Current jobs related to Claims Data Operations Analyst - Mason - Bernard Nickels & Associates
-
Claims Testing Analyst in Mason OH
2 months ago
Mason, United States Syntricate Technologies Full timeJob Title - Claims Testing Analyst Location - Mason OH - Hybrid - 2x a week Duration - 4+ months Claims Testing Analyst Work hours: 7 to 3:30 or 8 to 4:30 pm Start date: 09/15/2024 Length of assignment: 1/30/2025 Specific Skills Needed: Top 3-5 mandatory and/or minimum requirements • Experience in Claims or Data processing / testing. • Intermediate...
-
Data Analyst
4 weeks ago
Mason, Ohio, United States Cynet Systems Full timeJob Description:Overview:Cynet Systems is seeking a skilled Data Analyst to join our team. As a key member of our Business Configuration production team, you will be responsible for configuring all types of managed vision care products in our system. This role requires strong analytical and problem-solving skills, as well as the ability to work independently...
-
Claims Testing
1 month ago
Mason, United States Global Channel Management, Inc Full timeClaims testing needs 2 years experience Claims testing requires: Hybrid 2x week Facets Oracle SQL Business objects EDW SAP Claims testing Claims processing Data processing Claims testing duties: Liaison to the Senior Analysts and Manager of the Claims Testing team to identify claims processing discrepancies due to system setup issues that require...
-
Claims Testing
2 months ago
Mason, United States Global Channel Management, Inc Full timeClaims testing needs 2 years experience Claims testing requires: Hybrid 2x week Facets Oracle SQL Business objects EDW SAP Claims testing Claims processing Data processing Claims testing duties: Liaison to the Senior Analysts and Manager of the Claims Testing team to identify claims processing discrepancies due to system setup issues that require...
-
Senior Data Analyst
4 weeks ago
Mason, Ohio, United States Russell Tobin Full timeJob Title: Sr. Data AnalystJob Summary:Russell Tobin is seeking a skilled Sr. Data Analyst to join our Business Configuration Solutions team. As a key member of our team, you will be responsible for enabling member benefit configuration strategies by designing, implementing, and executing Configuration.Key Responsibilities:• Lead projects for the...
-
Senior Data Analyst
1 month ago
Mason, United States Russell Tobin Full timeJob Title: Sr. Data Analyst Duration: 4 months (potential extension)Location: HYBRID - 2-3x a week in Mason OHPay Rate: $40/hr -$45/hr (DOE)Required levels/ Years of Experience Education• Bachelor’s degree or equivalent work experienceServe as a Sr. Data Analyst on the Business Configuration Solutions team. Responsible for the enablement of member...
-
Pharmacy Claims Business Analyst III
4 weeks ago
Mason, Ohio, United States Elevance Health Full timeJob Summary:The Business Analyst III will serve as the liaison between the business and IT, translating complex business needs into application software. This role is responsible for understanding the Pharmacy benefit setup and validating the configuration using test claims/query testing.Key Responsibilities:Validate Formulary, Utilization Management & Drug...
-
Senior Configuration Data Specialist
1 month ago
Mason, United States Global Channel Management Full timeAbout the Role:Sr. Configuration Data Analyst is a critical position within Global Channel Management, requiring a seasoned professional with expertise in health plans and medical claims. The ideal candidate will have a minimum of 5 years of experience in this field, with a strong background in claims processing, medical plan benefit configuration, and SQL...
-
Business Analyst III
4 weeks ago
Mason, Ohio, United States Elevance Health Full timeAbout the Role:The Business Analyst III - Pharmacy Claims/Query Testing Specialist will serve as the liaison between the business and IT in translating complex business needs into application software. This role is responsible for understanding the Pharmacy benefit setup and validating the configuration using test claims/query testing.Key...
-
Data Analyst Position
4 weeks ago
Mason, Ohio, United States Insight Global Full timeJob Summary: Insight Global is seeking a skilled Data Analyst to support their operations team in Mason, OH.Main Responsibilities:Monitor requests (plan design) and translate them into a large Excel template.Run the template through a proprietary system to create the product.Ensure information accuracy and match the proposal.Responsible for product...
-
Claims Processor
2 weeks ago
Mason, United States Cynet Systems Full timeJob Description: Pay Range: $13hr $18hr Responsibilities: Processing - Efficiently and accurately processes standard claims or adjustments. Consistently achieves key internals with respect to production, cycle time, and quality. May participate on non-complex special claims projects initiatives, including network efforts. Understands and quickly...
-
Claims Processor
2 weeks ago
Mason, United States Cynet Systems Full timeJob Description: Pay Range: $13hr $18hr Responsibilities: Processing - Efficiently and accurately processes standard claims or adjustments. Consistently achieves key internals with respect to production, cycle time, and quality. May participate on non-complex special claims projects initiatives, including network efforts. Understands and quickly...
