recovery with other departments as needed. Assists in managing...
department with time sensitive daily executables needed to deliver products to customers, the claims specialist must drive claims... to completion in a timely way, to ensure minimal impact to operations and inventory management. The Logistics Claims Supervisor...
, the Case Manager performs clinical review of medical specialty pharmacy services, coordinates transition of care, product... rate negotiations, and accurately calculates medical cost savings. Case Managers performs case management evaluation...
and financial data, coordinate and develop financial reviews, prepare performance metrics and trend reports, and analyze allocation... with auditors to answer questions. Analyzes financial data to determine allowability and out-of-period costs based on government...
, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. Perform data analytics... to identify fraud, waste or abuse in claims data Responsible for investigating, researching and analyzing software data in order...
initiatives. Conducts analysis of claims and payment data across health plans in support of ensuring payment integrity and cost...'s contracted rates. Reconciles and validates underlying analytic data claims, and utilization management systems. Tests the...
Overview Support the Pharmacy Division with the data analytics needed to provide KPS clients with proactive... consultation on their Pharmacy Benefit program. Review pharmacy data and provide recommendations for improving plan performance...
., product re-design, state filings, claims platform enhancement, SOP/Job-Aid review, etc. Develop and maintain adviser... and Absence products and regulatory environment. Knowledge of Group Insurance Disability and Absence claims processes...
investigations, or health insurance environment 2+ years of experience working in a position processing pharmacy or medical claims..., data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented...