Reimbursement Analytics Specialist - Claims & Compliance
Cook Children's Health Care System
Cook Children's Health Care System is seeking a Systems Reimbursement Analyst in Fort Worth, TX. The role focuses on maintaining payment integrity, analyzing claims data to identify cost containment opportunities, and auditing provider contracts to ensure proper configuration for claims payments. The analyst collaborates with Claims Operation, Provider Contract, Compliance and Finance, serving as a liaison to IS for benefit configuration and fee schedules. #J-18808-Ljbffr Cook Children's Health Care System
$19.21 - $28.73 per hour
...The Revenue Cycle Specialist is responsible for analysis and monitoring of claims audit data across multiple platforms. Performs... ...and appropriateness of reimbursement made to healthcare providers.... ...use critical thinking Strong analytical and problem-solving skills...ReimbursementClaimsHourly payMinimum wageFull timeContract workWork experience placementWork at officeLocal areaRemote workFlexible hours- CorVel Corporation is seeking a Revenue Cycle Specialist to analyze and monitor claims audit data across multiple platforms, ensuring accurate reimbursement and resolving variances with internal and external partners. The role requires strong knowledge of claims processing...ReimbursementClaimsRemote jobWork at office
- ...Program (EAP) ~401(k) Plan ~ Tuition Reimbursement ~ Paid Holidays ~ Paid Time Off... ...! About The Position The Title Specialist will be responsible for the overall... ...overdue, and pending titles. Open claim investigations with DMV states due to...ReimbursementClaimsTemporary workWork experience placementWork at officeFlexible hours
- Cook Children's in Fort Worth, TX, is seeking a Claim Auditor I in Reimbursement Analysis. The role audits behavioral and medical claims, conducts post-claims reviews for Texas Medicaid and CHIP, and supports payment integrity in line with regulatory standards. You will...ReimbursementClaims
- Cook Children’s in Texas seeks a Systems Reimbursement Analyst to maintain payment integrity by analyzing claims data to identify cost containment opportunities and... ...lines of business, audits delegated entities for compliance, and collaborates with Claims Operation,...ReimbursementClaimsContract work
- Cook Children's in Fort Worth, TX is seeking a Claim Auditor I to audit behavioral and medical claims for Texas Medicaid and CHIP, ensuring payment integrity, coding accuracy, and compliance with regulatory standards. The role includes post-claims reviews, monthly sampling...ReimbursementClaims
- Cook Children’s Health Plan is seeking a Claim Auditor I to audit behavioral and... ...for Texas Medicaid and CHIP, ensuring compliance with regulatory standards. The role includes... ...dollar claims along with reporting to the Reimbursement and Analysis Manager. The ideal...ReimbursementClaims
- ...Advocate manages eligibility, billing, and claims inquiries, and provides day-to-day... ...QLEs). Support Account Managers with compliance deliverables and client documentation requests... ...matching 401k Gym membership reimbursement Hotchkiss is an EOE and drug-free workplace...ReimbursementClaimsWork at office
$160.3k - $297.7k
...Associate Director, Access & Reimbursement (ADAR) — field-based role. Major accountabilities... ...executives, providers, billing/coding, claims, and revenue cycle managers. Analyze... ...cross‑functionally; ensure integrity/compliance, handle PII appropriately (HIPAA/...ReimbursementClaimsLocal area$130k - $160k
...benefits package.The BNSF Railway Law and Claims Department provides expert in-house... ...dedicated to upholding the highest legal compliance standards. Additionally, our... ...building support, adoption and surrogacy reimbursement, and dependent care spending account (with...ReimbursementClaimsFull timeH1bWork at officeLocal areaRemote work1 day per week$130k - $160k
...benefits package.The BNSF Railway Law and Claims Department provides expert in-house... ...dedicated to upholding the highest legal compliance standards. Additionally, our... ...building support, adoption and surrogacy reimbursement, and dependent care spending account (with...ReimbursementClaimsFull timeH1bWork at officeLocal areaRemote work1 day per week- ...procedures, and programs.What you'll doConducts investigations into claims of potential harassment, retaliation, and discrimination both... ....Strong initiative and solid judgment abilities/skillsStrong analytical, fact-finding and evidence gathering skillsAbility to...ClaimsWork at officeFlexible hours
- Cook Children's is seeking a Systems Reimbursement Analyst in Fort Worth to maintain payment integrity through claims data analysis and cost containment initiatives. You... ...lines of business. This role requires strong analytical skills, familiarity with CPT/ICD coding, and...ReimbursementClaims
$142 per hour
...Receiving SpecialistAs a Receiving Specialist, you'll support the supply chain by managing... ...customer returns, vendor returns and damage claims.Work with the quality personnel to... ...regulations.Excellent problem solving and analytical skills.Superior interpersonal and communication...ClaimsBi-weekly payFull timeWork at office- ...SUMMARY The Medical Billing Specialist will be a primary point of contact... ...Clients Monitor the claim adjudications; identify the... ...insurance company claims filing and reimbursement practices - required. An... ...skills - required. Good analytical skills specifically in data...ReimbursementClaimsWork at officeLocal areaMonday to Friday
