- Healthfirst (FL)
- …in 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 ... Assist in the setup of code sets and defining pre-authorization guidelines used in claims configuration to drive application of medical policy and accurate … more
- Healthfirst (NC)
- …products, claims editing, reference data and their enhancements including claims configuration improvements, compliance and systems enhancements. + Follow ... the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier management. + Interpret… more
- Centene Corporation (Jefferson City, MO)
- …for assigned function and implement process improvements. + This role will focus on claims configuration for the state of Georgia Behavioral Health. Amisys ... claims configuration , pricing, fee schedule set up, benefit creation, authorization qualifier set up. + Lead the support of business initiatives through data… more
- Centene Corporation (Jefferson City, MO)
- …healthcare (ie documenting business process, gathering requirements) or claims payment/analysis experience. Advanced knowledge of Microsoft Applications, including ... Excel and Access preferred. Experience in benefits, pricing, contracting or claims and knowledge of provider reimbursement methodologies. Knowledge of managed care… more
- LA Care Health Plan (Los Angeles, CA)
- Quality Configuration Assurance Analyst III Job Category: Information Technology Department: IT Enterprise Data Management Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Quality Configuration Assurance Analyst III is responsible for...Required: At least 5 years of experience in Systems Configuration ; Claims and Health Services/Population Health department.… more
- UIC Government Services and the Bowhead Family of Companies (Dahlgren, VA)
- **Overview** Senior Configuration Management (CM) Analyst (ECM-2024-21289) Bowhead is seeking to network with multiple highly experienced and qualified Senior ... Configuration Management (CM) Analysts for an upcoming proposal effort....characteristics EOE/AA/M/F/D/V. In furtherance, pursuant to The Alaska Native Claims Settlement Act 43 USC Sec. 1601 et seq.,… more
- 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 ... small to large Operations Management + Collaborate system and data configuration into CES ( Claims Editing System) with BPaaS vendor and other PI partners,… more
- UIC Government Services and the Bowhead Family of Companies (Patuxent River, MD)
- **Overview** Bowhead seeks a Configuration Management Analyst to support future efforts on PMA 268 at Patuxent River, MD. Incumbents are encouraged to apply. ... and interprets data relating to aircraft and product programs. * Maintains configuration control of acquisition products and data. * Tracks configuration … more
- Molina Healthcare (Omaha, NE)
- …expected completion dates with Health Plans. + Must have experience with Benefits configuration , claims + The team is responsible for implementation and ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more
- Kelsey-Seybold Clinic (TX)
- …benefit issue resolution and Epic upgrade build/testing **Job Title: Tapestry Configuration Analyst -MC** **Location: Remote** **Department:** **Health Plans ... Required: Minimum 3 years' experience with healthcare applications, system design, configuration or support. Demonstrated knowledge of claims processing, vendor… more