Jobs
>
Scottsdale

    Medical Claims Data Analyst - Scottsdale, United States - Community Medical Services

    Community Medical Services
    Community Medical Services Scottsdale, United States

    2 weeks ago

    Default job background
    Description

    Overview:

    Schedule: Monday through Friday 5:30a - 1:30p

    Community Medical Services (CMS) is hiring a Claims Data Analyst responsible for reviewing and resolving denied, pended, and corrected claims. Analyzes claim resubmissions to determine areas for provider education or system re-configuration. Serves as the primary point of contact for claim issues raised by Providers and internal departments. Provides feedback on department workflows and identifies opportunities for redesign. Performs claims testing to ensure that systems are designed efficiently based on the Plan's benefit structure. Reflects a full understanding of Community Medical Services business practices, provider networks, reimbursement methodologies, and changes in reimbursement methodologies.

    As you join our mission to help those suffering from substance use disorders reclaim their lives, expect to thrive in a comfortable, welcoming, and fun environment where you are valued for the work you do, championed by passionate leaders, and equipped with the tools and ongoing training you need to achieve your goals.

    Along the way, well invest in your well-being through a benefits package that includes:

    • Subsidized medical, dental, and vision insurance
    • Health savings account
    • Short and long-term disability insurance
    • Life insurance
    • Paid sick, vacation, and holiday time
    • 401K retirement plan with match
    • Tuition and CME reimbursement up to 100%
    • Employee assistance program to support your mental health and wellness
    • Ongoing professional development
    Responsibilities:

    Responsibilities:

    • Monitors and resolves high volume of claims for all lines of business, as well as claims for performance guarantee groups and high dollar claims, to minimize late payment interest penalties and ensure compliance with established guidelines.
    • Identify defects and improve departmental performance by supporting quality, operational efficiency and production goals.
    • Responsible for conducting root cause analysis and working with staff in other business areas to assist with the resolution of complex Provider claim issues.
    • Analyze data issues and work with development teams for problem resolutions.
    • Identify problematic areas and conduct research to determine the best course of action to correct the data, identify, analyze and interpret trends and patterns in complex datasets.
    • Performs other duties as assigned or required.
    • Manages top tier payors claim submissions and AR Reconciliation.
    • Trains and develops Billing staff when applicable.
    Qualifications:
    • Bachelors Degree in Information Management, Healthcare Informatics, Computer Science, Business Administration, or Statistics preferred.
    • Minimum of 3-5 years' experience contributing to the analysis of large medical insurance claims databases required.
    • Extensive knowledge in Claims Systems Processes required.
    • Proficient in MS Excel and SQL Server for testing and validating data required.
    • Proficient in writing Microsoft Structured Query Language (SQL) queries required.
    • Strong analytical and quantitative skills required.
    • Proficient knowledge of contracts, benefits and pricing modules required.
    • Advanced understanding of medical coding systems (CPT/HCPCS, ICD-9 and 10, DRG, etc. required.
    • Extensive knowledge in formalizing testing strategy and detailed auditing principles and techniques required.
    • Ability to manage full cycle analytical/reporting solution from requirements gathering to data modeling and report authoring required.
    • Understanding of relational database concepts - Familiarity with healthcare reimbursement systems and methodologies.

    #CRPSF

  • DriveTime Automotive Group, Inc.

    Data Analyst

    4 days ago

    DriveTime Automotive Group, Inc. Tempe, United States

    **What's Under the Hood** · DriveTime Family of Brands includes in-house financing and servicing through Bridgecrest, which is one of the country's leading financial servicing providers. Bridgecrest services roughly $17 billion in finance receivables for DriveTime and other third ...

  • Arizona State University

    Geospatial Data Analyst

    2 weeks ago

    Arizona State University Tempe, United States

    **Job Family** · - Research Operations · **Department Name** · - Maps,Imagery,Geospatial Srvcs · **Full-Time/Part-Time** · - Full-Time · **VP Code** · - EXEC VP/PROVOST · **Scope of Search** · - Open · **Grant Funded Position** · - This is not a grant funded position and is not c ...

  • Green solutions

    Data Analyst

    5 days ago

    Green solutions Phoenix, United States

    **Position Summary** · - We are seeking a highly motivated and tech-savvy professional to join our team as a Data Science and Analytics Specialist. · - As a key member of our PMO (Project Management Office), you will assist in building project management capabilities, driving dig ...

  • SLP Alliance Trade Services

    Data Analyst

    3 days ago

    SLP Alliance Trade Services Phoenix, United States

    **About Alliance Plumbing**: · Alliance Plumbing is a premier provider of predominately multifamily plumbing, mechanical, and HVAC (Heating, Ventilation, and Air Conditioning) solutions. Backed by a private equity fund, we possess the resources, vision, and strategic guidance nec ...

  • Frequence, Inc.

    Data Analyst

    3 days ago

    Frequence, Inc. Phoenix, United States

    **About Frequence** · Frequence is an ad tech platform for media companies that connects all aspects of digital advertising—sales, operations, and reporting—from beginning to end. Our software makes selling local advertising scalable and provides users with an all-in-one platform ...

  • Design Works Gaming

    Data Analyst

    2 weeks ago

    Design Works Gaming Scottsdale, United States

    Job Title: Data Analyst · Location: Scottsdale, AZ · Job Type: Full Time · No C2C or Third Parties. Must be local to U.S. Sponsorship for employment visa status (e.g. H-1B visa status) is not available. · As a regulated gaming company, you may be required to obtain a gaming lic ...

