of subordinate personnel engaged in the processing of healthcare medical claims and/or the collection of patient accounts including... medical claims or healthcare service reimbursements from Medicare, Medi-Cal (Medicaid), insurance, third-party payors...
Approve invoice and deduction claims above TPM analyst limits and deviation. Inform Sales and Marketing Accounting... with analytical support with relations to trade programs or data from the trade system. Oversees the reconciliation, creation...
EDUCATION & EXPERIENCE: High school diploma or equivalent Minimum 1 year as a Setup Analyst Data Entry experience PAY.... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Must maintain ½ production quota Organize and distribute claims...
data maintenance within HPS systems, including provider demographic data and fee schedule analysis for Health Plan Services... (HPS) along with HPS Business Analyst. Investigates fee schedules and reimbursement methodologies and participates...
. As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health... with compliance analyst audit research. Attend billing and PM system workshops as required. Attend staff meetings and organization...
responsibility for the Master Scheduler, Material Analyst, Customer Service Analyst and Warehouse Supervisor. Responsible.... Issue, monitor, change and distribute weekly production schedules. Work with Material Analyst to file customer/supplier...
. Communicates with provider, claims and provider relations personnel and Business Analyst to resolve pending claims. Determines... whether claims received are contracted or non-contracted based on medical services rendered and billed, contractual...
with one or a combination of the following new business, claims, and underwriting systems: Limelight Health, FINEOS AdminSuite, iPipeline... or Business Architect, Business Analyst, Developer, Program Lead, Technical Lead, Scrum Master, or Project Manager. Requires...
with Eligibility, Medical Claims, Pharmacy Claims and Lab Results. Experience with the Data Warehouse and Structured Query Language..., a Philadelphia based Healthcare Insurance organization, is seeking an experienced SQL Data Analyst to join their team...
guidance to other data analysts. The position is part of the Enterprise HEDIS Analyst Team. It will be responsible... performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations...
seeks a Financial Analyst III-Medicaid Billing Specialist to be responsible for managing and processing Medicaid claims...Job Description Financial Analyst III-Medicaid Billing Specialist The Utah Department of Health and Human Services...
, working capital improvements, preparing liquidation analyses, loan negotiations/modifications, and oversight of claims... Financial Analyst (CFA); Certified Fraud Examiner (CFE), and/or Certified Turnaround Professional (CTP) is a plus. Highly...
pharmaceutical or healthcare industry. Experience with IQVIA data sources (e.g. HCOS data), Rx claims data, PBM rebate data... serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives...
, working capital improvements, preparing liquidation analyses, loan negotiations/modifications, and oversight of claims... Financial Analyst (CFA); Certified Fraud Examiner (CFE), and/or Certified Turnaround Professional (CTP) is a plus. Highly...
or healthcare industry. Experience with IQVIA data sources (e.g. HCOS data), Rx claims data, PBM rebate data. Knowledge of 340B... serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives...
documentation and the data within the electronic business record, using coding clinics, coding guidelines, and established medical..., analyze, evaluate and compose a comprehensive rebuttal via the appeal process in a timely manner to the DRG denial claims...
administrative data is primarily made up of 1) medical claims submitted by health providers and Coordinated Care Organizations (CCOs... and claims data that is accessed by two main sets of users: s Office of Actuarial and Financial Analysis (OAFA) team users, who...
. Contacts insurance companies and/or medical review departments by phone, Internet, fax (face sheets), electronic interface... with Analyst and vendors to resolve issues. Re-verifies eligibility and ensure authorization of days extended for large dollar...
authorization. Contacts insurance companies and/or medical review departments by phone, Internet, fax (face sheets), electronic... with Analyst and vendors to resolve issues. Re-verifies eligibility and ensure authorization of days extended for large dollar...
. guidelines. Schedule of independent medical exams as directed by manager/analyst. Prepare file for review and submit file..., to include medical documentation for PA claims, maintain clear, accurate and factual documentation of claims activities...