Senior Claims Recovery & Overpayments Analyst
EmblemHealth
EmblemHealth, a leading not-for-profit health insurer in New York, seeks an experienced Senior Claims Overpayment & Recovery Analyst to drive financial recovery and improve payment accuracy. Your role will involve auditing, data analysis, and collaboration with providers and internal teams to identify overpayments and implement corrective actions. You will analyze complex claims and support leadership with actionable insights. #J-18808-Ljbffr EmblemHealth
- EmblemHealth Remote position seeks a Health Care Claims Data Analyst to develop business requirements for... ...to leverage post-claim editing and recovery programs. You will analyze claims, payments, and vendor data to identify overpayments, support cost containment, and drive...SeniorClaimsRemote job
$56.16k - $99.36k
...to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com . Senior Claims Overpayment & Recovery Analyst Proactively assess and monitor vendor operational performance to ensure contractual targets and quality expectations...SeniorClaimsContract workWork experience placementH1bVisa sponsorship$68.04k - $118.8k
...needed to analyze vendor payment data. Utilize pre/post claim editing, auditing, and claim recovery programs that will drive incremental value year over... ..., and vendor data to identify, prevent, and recover overpayments, as well as to drive process improvements and cost...SeniorClaimsRemote work- Job Title Senior Analyst (Freight) Employment Type Full-time Work Authorization Requirements... ...and software, and tech-enabled profit recovery services. We provide software and services... ...experience and a wide variety of claim approaches. Communicate with carriers and...SeniorClaimsFull timeWork at officeLocal area
- CareFirst BlueCross BlueShield is seeking a Claims Recovery Specialist I to review and audit medical and dental claims to recover overpayments and manage active recoveries. You will work with claims, service, and finance teams to adjust claims and document processes. Under...ClaimsRemote jobLocal area
- Xsolis is seeking an Appeals Analyst to investigate denied claims, document findings, and pursue reimbursement for services denied. The role supports... ...bring strong communication, negotiation, and analytical skills to identify recovery opportunities. #J-18808-Ljbffr XsolisClaimsRemote jobWork at officeWork from homeHome office
$70k - $75k
Zeeba Automotive Group Inc is seeking a Senior Subrogation and Claims Specialist to own recovery and the insurance interface end to end. The role is remote, full-time, with compensation tied to recovery performance and an uncapped incentive structure. The base salary ranges...SeniorClaimsRemote jobFull time- ...Senior Actuary – Professional Lines Pricing Chicagoland / NYC - Hybrid in office 3 days/week A leading specialty insurer is seeking... ...emerging product lines Partner closely with Underwriting, Claims, and senior business leaders Present strategic recommendations...SeniorClaimsWork at office3 days per week
- CVS Health in Georgia seeks a Senior Analyst, Informatics (Encounter Technical Analyst) to analyze and document business data, run root-cause... ...with stakeholders across teams to deliver reliable data insights for encounters and claims. #J-18808-Ljbffr CVS HealthSeniorClaims
- S2Tech is seeking a Senior Business Analyst for MMIS Claims Processing to drive modernization initiatives. The role requires deep expertise in MMIS claims and the ability to facilitate critical discussions with stakeholders while documenting business requirements. A successful...SeniorClaimsRemote job
- CVS Health in Idaho is seeking a Senior Analyst, Informatics (Encounter Technical Analyst) to analyze and document business data, perform root... ...across teams to deliver data-driven insights and improvements for claims and encounters data. #J-18808-Ljbffr CVS HealthSeniorClaims
- ...reduce insured losses. The role offers remote work for candidates residing in Iowa. You will collaborate with Underwriting, Sales and Claims, deliver advanced training, and build strong relationships with clients and agents while applying knowledge of OSHA, NFPA, DOT and...SeniorClaimsRemote job
- Great American Employer Health Solutions is hiring a Senior Product Analyst to support the development, enhancement, and administration of Employer... ...Funded Plus programs. The role works across underwriting, claims, operations, compliance, and marketing to drive product...SeniorClaimsRemote job
- Capitole seeks a Senior Business Analyst with strong Insurance experience to join an international project focused on motor claims management. You will translate business needs into clear requirements, model processes with BPMN, write user stories and acceptance criteria...SeniorClaimsFreelance
- Conduent seeks a Senior Business Analyst to lead the Claims module on MMIS health care projects. You will drive the claims process, analyze business requirements, designs and documentation, ensure quality, and coordinate with customers in a team setting. You will work...SeniorClaims
