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The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations listed here: Norfolk, VA; Atlanta, GA; Cincinnati, OH; Richmond, VA.The Manager Rating/Claims Analysts will be responsible for managing the day to day workload/workflow for team members.
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The Patient Safety Services/Risk Management Analyst is responsible for the assessment investigation and evaluation of the incident reporting system used to identify potential professional liability claims as well as interfacing with physicians hospital employees and legal counsel in defense of such claims.
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The Senior Medical Policy Analyst will work closely with organizational teams to ensure medical policy and operating procedures are accurately operationalized for optimal claims adjudication and utilization management.
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Act as product advocator, participate in press activities, conferences and discussion session with thought leaders and market analyst. From mortgage approvals, medical results, and insurance claims, to accounts receivables, invoices and inbound packages.
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End to End Claims processing Knowledge. May have started as an Analyst and moved into management. QNXT Benefit Configuration background and management exp specific to QNXT Benefit Configuration-(Front End.
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As a Product Analyst, Claims Analytics , you will join our growing product team focused on the development of new features and products within the claims analytics product suite. Product Analyst, Claims Analytics.
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Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.
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The Financial Fraud Risk Analyst role is to monitor and review all payments transaction activity to detect and minimize fraudulent payment activity across multiple electronic channels including online banking, ACH, wires, ATM/Debit cards and check.
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The Applications Analyst Sr - Epic Billing provides support, analysis, configuration, development, testing and implementation services for Resolute Hospital Billing. This will also include other related applications: Resolute Professional Billing, Claims.
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Under the direction of the Supervisor, Business Analytics this position is responsible for performing analytical and data support for complex Finance Operations systems and processes including claims disbursements, provider negative balance, accounts payable and commissions.
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The analyst must work with the team to support various lines of payer business, Medicare, MediCal, Commercial, and Accountable Care Organization (ACO) as well as various provider specialty and groups.
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Subject matter expertise in healthcare claims data preferred, and even better with experience in HEDIS, quality reporting, clinical (EMR/EHR; Epic) or enrollment/membership data; experience with Medicare and Medicaid data is a plus.
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Watts Healthcare Corporation is deemed by the Bureau of Primary Health Care of the U.S. Department of Health and Human Services to be a federal employee for purposes of medical malpractice claims and, as such, qualified for protection under the Federal Tort Claims Act.
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Experience with Policy/Claims Administration systems such as Cogitate, Instanda, Insuresoft, Majesco, DuckCreek, Guidewire, Insurity, or similar. Commercial Insurance Systems Analysis: Collaborate with key stakeholders to analyze existing manual and automated aspects of commercial insurance systems, including policy administration, claims management, and related processes.
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SME Knowledge of more than one payor domains such as Membership, Claims, Benefits, Pricing, Vendor Delegation etc. guidance from the Business Analyst Level 3 and above, and relationship managers.
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