- ...platforms to ensure accuracy, compliance, and efficiency. Works... ...understanding of repricing claims processing, and contractual... ...healthcare revenue cycle and reimbursement Knowledge of applicable regulations... ...platform systems Excellent analytical, problem-solving, and...ReimbursementClaimsMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours
- ...FundWellness ProgramTuition Reimbursement ProgramWho We Are:It's pretty... .... This position maintains compliance with relevant contract policies... ..., Box and DocuSignExcellent analytical, time-management, judgment... ...the investigation of any complaint or discrimination claim....ReimbursementClaimsContract workWork at officeImmediate startWorldwideFlexible hours
$95k - $125k
...projects to assist federal contractors with compliance, financial analysis, regulatory research... ...equitable adjustment and termination claims as well as providing strategic pricing... ...specifically business / report writing Strong analytical and basic research skills Solid...ClaimsContract workFor contractorsWork at office- Specialist/Sr Specialist, HR Investigations View Profile Need Accommodation Assistance? Location... ...you'll do Conducts investigations into claims of potential harassment, retaliation,... ...solid judgment abilities/skills Strong analytical, fact-finding and evidence gathering...ClaimsWork at officeFlexible hours
$151.04k - $198.2k
...Senior Oncology Sales Specialist is responsible for... ...partners with appropriate reimbursement/market access... ...operating costs and compliance with territory budget... ...Kickback Statute; False Claims Act, OIG/DOJ Guidance... ...Experience in business analytics to understand and analyze...ReimbursementClaimsFull timeWork at officeLocal area- ...efficiency, including expense oversight and reimbursement programs. As a key resource for base... ...guiding flight attendants through compliance requirements and ensuring accountability... ...Skills, Licenses & Certifications Strong analytical and financial acumen. Excellent written...ReimbursementWork at officeFlexible hours
$22.25 - $30.25 per hour
...Division Group Job Title Customs Specialist - Entry Writer Time Type... ...when necessary. Ensure compliance with customs regulations. Obtain... ...documents required to support claims or disclaims. Ensure the... ...and record-keeping. Strong analytical and problem-solving skills....ClaimsHourly payFull timeWork at officeLocal area$87.19k - $114.43k
...performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines. The... .... Utilizes data and analytics of provider financial issues... ...organizing large data sets such as claim files and provider rosters Bonus...ReimbursementClaimsContract workWork experience placementLocal areaRemote workWork from homeHome office- ...Insurance Employee Assistance Program (EAP) 401(k) Plan Tuition Reimbursement Paid Holidays Paid Time Off (PTO) Transportation... ...Directory with Azure AD/Entra ID in hybrid configurations Strong analytical and problem solving skills. Ability to interact with others in...ReimbursementTemporary workWork experience placementWork at officeFlexible hoursNight shift
$140k - $160k
...support hospital billing operations in a role focused on claim accuracy, timely reimbursement, and revenue cycle performance. As an Epic Denials... ...Resolute Hospital Billing applicationProficient in Epic Analytics and Reporting applications (e.g., SlicerDicer)Bachelor’...ReimbursementClaimsLocal areaRemote work$66.94k - $101.26k
...accurately reviewing pre and post pay claim audits based on client, policy, industry... ...Ability to use clinical judgement and analytical skills to appropriately review documentation... ...of healthcare revenue cycle and claims reimbursement Proficient in Microsoft Office...ReimbursementClaimsMinimum wageFull timeWork experience placementWork at officeLocal areaRemote workFlexible hours- ...Operations Building Department: Reimbursement Analysis Shift: First Shift... ...integrity by executing a claim recovery strategy, which... ...system are operational and in compliance with regulatory and statutory... ...claim life cycle. Strong analytical skills and problem-solving skills...ReimbursementClaimsContract workShift workDay shift
- XPO is seeking a Senior Specialist, AR in North Richland Hills, TX to audit LTL invoices, correct billing issues, and ensure pricing contract compliance. The role requires experience in AR, billing, and a strong analytical mindset. You will drive process improvements,...Contract work
- ...seeking an experienced, organized, and motivated Personal Injury Claims Manager to join our team and take ownership of the day-to-day... ...insurance, medical liens, letters of protection, and other reimbursement claims. Assist with reductions and negotiations of medical bills...ReimbursementClaimsFull timeWork at office
$71k - $73k
...from you. The Supervisor, CGT Reimbursement & Medical Benefit Operations... ...and medical benefit specialists. Conduct performance reviews... ...medical billing teams to ensure claims are billed accurately and compliantly... ...methodologies. Strong analytical, communication, and cross-...ReimbursementClaimsWork at officeRemote work
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