$65k - $75k
...as the subject-matter specialist for Rental vehicle and truck recovery, protecting Home Depot Rental assets by identifying, vetting, and... ...of stolen, converted, and slow-rent vehicles. Analyze GPS, claim, and system data to determine asset status and recovery priority...ClaimsWork experience placementNight shift- Crossing Hurdles is seeking a Senior Claims Investigation and Evidence Review Expert on a contract basis in a remote capacity. The role offers hourly compensation of CAD 20-60 and requires 10-40 hours per week, with a focus on thorough analysis of digital evidence and fraud...SeniorClaimsRemote jobHourly payContract work10 hours per week
- ...Senior Associate Consulting Actuary — Government Programs (Medicare, Medicaid & ACA) Location: New York City, NY / Hybrid / Remote... ...Use advanced Excel and actuarial modeling skills to analyze claims, membership, utilization, costs, revenue, and financial performance...SeniorClaimsFull timeRemote work
- Molina Healthcare is seeking a Senior Analyst, Claims Research (Medicaid Claims) for a fully remote role in the United States. The position emphasizes research on Medicaid claims, advanced Excel usage, and deep root-cause analysis to improve claim accuracy and regulatory...SeniorClaimsRemote job
- Evio is seeking a Healthcare Data Analyst to join its analytics team. You’ll work with medical and pharmacy claims data to build analytics tools and deliver insights that improve outcomes and medication use. You’ll collaborate with Evio’s clinical research, product, and...SeniorClaims
- ...Senior Analyst/Associate Revenue Cycle Management - Due Diligence, Advisory & Implementation Marwood Group is a leading healthcare advisory... ..., and rapid-turn analyses. Ingest, normalize, and analyze claims, charges, payments, adjustments, denials, AR, payer, provider,...SeniorClaimsWork at officeLocal areaRemote work
- Jobgether is seeking an experienced healthcare data analyst to transform claims data into actionable insights. You will build tools for health plans and digital health products and collaborate on real-world evidence studies while advancing process automation. A strong background...SeniorClaims
$150k - $200k
...Senior Actuary - Pricing (P&C Insurance | Remote (U.S.) We’re partnering with a leading... ...closely with Product, Pricing, Underwriting, Claims, and Finance to align actuarial work with... ...audiences Guide and support actuarial analysts throughout the rate filing lifecycle,...SeniorClaimsRemote workFlexible hours- ...compliance with industry regulations. We are looking for a Business Analyst to support Subject Matter Experts (SMEs), allowing them to... ...business requirements. Support business process analysis related to claims, enrollment, provider management, authorizations, and...SeniorClaimsFlexible hours
- Position Title: Senior Business Analyst Location: 318 Seaboard Lane, Ste. 110, Franklin, TN 37067 Company: Specialist Resources Global, Inc.... ...experience in Technical Business Analysis with Healthcare RCM (Claims). Conduct an aggregation of data into a Data Lake on AWS....SeniorClaimsRemote work
$46.99k - $112.2k
...one family and one community at a time. Position Summary The Senior Analyst, Compliance COE will be a key member of the Compliance Monitoring... ...medical record validation, provider documentation standards, claims integrity, and coding compliance requirements. Additionally,...SeniorClaimsHourly payFull timeTemporary workWork experience placementLocal area$85.47k - $111k
Senior Business Analyst - Claims module: Summary: Play the role of Claims Domain lead for MMIS health care projects. Drive the claims module and process, domain knowledge, perform analysis of business requirements, designs and develop documentation, ensures quality process...SeniorClaims$64k - $147.25k
The Senior Business Analyst is responsible for ensuring that business requirements are documented, and every functional/business consideration is identified before implementing each project. This position must clearly understand and review/confirm with the client and internal...SeniorClaimsContract work$63.4k - $105.6k
Operating Effectivness Senior Analyst (Workflow Automation) - Evicore - Remote# The Cigna Group Careers## Operating Effectivness Senior Analyst... ...matter expertise in collaboration with client services, claims, implementations, clinical, Non-Clinical, and IT organizations...SeniorClaimsRemote jobFull timeLocal areaWork from home$96.09k - $111.71k
...robotics, shipbuilding, and so much more. Position Summary The Senior Benefits Analyst plays a key role in the administration, analysis, and... ...associate inquiries involving benefits eligibility, enrollment, claims, and payroll deductions. Communicate directly with...SeniorClaims
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