Claims Analyst I - Boston

The Claims Analyst under the direction of the Manager of PACE Claims is responsible for overall claims adjudication insurance validation process.This includes auditing adjudicated claims ensuring payments made in accordance with their contracts analyzing claims data for trends re ...

The Claims Analyst under the direction of the Manager of PACE Claims is responsible for overall claims adjudication and insurance validation process. · Maintaining up-to-date knowledge of fee schedules for both Medicare and MassHealth. · Auditing adjudicated claims to ensure paym ...

The Office of the Massachusetts State Treasurer and Receiver General is seeking a Claims Analyst I to process pending unclaimed property claims. · The successful candidate will provide independent initial approval for all valid claims in a timely fashion, research the status of p ...

The Claims and Credentialing Analyst will be a pivotal role in analyzing and coordinating all activities of the Provider Data team by evaluating and refining processes,,conducting comprehensive data analysis,,and ensuring compliance with all applicable State,CMS(contractual guide ...

+The Professional Billing Claims Analyst III position will be housed under a subsidiary organization of C3, Community Technology Cooperative, LLC (CTC). To implement, maintain support and maximize the use of clinical financial and administrative portions of the software applicati ...

This role involves extracting knowledge and insights from data to investigate business/operational problems using various techniques. Key responsibilities include collecting and analyzing Medicare Advantage claims data to ensure timeliness accuracy compliance; reviewing tracking ...

The Professional Billing Claims Analyst III position will be housed under a subsidiary organization of C3, Community Technology Cooperative, LLC (CTC). To implement, maintain, · support, · and maximize the use of clinical, · financial, · and administrative portions of the softwar ...

We're looking for a Healthcare Claims Analytics Analyst to join our IT team and play a pivotal role in delivering accurate, high-quality demographic, eligibility, and claims data. · Data collection and preprocessing of complex healthcare datasets. · Analyze incoming data from hea ...

Join our IT team as a Healthcare Claims Analyst and bridge clinical concepts with technical expertise to deliver accurate demographic eligibility and claims data for vulnerable populations. ...

Responsible for extracting knowledge and insights from data in order to investigate business/operational problems through a range of data preparation, modeling, analysis, and/or visualization techniques. · This role is responsible for collecting monitoring and analyzing Medicare ...

Epic PB/PB Claims Install Analyst residing on the Epic Install Billing Teams. · 5–15 years of Epic PB build or PB Claims experience · Certifications Required: Epic Resolute Professional Billing Administration and Epic Resolute Claims · ...

We're looking for a Healthcare Claims Analytics Analyst to join our IT team and play a pivotal role in delivering accurate, high-quality demographic, eligibility, and claims data. · In this role, you'll bridge clinical concepts with technical expertise, · transforming complex da ...

This position manages complex claims with special emphasis on high dollar and litigated claims. Ensures compliance with state laws and company policies along with mentoring assigned Analysts regarding basic claims standards and department policies. · Provides professional, techni ...

This Quality Assurance Analyst will conduct claims related operational functions that focuses on Employer Stop Loss quality reviews. · The role may encompass SOX audits, subrogation referrals, overpayment/check void and refund processing, · external auditor requests, · and reserv ...

Company Details: · StopLoss #SelfFunded #accidentandhealth · Berkley Accident and Health is a risk management company that designs innovative solutions to address the unique challenges of each client. With our entrepreneurial culture and a strong emphasis on analytics, we can hel ...

Manages complex claims with special emphasis on high dollar and litigated claims.Ensures compliance with state laws and company policies along with mentoring assigned Analysts regarding basic claims standards and department policies. · ...

This role focuses on the design, development and implementation of IT solutions to meet organizational needs through new and existing applications. · Designs, develops, implements and updates internal IT applications in accordance with specifications and business needs. · Designs ...

This role focuses on the design, development and implementation of information technology (IT) solutions in order to meet the organization's needs through new and existing applications, systems architecture, network systems and applications infrastructure and the management of th ...

We're seeking a Business Analyst with experience in the Property & Casualty Insurance domain to support key digital, policy, and claims initiatives. · The ideal candidate brings deep knowledge of Policy Administration, Billing, Claims, eCommerce and third-party integrations. · ...

We're seeking a Business Analyst with experience in the Property & Casualty Insurance domain to support key digital, policy, and claims initiatives. · Apply structured analysis: object modeling, ER modeling, state transition diagrams, and workflow mapping · Support digital/web-ba ...