Claims Research & Process Improvement Analyst
Molina Healthcare of Illinois
Molina Healthcare in the Town of Florida is seeking an experienced claims analyst to provide support for claims research activities. The role involves analyzing claims to ensure compliance with regulations and effectively collaborating with various departments. The ideal candidate will have at least 3 years of medical claims processing experience and a strong understanding of claims related to Medicare and Medicaid. A competitive benefits and compensation package is offered. #J-18808-Ljbffr Molina Healthcare
Vacancy posted 16 hours ago
Similar jobs that could be interesting for youBased on the Claims Research & Process Improvement Analyst in Florida, NY vacancy
- ...consumer products , is seeking a Financial Processing Analyst to support high-volume rebates and... ...and challenge inaccurate claims Maintain detailed documentation to support... ...patterns, variances, and areas for process improvement Required Qualifications 3+ years of...Process improvementClaimsContract work
$75k - $90k
Postman Law is seeking a proactive Business Analyst to join our Intake Department in Lake Mary, Florida. This role will evaluate processes, identify improvements, and deliver data-driven solutions to enhance efficiency and client experience. The ideal candidate will have...Process improvement- SGA Inc. is seeking a Business Process/Governance Operations Analyst in New York to support governance processes and documentation in a large procurement... ...focuses on process standardization and operational improvement. The ideal candidate will have a Bachelor's degree and...Process improvement
- Business Process/Governance Operations Analyst One of SGA's major management consulting clients is seeking a Business Process/Governance Operations Analyst... ...workflows, and create governance artifacts that improve operational consistency and audit readiness. Responsibilities...Process improvementWork at office
$70.1k - $126.2k
...Evaluate and analyze benefit configuration processes, initiatives, and requirements to... ...technologies and business processes to improve training development, delivery, and support... ...coding rules (CPT, HCPCS, ICD) 4+ years of claims payment/analysis experience 4+ years of...ClaimsFull timePart timeWork at officeRemote workFlexible hours- We are seeking an experienced Claims Center Business Analyst with a strong background in Guidewire ClaimCenter... ...requirements, define business processes, and support implementation and... ...for system enhancements or process improvements. Assist in incident investigation, root...Process improvementClaims
- ...requires an active RN license and the ability to analyze claims data and regulations effectively. The candidate will... ...for documentation and reporting within the appeals process, contributing to continuous improvement initiatives in a dynamic healthcare environment. #J-1...Process improvementClaimsRemote work
Performant
Florida, NY17 hours ago - ...client‑facing teams Extremely detail‑oriented and organized Preferred Experience with benefit setup in a PBM system Familiarity with health plan or TPA operations Process improvement or documentation experience Prescription claims adjudication experience #J-18808-Ljbffr...Process improvementClaims
BeneCard PBF
Florida, NY17 hours ago - ...strong understanding of medical claims billing, denial management,... ...resolve billing issues and improve revenue cycle performance. Key... ...timely reimbursement. Research and resolve claims denials using... ...feedback to management regarding process improvements and challenges....Process improvementClaimsRemote jobWork at office
- ...while also assisting with documentation improvement, audits, and quality initiatives across... ...trends in documentation issues and suggest process improvements Collaborate with coding,... ...billing, and clinical staff to support clean claims Collaborate and assist our...Process improvementClaimsFull timeWork at office
East Florida Eye Institute
Florida, NY1 day ago - ...enhance customer relations through efficient account handling and claim resolutions. Candidates should have experience in medical... ...while the supervisor drives team performance and implements process improvements. Competitive salary and diverse benefits are offered. #J-188...Process improvementClaims
- ...revenue cycle operations by reviewing denied claims for clinical accuracy and medical... ...a critical part in overturning denials, improving reimbursement outcomes, and ensuring compliance... ...standards Participate in process improvement initiatives to enhance appeal...Process improvementClaimsRemote work
Health Business Solutions
Florida, NY1 day ago - ...health plans and employers to improve the safety, quality, and... ...Summary The Operations Analytics Analyst provides analytical support for... ...members Participate in team process improvement efforts by... ...of healthcare data—including claims, medical coding, provider data...Process improvementClaimsWork at office
- Position Operations Analytics Analyst (Lake Mary, FL) - Job ID 698-... ...plans and employers to improve the safety, quality, and affordability... ...a commitment to accuracy and process improvement. Roles and... ...of healthcare data including claims, medical coding, provider data...Process improvementClaimsWork at office
- Data Operations and Reporting Analyst (Business Information Analyst I) Location: This... ...business performance reports (e.g. for claims data, provider data, utilization data).... ...data-driven decision making and drives process improvements. Minimum Requirements Requires a HS diploma...Process improvementClaimsTemporary workWork at officeLocal area2 days per week1 day per week