  • Curaleaf

    Data Analyst

    2 weeks ago

    Curaleaf Scottsdale, United States

    Curaleaf Holdings, Inc. (CSE: CURA) (OTCQX: CURLF) ("Curaleaf") is a leading international provider of consumer products in cannabis with a mission to enhance lives by cultivating, sharing and celebrating the power of the plant. As a high-growth cannabis company known for quality ...

  • Edward Jones

    Data & BI Analyst Ii

    1 week ago

    Edward Jones Tempe, United States

    **Want a meaningful career where you can make a difference? Edward Jones sounds perfect for you.** · Collaboration. Autonomy. Opportunity. Words our headquarters associates use when talking about working at Edward Jones. Words that describe what it's like being part of a firm whe ...

  • Infusion Software Inc

    Data Analyst

    4 days ago

    Infusion Software Inc Chandler, United States

    **About Keap**: Keap is the leading Sales & Marketing Automation platform for serious small businesses. We are a purpose-driven, values-based company that loves helping small businesses grow and understands how hard it is to run a successful small business. Keap's vision is to li ...

  • Avenue5 Residential, LLC

    Business Data Analyst

    1 week ago

    Avenue5 Residential, LLC Phoenix, United States

    **Avenue5 is growing, and we are in search of a business data analyst to join our dynamic team of Fivers** · **About Us** · We are a vibrant third-party multifamily property management firm with locations across the United States. We are proud of our vibrant, inclusive, make-it-h ...

  • Cox Communications

    Data Analyst Ii

    2 weeks ago

    Cox Communications Phoenix, United States

    Key Focus: The Data Analyst II is responsible for providing information, insights, and analyses regarding the performance of Cox Business sales channels, including standard reporting and monitoring of the health of the business, ad-hoc analyses, and proactive identification of ac ...

  • CALERO

    Invoice Data Analyst

    5 days ago

    CALERO Phoenix, United States

    **Specific Responsibilities**: · - Ensure proper, timely and accurate invoice processing for assigned group of customers · - Execute customer requirements for GL Coding and Cost Allocations · - Create and submit AP files to the customer(s) for payment in line with SLA/KPIs · - In ...

  • fairlife

    Qse Data Analyst

    2 weeks ago

    fairlife Goodyear, United States

    fairlife, LLC is a Chicago-based nutrition company that creates great-tasting, nutrition-rich and dairy products to nourish consumers. · With nearly $2B in annual retail sales, fairlife's portfolio of delicious, lactose-free, real dairy products includes**:fairlife ultra-filtered ...

  • Compri Consulting

    Financial Data Analyst

    2 weeks ago

    Compri Consulting Scottsdale, United States

    Financial Data Analyst - Hybrid on site/remote - Bonus eligible position. · Growing insurance industry company looking to add to their data and financial analysis team. This person should be literate and well versed in financial analysis in a data driven (SQL) environment to con ...

  • Knewin

    Marketing Data Analyst

    1 week ago

    Knewin Scottsdale, United States

    As a member of the Digital Performance and Analytics team, within the Marketing Ops org team, the Marketing Data Analyst will be a trusted advisor to core Marketing functions. This role will help stakeholders accelerate business strategies, meet goals/objectives, enhance customer ...

  • The Diamond Guys

    Sr. Data Analyst

    3 weeks ago

    The Diamond Guys Scottsdale, United States

    Sr. Data Analyst (Scottsdale, Maricopa AZ): Analyze Users' journey and behavior to extract actionable insights and drive marketing initiatives to increase brand awareness, visibility and customer performance using Google Analytics and Google Ads. Develop and manage (A/B) test str ...

  • GTN Technical Staffing

    Financial Data Analyst

    3 weeks ago

    GTN Technical Staffing Scottsdale, United States

    Financial Data Analyst · DETAILS · Location: · Scottsdale, AZ · Work Schedule : Hybrid - 2/3 in-office/remote · Position Type : Direct-Hire · Salary : $70,000 - $80,000 · Residency Requirements: · Candidates authorized to work in the US are encouraged to apply. No sponsorship ...

  • PeerLogic, Inc.

    Data Analyst Internship

    2 weeks ago

    PeerLogic, Inc. Scottsdale, United States InternshipSHIP

    Data Analyst Internship -Data Science & Gen-AI Team · At Peerlogic, we're pioneering the integration of artificial intelligence to revolutionize communication within the healthcare community. Guided by our core values of Curiosity, Accountability, Grit, and Enthusiasm (CAGE), we ...

  • Resideo

    Marketing Data Analyst

    1 week ago

    Resideo Scottsdale, United States

    Job Description · As a member of the Digital Performance and Analytics team, within the Marketing Ops org team, the Marketing Data Analyst will be a trusted advisor to core Marketing functions. This role will help stakeholders accelerate business strategies, meet goals/objective ...

  • Resideo

    Marketing Data Analyst

    1 week ago

    Resideo Scottsdale, United States

    Job Description · JOB DESCRIPTION · As a member of the Digital Performance and Analytics team, within the Marketing Ops org team, the Marketing Data Analyst will be a trusted advisor to core Marketing functions. This role will help stakeholders accelerate business strategies, me ...