Claims Analytics & Process Improvement Specialist
Johns Hopkins Health Plans
Johns Hopkins Health Plans is seeking a Claims Business Analyst to investigate complex claims processing and payment issues, identify root causes, and implement corrective actions across Medicaid, Commercial, and other managed care lines. You will partner with Claims Operations, Provider Relations, Systems Configuration, and Adjustments teams to ensure accurate adjudication and compliant processing, while communicating findings to vendors and stakeholders. #J-18808-Ljbffr Johns Hopkins Health Plans
$3,500 - $4,000 per month
...RCM Specialist Fully Remote Remote Employee Location - Fife,... ...role ensures timely billing, claims submission, payment posting... ...internal policies Assist in process improvement and optimization of billing... ...AR management ~ Strong analytical, organizational, and...Process improvementClaimsRemote work$69.4k - $100.6k
...Description The Logistics Quality Specialist (LQS) is responsible for... ..., analyzing, and continuously improving quality processes. Using Quality Assurance and LEAN... ...and analyze quality and claims data, applying statistical and analytical methods to validate results, and...Process improvementClaimsTemporary workFor contractorsWork experience placementWork at officeLocal area$30.91 - $51 per hour
...As our Auditor Coder Specialist, you will be a critical... ...financial records, processes, and regulatory compliance... ...'ll combine strong analytical and investigative... ...insights into tangible improvements.Performs internal... ...corrects or appeals denied claims as assigned;...Process improvementClaimsFull timeWork experience placement$20.91 - $45.04 per hour
...leader in TE's core manufacturing processes by driving Continuous Improvement and Innovation. We use a collaborative... ..., Supply Chain or Business Analytics or Engineering from an accredited... ...individuals or organizations falsely claiming to represent TE Connectivity. Please...Process improvementClaimsRemote jobContract workWork experience placementSummer workInternshipLocal area- ..., the position of Sr. Patient Relations Specialist manages, investigates and responds to high... ...from the Risk Management Department, claims, and litigation. They are also responsible... ...within this job or equivalent. Requires analytical ability to investigate patient...ClaimsFull timeLocal areaImmediate startDay shift
- ...technology, payroll, benefits, compliance, and process improvement. The Director will own significant HR... ..., plan design, utilization and claims analysis, employee education, and... ...and support to HR team membersWorkforce Analytics and Strategic ProjectsEnsure HR data integrity...Process improvementClaimsWork at officeLocal areaNight shift
$40k - $67k
...accommodation or an alternative application process. Rate Specialist Tacoma, WA, US 5 days ago... ...seeking a highly detail-oriented and analytical Rate Specialist to join our team in... ...department initiatives and process improvements that enhance operational efficiency...Process improvementFull timeTemporary workFor contractorsWork experience placementWork at office- ...opportunities for growth, a community-focused culture, and comprehensive benefits. You will produce workforce analytics, maintain HR records, and contribute to process improvements while partnering with our teams to deliver strong HR services across the organization. #J-18808-...Process improvement
- ...Full Time Position Summary The Claims Business Analyst is... ...investigating complex claims processing and payment issues, identifying... ...solutions and driving process improvements. The Claims Business Analyst leverages advanced analytical skills, claims system expertise...Process improvementClaimsFull timeContract workWork experience placementLocal areaDay shift
$97k - $125k
...benefits, HR systems, and routine processes. Resolve routine inquiries... ...resources for coverage or claim-specific support.... ...Assist with HR projects, process improvements, and program rollouts by maintaining... ...to meet deadlines. Strong analytical and problem‑solving skills....Process improvementClaimsWork at office- ...recommendations for maintenance and improvement. Designs and develops... ...Generates descriptive and analytic data to inform public health... ...in the Title XIX Medicaid Claiming Program. Performs other duties... ...safely and understands processes for reporting an accident or...Process improvementClaimsFull timeWork experience placementWork at officeLocal areaFlexible hours
- ...Department of Justice seeks a Medical Advisor (GS-0601-15) to support a growing data, research, and analytics team focused on health care fraud under the False Claims Act. You will apply medical expertise to guide investigations, review records, and advise attorneys on...Claims
- ...specifications that impact accurate claims submission, payments, and... ...units to expedite and improve enrollment information accuracy. Facilitate PECOS/E-Prep processes and approvals. Continually look... ...skills, including negotiation, analytical, written and oral communication...Process improvementClaimsFull timeWork at officeLocal areaDay shift
- ...Intake Specialist OpportunityAre you driven to transform stressful situations into seamless... ...videos and assets to maintain engagement and improve conversion rates. You will also help... ...updates and enhancing team synergy.Process Improvement: Continuously refine the intake...Process improvement
$97k - $125k
