Claims Review & Root-Cause Analytics Analyst
EmblemHealth
EmblemHealth in New York seeks a Claims Support Analyst to manage contract performance for a large health system. You will review disputed hospital, ancillary, and provider claims, analyze root causes, and recommend solutions to reduce errors and delays in processing. You will maintain dispute files, track trends, and work with provider groups to resolve AR matters while supporting department goals for cycle time and data integrity. #J-18808-Ljbffr EmblemHealth
$43.89k - $102.08k
...Client Performance Management Analyst supports the financial and... .... Prepare quarterly customer claims and performance reports with... ...and reliable outputs. Provide analytical and data support for maintaining... ...data discrepancies, identify root causes, and produce clear, audit‑...ClaimsHourly payFull timeTemporary workWork experience placementWork at officeLocal area$80k - $125k
...a Senior Health Data Analyst, you will focus on analyzing... ...and medical claims data to power longitudinal... ...de-identified patient analytics for commercial use cases... ...nuances, uncover root causes, and build robust data... ...assessment, our team will review your full application...ClaimsWork at officeLocal areaRemote workWork from home3 days per week$55k - $65k
...For: The AR Chargeback Analyst is responsible for... ...Operations to identify root causes, recover revenue, and... ...reduce future deductions. Review, validate, and process... ..., deductions, and claims. Research discrepancies... ...financial analysis. Strong analytical and problem-solving...ClaimsFull timeTemporary workLocal areaRemote workFlexible hours- Senior Business Analyst - Healthcare Payer (Claims & Benefits Systems) Role Summary:... ...analysis, SQL queries, and root cause analysis for issue... ...workshops, and milestone reviews, and track feedback through... ...documents, and RTM Strong analytical and problem‑solving skills...Claims
- ...Description - Business Analyst Manager... ...design / System testing, Root Cause analysis (RCA). Good... ...methodology. Meetings & Reviews, Estimations, Reporting... ...thinking skills. Good analytical skills. Effective communication... ...administration, claims and agent compensation...ClaimsTemporary workWork experience placementFlexible hours
- ...Title: Business Systems Analyst Location: 2... ...analysis, data validation, root cause investigation, and troubleshooting... ...deliverables, reviewing documentation,... ...platforms: o Risk, Claims, Legal, Compliance, and... ...ServiceNow • Reporting & Analytics: o Power BI o...ClaimsRemote work
$102.7k
...premium and pricing development, claim trend analysis, experience... ...creative solutions. Uncover the root causes of problems and reject superficial explanations. Review the appropriateness of the results... ...Develops, designs, and tests analytic frameworks to solve complex problems...ClaimsLocal areaShift work$80k - $100k
BerryDunn is seeking a Business Analyst to support Hawaiʻi Med-QUEST... ...), payment integrity, and claims review initiatives. This role will... ...gaps, process issues, root causes, and opportunities for redesign... ...Strong facilitation, writing, analytical, communication, and stakeholder...ClaimsWork at office$65k - $70k
...seeking a detail-oriented and analytical Carrier Revenue Analyst to support backend Revenue... ..., with a strong focus on claims investigation, denial... ...commercial payors, identifying root causes of payment discrepancies,... ...Perform detailed review of claims lifecycle (submission...ClaimsSummer workWork at officeFlexible hours3 days per week- ...support. The Senior Analyst/Associate - Revenue Cycle... ...strong RCM expertise, analytical rigor, business... ...project documentation. Review data room materials, identify... ...Validation Analyze claims, charges, payments,... ...information, and identifying root causes. Client Communication...ClaimsWork at officeLocal area
$68.9k - $99.62k
The Configuration Analyst of Office365 is responsible... ...configuration and claims across multiple lines... ...and state requirements. Review technical specifications... ...trends, variances, and root causes. Conduct financial and... ...using SQL or data analytic/reporting tools such as...ClaimsDaily paidContract workWork experience placementWork at office$104k - $116k
...TM Group actuarial policies, reviewing governance‑related... ...interest of the business. Analytical and reasoning skills with the... ...capability to determine the root cause of actuarial problems. Ability... ...Inc., TMNA Services, LLC, TM Claims Service, Inc. and First Insurance...Claims$80k - $125k
...the Senior Health Data Analyst on the Compass Patient... ...prescription and medical claims record-level data to... ...de-identified patient analytics for commercial use cases... ...assessment, our team will review your full application... ...a country it does not cause a change in salary. Where...ClaimsWork at officeLocal areaRemote workWork from home3 days per week- ...at the intersection of Health Insurance Analytics and Operations, who excels at creative problem... ...issues - this includes identifying the root cause, devising plans to remediate, and... ...warehouse to evaluate member, provider, claims, and enrollment data in support of Risk...Claims
