CLAIMS ADJUSTMENT ANALYST jobs in UNITED STATES, United Kingdom #3

Typically 2-5 years healthcare industry experience Preferred Knowledge of Risk Adjustment and HEDIS Preferred. Experience in... troubleshooting data files and technical systems. Understanding of claims data, provider data, and supplemental data. #LI-REMOTE...

Typically 2-5 years healthcare industry experience Preferred Knowledge of Risk Adjustment and HEDIS Preferred. Experience in... troubleshooting data files and technical systems. Understanding of claims data, provider data, and supplemental data. #LI-REMOTE...

Typically 2-5 years healthcare industry experience Preferred Knowledge of Risk Adjustment and HEDIS Preferred. Experience in... troubleshooting data files and technical systems. Understanding of claims data, provider data, and supplemental data. #LI-REMOTE...

documents for new products. ➢Develop loss adjustment procedures, forms, and related documents for new products. ➢Revise policy..., procedures, forms, loss adjustment procedures and related documents as necessary for existing products. ➢Prepares filing...

, data, systems, reimbursement methodology, case-mix adjustment, and applications for claims payment, providers...

1a environment to promote work productivity. Position Qualifications: Minimum of 5 years’ experience in claims... processing. Proven leadership skills. Knowledge of AmeriHealth Administrators claim-is payment/adjustment system...

, data, systems, reimbursement methodology, case-mix adjustment, and applications for claims payment, providers...

. Required Qualifications: 2+ years of data analysis experience 2+ years of writing SQL and/or PL/SQL 1+ years of CMS risk adjustment model.../version experience or ACA or Medicaid model risk adjustment or quality performance measurement experience performing a wide...

for healthcare organizations. Participate in analyst meetings, industry speaking engagements, publish white papers/viewpoints in...: Operational Excellence - Member eligibility and enrollment, provider data management and networks, claims and encounter processing...

Solutions team, responsible as the U.S. Home Office lead analyst supporting the U.S. commercial business units by delivering..., or external analyst reports Be a key point of contact within the commercial organization to help assist people in understanding...

, Administrative, Product, Claims and trend analytics. This position is the team lead for all market financial reporting, budget... Analyst Staff directly providing support for all key functions and deliverables. Leads 2-3 direct Analytical Staff Works...

managing of the completion, adjustment, and verification of HMO, PPO, POS and other networks, maintenance of the PREMIER system... and claims. In addition, responsible for the supervision of staff in the handling of provider inquiries concerning the...

Plan is calling a Senior Actuarial Analyst, Medicare Bid who will: Be responsible for developing and maintaining actuarial... Advantage plans Have a deep understanding of Medicare Advantage regulations, risk adjustment methodologies...

of MAPFRE's IT systems and general knowledge of policy admin/claims adjustment processes · Extensive experience carrying out... Actuarial Society) principles. Additionally, the Manager, Actuarial must monitor the Actuarial Analyst and Actuary positions...

of insurance operations, accounting, and regulation General knowledge of policy admin/claims adjustment processes Extensive...) principles. Additionally, the Manager, must monitor the Actuarial Analyst and Actuary positions activities to ensure the timely...

report review, validation and posting Monitors vendor ledgers Works with Financial Analyst, Program Manager/Admins... of WBS (Work Breakdown Structure) Experience in preparation of rate adjustment invoices Experience with government contract...

refund, redistribution of funds or adjustment. Analyze, research and answer refund questions. Ensure correct reimbursement... qualifying letters to Payer Audit Analyst for review. Identify insurance refund requests that are for Government payers...