- 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 (FL)
- …disputes/appeals and provides guidance across all areas of the company with regards to claims editing and proper coding , billing, and payment. + Researches and ... **Duties & Responsibilities** : + Conducts routine assessments of current claims edits and ensures comprehensive and defensible editing across all Healthfirst… more
- Highmark Health (Honolulu, HI)
- …effectively to explain technical benefits, application of medical policy, and claims processing capabilities and functionality. + Work independently or a team ... member, to develop benefits and medical policy coding applications/solutions and perform project activity. Provide required business and/or subject matter expertise… more
- Dayton Children's Hospital (Dayton, OH)
- …efficiency, and maximum financial return of Dayton Children's professional billing claims for reimbursement. Ensures billing compliance; maintains knowledge of CPT ... and ICD-10 coding guidelines, as well as Medicare/Medicaid billing rules and...Medicare/Medicaid billing rules and regulations. Serves as a professional coding resource to providers and staff. The professional fee… more
- Healthfirst (NY)
- …a simple and easy to understand manner to other staff. As the SME, the Claims Configuration Analyst will need to effectively communicate with all levels of the ... + Assist in the on-going evaluation of configuration for new and existing claims business rules including member benefits, claims editing, reference data and… more
- TEKsystems (Tampa, FL)
- Claims Analyst In-Office: Tampa, FL 33609 Pay Rate: $23/hr Anticipated Start Date: 2/17/2025 Contract Position Description + This person will be on the bill ... team specifically working in the backlog of appeals. + The Bill Review Analyst position holds accountability for accurate and timely review, processing and payment… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …the Patient Financial Services Director, the Nurse Auditor/ Revenue Integrity/ CDM Analyst is responsible for performing audits of itemized charges versus the ... record and other applicable hospital documentation, assigning modifiers to appropriate claims , researching edited claims for medical necessity, and advising… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- HUMAN RESOURCES ANALYST A/B/C/SPECIALIST Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4824705) Apply HUMAN RESOURCES ANALYST ... be filled from this recruitment as a Human Resources Analyst A, Human Resources Analyst B, Human...Forms for completion and accuracy. Ensure that all injury claims are reported to Risk Management in a timely… more
- Great River Health (West Burlington, IA)
- …and other corporate departments to facilitate system usage and acceptance. The analyst handles complex build and configuration tasks, resolves advanced issues, and ... ensure reliable application system availability and performance. Additionally, the analyst designs, verifies, documents, and refactors software configurations, investigates… more
- ManpowerGroup (CA)
- …29-Mar-2025** **Target Pay: $50** ** ** **Primary Purpose** The Workers' Compensation Claims Analyst is responsible for analyzing complex or technically ... professional relationships + Ensure proper documentation of claim files and accuracy in claims coding + Refer cases to supervisors or management as appropriate.… more