$72k - $141k
...potential. Consider joining CNA Insurance’s Portfolio Management Data Analytics team, which partners closely with Underwriting and business... ...policy attributes, distribution, risk control, operations, and claims to inform decision making across the underwriting value chain....ClaimsFull timeWork experience placementWork at office$92k - $115k
...Senior Analyst, Analytics - Business Insights Judi Health is an enterprise health technology company providing a comprehensive suite of solutions... ...Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform...ClaimsWork at officeLocal areaFlexible hours$106.11k - $174.72k
...nd Street, New York, NY The Data Science Analyst III is a senior role, collaborating with... ...organization to develop sophisticated analytics and tools to provide information, insights... ...information technology, enrollment, claims, pharmacy, clinical, contract, medical management...ClaimsContract workTraineeshipLocal area- ...operations, benefit plan design, claims processing, SQL, and end-to-... .... Collaborate with Business Analysts, Product Owners,... ...configuration issues and identify root causes. Support production incidents... ...technical documentation. Strong analytical and problem-solving skills....Claims
$80k - $125k
...Senior Health Data Analyst - Payer Veeva Systems is... ...data (e.g., payers on claims, payment systems, formulary... ...with Market Access Analytics Experience with Python... ..., our team will review your full application package... ...a country it does not cause a change in salary. Where...ClaimsWork at officeLocal areaWork from homeFlexible hours3 days per week$70.48k - $94.61k
...our team as a Revenue Integrity Analyst (FGP) - Manhattan, CBO North Billing... ...Conducts internal audits and reviews activities to improve the revenue cycle, claims production and coding integrity.... ...and denial data to identify root causes. Executes on work plans to correct...Claims- Xeris Pharmaceuticals, Inc. seeks a Senior Business Analyst, Commercial Operations, to lead integrated analytics and predictive insights across the portfolio. You... ...include producing actionable insights from CRM, claims, payer, and finance data; developing analytic frameworks...Claims
- ...Of Essential Duties And Responsibilities Review incident reports and provides analysis/... ...lead to patient harm; Facilitates /Conduct root cause analysis investigation; Conducts chart... ..., Criminal Court; Process all Notice of Claims maintain files electronically and hard...ClaimsFull timeWork at office
- ...providers efficiently dispute underpaid claims, reduce administrative burden, and... ...We're looking for an Optimization Analyst to help with our fast growing team!... ...from Metabase to uncover the real root cause. Lead deep-dive payor reviews: You'll investigate payors to find...ClaimsRemote workFlexible hours
$83.1k - $120.36k
The Senior Analyst, Total Cost of Care, will develop analyses and... ...financial performance and provide analytic insights into all products... ...concise insight into the root cause drivers, and work with the team... ...‑driven analysis to Finance, Claims, Pharmacy, Payment Integrity,...ClaimsContract workTemporary workWork experience placement- ...Incorporated is a leading healthcare management consulting firm in New York that is expanding its analytics team with a strong healthcare data analyst who can dive into claims data and drive actionable insights. The role involves cross-team collaboration, mentoring junior...ClaimsRemote job
$103.2k - $155k
...systems with the industry's first Unified Claims Processing architecture, seamlessly... ...Summary: We are seeking a highly analytical and detail-oriented Analyst to join our growing Analytics team.... .... Participate in quality control reviews and help maintain documentation and...ClaimsFull timeLocal areaFlexible hours$46.99k - $122.4k
...Overview The Senior Analyst will support provider-... ..., ensuring accurate claims processing, issue resolution... ...e.g., IT) and support root cause analysis and... ...experience Perform claim reviews for disputes and... ...healthcare providers Strong analytical and problem-solving...ClaimsHourly payFull timeContract workTemporary workWork experience placementWork at officeLocal area$98.4k - $123k
...industry's first Unified Claims Processing™... ...Summary : The Senior Analyst, Client Experience & Optimization... ...-coordination and analytical skills, to surface... ...Support intake review, issue validation, routing... ...functional inputs to evaluate root causes, identify client-...ClaimsFull timeLocal areaFlexible hours- ...leaders, sophisticated data analytics and research, and policy advocacy... ...datasets.Perform code reviews and quality checks of peer work... ...Proactively investigate, identify root causes, and address data quality... ..., medical and pharmaceutical claims, eligibility, provider, survey...ClaimsVisa sponsorship
- New York Workers' Compensation Report Reviewer / Quality Analyst Job Summary The New York Workers' Compensation Quality Analyst is responsible for... ...‑thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers'...ClaimsTemporary workRemote workWork from home
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