...benefits, HR systems, and routine processes. Resolve routine inquiries... ...resources for coverage or claim-specific support.... ...Assist with HR projects, process improvements, and program rollouts by maintaining... ...to meet deadlines. Strong analytical and problem-solving skills....Process improvementClaimsFull timeTemporary workWork at officeLocal areaImmediate start- ...Are you an experienced Medical Appeals Specialist in the Tacoma, WA area seeking a great career... ...presented on EOBs, entering denied claims into company database & escalating paymment... ...of the insurance denials / appeals process Excellent computer skills with emphasis...ClaimsHourly payContract workPrivate practice
$80.2k - $93.8k
...Permit Specialist Any Lightcurve Office, currently including Eatonville, Yelm, Ellensburg... ...the permitting and regulatory approval process for Lightcurve’s telecommunications and... ...the detailed analysis. · Process Improvement: Identify and implement efficiencies in...Process improvementFull timeFor contractorsWork at officeLocal areaRemote workFlexible hoursAfternoon shift$70k - $95k
...Health Counselor (LMHC) to join our team as a Crisis Intervention Specialist. This full-time role is designed for mental health... ...Malpractice insurance coverage to safeguard professionals against legal claims. A retirement savings plan with employer contributions to...ClaimsFull timeImmediate startRemote workRelocation packageMonday to Friday$103.71k - $138.28k
...overseeing and managing quality assurance processes that support Field Engineering... ...delays, material discrepancies, damage claims, provider performance issues, and other... ...Documentation Review and Validation Process Improvement Technical Communication and Reporting...Process improvementClaimsFull timeTemporary workFor contractors$120k - $145k
...and oversees the collection, processing and treatment of Auto... ...Continuous process analysis and improvement is required to ensure maximum... ...avoid downgrades and eliminate claims. Participate in Joint... ...documented success. Must exhibit analytical skills to manage production...Process improvementClaimsHourly payWork experience placementWork at officeFlexible hoursShift workNight shiftWeekend workDay shiftWeekday work$25 per hour
...is seeking a full-time RCM Specialist / Medical Biller to work rejections... ...Identify and resolve claims processing issues, including pre-... ...environment Requires strong analytical skills and attention to detail... ...telemedicine model is improving clinical outcomes and eliminating...ClaimsFull timeWork at officeLocal areaRemote workFlexible hours2 days per week$75k - $85k
...cycle—from patient intake and billing to claims submission, denial resolution, and... ...healthcare regulations, analyzes end-to-end processes to identify inefficiencies, and implements... ...Consultant also supports process improvement initiatives through methodologies such as...Process improvementClaimsFull timeContract workCasual workWork at officeRemote workAfternoon shift$23.9 - $34.79 per hour
...Summary And Responsibilities As a Patient Access Specialist, you manage administrative duties related to the patient intake process, adhering to established guidelines and... ...insurance eligibility and benefits to reduce claim denials and reimbursement delays, and collect...ClaimsWork experience placementLocal areaRemote workMonday to FridayShift work$23.27 - $28.3 per hour
Prior Authorization Specialist (Remote - Select States Only) TRA Medical Imaging Remote | Full... ...insurance websites for eligibility and claim status Understanding of radiology... ...Experience with PET scan authorization processes Knowledge of HCPCS coding Work Environment...ClaimsRemote jobHourly payFull timeWork at officeImmediate startMonday to FridayShift workWeekend work$60.93 per hour
...Description The Disaster Program Delivery Specialist: Collects, coordinates and/or reviews... ...priorities. Supports the communication process with the applicant about their status by... ...program delivery process. Supports the claims process by reviewing and validating...ClaimsWork experience placementH1bImmediate startFlexible hours$123.6k - $140k
...role also drives continuous improvement across Product Development & Innovation, simplifying processes and improving development speed... ..., and evidence-based claims.Build strong scientific, supplier... ...and commercialization.Advanced analytical, research, problem-solving, decision...Process improvementClaimsCasual workWork at office$5,376 - $7,224 per month
...through the application of analytical methodologies, data evaluation... ...systems, and evidence processing. Knowledge of law enforcement... ..., leading process improvements, or producing similar statistical... ...perform in the position. If claiming veteran status, please send...Process improvementClaimsHourly payFull timeWork at officeImmediate start$31.87 - $34.12 per hour
...internal compensation review process, the starting hourly wage... ...Administrator Communications Specialist I, II Executive Assistant... ...in the Title XIX Medicaid Claiming Program. Perform other duties... ...and continuous process improvement. Cross cultural communication...Process improvementClaimsHourly payFull timeContract workWork experience placementWork at officeLocal areaImmediate start$49.98 - $53.5 per hour
...Based on our internal compensation review process, the starting hourly wage for this... ...explain variances and opportunities for improvement. Acts as an advisor for the development... ...to participate in the Title XIX Medicaid Claiming Program. Performs other duties as assigned...Process improvementClaimsHourly payFull timeContract workWork experience placementWork at officeLocal area$73k - $108k
TechSphere is hiring a HR Generalist in Washington (Tacoma) to systematically hunt small inefficiencies and drive people and process improvements. This mid-level role values conflict resolution and hands you the wheel early as you translate goals into actionable plans....Process improvement
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