- ...Job Title - AI Analyst (NO C2C/C2H/W2. NO VISA SPONSORSHIP AVAILABLE NOW OR... ...identify opportunities for automation, process optimization, cost reduction, and improved decision-making across the... ...operational analytics, population health, claims, EMR/EHR, or managed care...Process improvementClaimsPermanent employmentLocal areaRelocationVisa sponsorship
Premier Staffing Solution
Florida, NY17 hours ago - ...Frontline Insurance here. About the Role The Claims Quality Assurance Specialist plays a... ..., and efficiency of the claims processing function within the organization. This position... ...inconsistencies, and opportunities for process improvement. The specialist collaborates closely...Process improvementClaimsWork at officeRemote work
- ...medical necessity denials, payer appeal processes, and team leadership—ideally across both... ...timely and effective resolution of denied claims, supporting revenue recovery efforts,... ...issues. Identify and implement process improvements to increase efficiency, reduce denials,...Process improvementClaimsRemote work
Health Business Solutions
Florida, NY18 hours ago $57k - $60k
...Purpose To supervise a team of examiners for disability/leave claims for clients and monitor team's workload; to provide... ...informs management of new procedures and ideas for continuous process improvement. Develops and conducts training to address examiners' needs...Process improvementClaimsWork at officeLocal areaFlexible hours- ...Positive Pay Exceptions which includes researching and decisioning check and ACH... ...completing and tracking fraudulent check claims. Work with our banking partners and local... ...payments. Identify, propose and engage in process improvements to our current systems and new systems...Process improvementClaimsLocal areaDay shift
6AM City
Florida, NY17 hours ago - Principal Insurance Operations Analyst At PALMS Insurance, a... ...Principal Operations Analyst for Claims & Finance, you will be... ...day activities. This includes processing FNOLs (First Notice of Loss)... ...document processes and recommend improvements Establishes, communicates,...Process improvementClaimsFull timeFor contractorsLocal areaRelocation
$40 per hour
...policy reviews for Medicaid claims. This involves meticulous examination... ...end-to-end case screening processes, ensuring all activities are... ...standards, utilizing research of relevant ICD‐10, CPT, and... ...priority setting and process improvement Ability to work independently...Process improvementClaimsContract workWork at officeLocal areaImmediate startRemote workHealthcare Quality Strategies
Florida, NY1 day ago- ...seeking a Chargeback Accounting Analyst to support high-volume... ...reviewing system-flagged chargeback claims, identifying error messages,... ...Responsibilities Review, research, and adjudicate customer... ...members or leadership. Support process improvement efforts to improve accuracy,...Process improvementClaimsContract work
- ...urgency and taking accountability for resolution. Champions process improvements that cut across organizational lines. Plans and delivers improvement... ...expertise, including 5 plus years of management experience. Claims financial operation experience preferred. CNA offers a...Process improvementClaimsWork experience placement
01460 Continental Casualty Company
Florida, NY1 day ago $45.39k - $88.51k
...Leads and supervises team responsible for claims activities including administering... ...priorities, and responds to new priorities and process improvement opportunities assigned by leadership.... ..., Medicaid, and Marketplace plans. Research, analysis, data entry, and auditing...Process improvementClaimsWork experience placementWork at office$105k - $120k
...looking for an innovative, results-driven Research & Development Manager to turn great... ...analyzing results, and scaling smarter tools, processes, and field solutions across the company... ..., tool development, and process improvement initiatives based on impact, feasibility...Process improvementFull timeBroughton Group
Florida, NY17 hours ago- Case Review Analyst - Exact Billing Solutions (EBS) Location: Lauderdale... ...Analyst, you will review and process clinical records to submit... ...and resolve utilization or claim denial issues. Provide... ...reports to management for process improvement. Track utilization patterns,...Process improvementClaimsFlexible hours
- ...maturities.* Responsible for processing Corporate Actions from trade... ...Loan positions and settle claims.* Respond to both internal and... ...and broader process improvement functions to identify client... ...key business opportunities, research and recommend system enhancement...Process improvementClaims
TD Bank
Florida, NY17 hours ago - ...supplier invoices, banking relationships, payment processing, treasury management, and month-end activities. Oversee... ..., compressor commissioning, restocking activities, claims management, and service process improvements. Oversee inventory management within AX, including...Process improvementClaimsWork at office
Resourceful Talent Group
Florida, NY1 day ago - ...for all TPA activity including accountability for Eldercare, claims processing, appeals, denials, payments, and all required reporting,... ...suspended claims to ensure accuracy, identify errors, process improvements, and works with providers/vendors to resolve issues....Process improvementClaimsFor contractorsWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims Research & Process Improvement Analyst. Be the first to apply!
Related searches
- claim specialist Florida, NY
- claims resolution specialist Florida, NY
- senior claims specialist Florida, NY
- claims assistant Florida, NY
- medical claims analyst Florida, NY
- medical insurance claims specialist Florida, NY
- insurance claims processor Florida, NY
- claims specialist remote Florida, NY
- remote medical claims processor Florida, NY
- claims analyst Florida, NY