-
Claims Processor
2 weeks ago
Mason, United States Global Channel Management Full timeClaims Processor needs 1 years' claims processing/data entry experience. Claims Processor requires: •Data entry and claims processing knowledge •working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet •Some basic working knowledge of software programs, specifically Excel and Access •Understands...
-
Claims Processor
3 weeks ago
Mason, United States Global Channel Management Full timeClaims Processor needs 1 years' claims processing/data entry experience. Claims Processor requires: •Data entry and claims processing knowledge •working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet •Some basic working knowledge of software programs, specifically Excel and Access •Understands...
-
Medical Claims Processor
1 week ago
Mason, United States Belcan Full timeGENERAL FUNCTION: Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication.MAJOR DUTIES & RESPONSIBILITIES:* Processing - Efficiently and accurately processes standard claims or...
-
Claims Processor
3 weeks ago
Mason, United States Global Channel Management Full timeClaims Processor requires: Data entry and claims processing knowledge working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet Some basic working knowledge of software programs, specifically Excel and Access Understands third party benefits and administration Claims Processor duties: Efficiently and...
-
Insurance Claims Processor
4 weeks ago
Mason, Ohio, United States Global Channel Management Full timeAbout the JobGlobal Channel Management is seeking an Insurance Claims Processor to join our team. As an Insurance Claims Processor, you will be responsible for researching and applying insurance payments from clients to the appropriate system invoice.Key ResponsibilitiesResearch insurance claim payments in the AS/400 to identify correct claim based on...
-
Claims Testing Specialist
4 weeks ago
Mason, Ohio, United States Syntricate Technologies Full timeJob Summary:As a Claims Testing Specialist at Syntricate Technologies, you will be responsible for validating base data in the test environment to ensure setup is complete prior to testing efforts. This role requires strong analytical skills and the ability to work cross-functionally to identify claims processing discrepancies due to system setup issues.Key...
-
Senior Data Analyst
1 month ago
Mason, United States Axelon Full timeAbout the Role:As a Senior Data Analyst at Axelon, you will be responsible for extracting and analyzing information from large structured and unstructured datasets using data mining, data modeling, natural language processing, and machine learning techniques. You will work closely with the team to visualize, interpret, and report data findings, and create...
-
Data Analyst III
4 weeks ago
Mason, Ohio, United States Golden Technology Full timeAt Golden Technology, we're seeking a highly skilled Data Analyst III to drive business growth through data-driven insights.The ideal candidate will possess a strong background in data analysis, with expertise in statistical modeling, data visualization, and business intelligence. Key responsibilities include:Developing and implementing data collection...
Claims Data Operations Analyst
1 month ago
Start Date: ASAP
Duration: 6 Months (with potential for extension)
Location: Mason, OH (HYBRID; in-office 2 to 3 days per week)
Schedule: Monday-Friday, 8am to 5pm EST (8 work hours per day, 40 work hours per week).
Pay Range: $38 to $44 per hour
GENERAL FUNCTION:
The Claims Data Operations Analyst will serve as an Analyst on the Business Configuration team, responsible for the structure and benefit plan set up for managed vision care clients. Provide subject matter expertise for product configuration in the Facets system.
RESPONSIBILITIES:
• Responsible for configuring all types of managed vision care products in the system (using both the Product Key Sheet method and manual configuration)
• Responsible for product configuration accuracy utilizing the configuration tools for manual and automated product creation.
• Write SQL queries and export from database to analyze and troubleshoot configuration issues, as well as perform issue resolution of requests.
• Perform and resolve product configuration questions/issues sent to the Business Configuration production team without guidance.
• Maintain relationships with Implementation Managers, Account Managers, and develop a cohesive cross functional, results driven working environment.
• Self-manage completion of work inventory in the production queues within established quality and turnaround time service levels.
• Coordinate and participate in cross-functional team activities for issue resolution.
• Coordinate and participate in cross-functional team activities for issue resolution.
• Recommend process and system enhancements to drive improvements.
• Support the management team with on-going training activities, misc. projects, resolving issues, and serving as a subject matter expert for all Configuration requests.
BASIC QUALIFICATIONS:
• Associate's degree OR equivalent experience required.
• 5+ years of experience working within a core claims administration system.
• Good analytical and problem-solving skills.
• 2+ years of experience writing SQL queries and exporting data from database tables into Excel for analysis.
• Good communication and interpersonal skills.
• Ability to work independently or as a part of a team.
• Ability to manage multiple complex assignments at once.
PREFERRED QUALIFICATIONS:
• 3+ years of experience in Operations in the Healthcare industry.
• Experience understanding claims adjudication for member and provider reimbursements.
• Experience with Facets platform using Claims, Provider, Network, Product Benefit Configuration.
• Knowledge of Medicare and Medicaid programs.
