Current jobs related to Provider Network Operations Claims Analyst Sr - Manchester - AmeriHealth Caritas
-
Claims Analyst, APO
7 days ago
Manchester, New Hampshire, United States The RiverStone Group Full timeAbout The RiverStone GroupWe are a dynamic and growing company specializing in the management of legacy and run-off insurance businesses and portfolios. Our team of experts from various disciplines has amassed unrivaled insurance industry and regulatory experience, making us a recognized market leader in the resolution of complex insurance claims.Job Title:...
-
Claims Analyst, APO
2 weeks ago
Manchester, New Hampshire, United States The RiverStone Group Full time{"title": "Claims Analyst, APO", "description": "Transforming the Future of Mass TortsRiverStone is seeking a skilled Claims Analyst to join our dynamic team in Manchester, NH. As a key member of our team, you will play a critical role in shaping the future of mass torts and pollution litigation.About the RoleReview loss notices, confirm policy coverages,...
-
Claims Analyst
2 weeks ago
Manchester, New Hampshire, United States The RiverStone Group Full timeAbout The RiverStone GroupWe are a leading provider of insurance and reinsurance solutions, specializing in the management of legacy and run-off insurance businesses and portfolios. Our team of experts has unrivaled industry experience and regulatory knowledge, enabling us to deliver innovative and effective solutions to complex insurance claims.Job Title:...
-
Lead Claims Analyst, General Liability
4 weeks ago
Manchester, New Hampshire, United States The RiverStone Group Full timeSenior Claims Analyst, General LiabilityFlexible Remote and Hybrid Work Options AvailableAbout Us At The RiverStone Group, we pride ourselves on being a premier third-party claims administrator. Our mission is to deliver exceptional service within the insurance sector, managing a diverse range of claims while providing innovative solutions tailored to our...
-
Senior Claims Specialist
4 weeks ago
Manchester, New Hampshire, United States The RiverStone Group Full timePosition OverviewAs a key member of our team, the Complex Claims Analyst plays a vital role in the evaluation and management of intricate claims. This position is integral to ensuring that our clients receive exceptional service and that claims are handled with the utmost professionalism.About UsThe RiverStone Group is a reputable third-party claims...
-
Complex Claims Coordinator
4 weeks ago
Manchester, New Hampshire, United States The RiverStone Group Full timePosition OverviewAs a vital member of our team, the Complex Claims Analyst will engage in the thorough evaluation of loss notifications, ensuring comprehensive coverage assessment and establishing appropriate reserves. This role is pivotal in investigating and managing claims effectively.Company InsightJoin a forward-thinking organization, a subsidiary of...
-
Senior Liability Claims Consultant
4 weeks ago
Manchester, New Hampshire, United States The RiverStone Group Full timeJob Title Senior D&O Claims Analyst Location Hybrid or Remote Overview As a pivotal member of the Management & Professional Liability team, the Senior D&O Claims Analyst is tasked with the comprehensive management of claims associated with Directors' & Officers' (D&O) liability insurance for Public, Private, and Not-For-Profit entities. This role involves...
-
Manchester, New Hampshire, United States The RiverStone Group Full timeAbout The RiverStone GroupThe RiverStone Group is a leading provider of insurance and reinsurance services, specializing in the management of legacy and run-off insurance businesses and portfolios.Job SummaryWe are seeking a highly skilled Claims Analyst to join our dynamic team, responsible for handling complex claims involving asbestos, pollution, and...
-
Claims Risk Manager
3 weeks ago
Manchester, New Hampshire, United States Genworth Financial Full timeAbout the RoleAs a key member of the Genworth Financial team, you will play a critical role in delivering exceptional customer service and capabilities to our policyholders. As a LTC Adjudication Specialist, you will be responsible for making final determinations on complex adjudication decisions that impact the management of claims risk across our product...
-
Field Claims Representative
6 days ago
Manchester, New Hampshire, United States Cincinnati Insurance Company, Inc. Full timeInsurance Claims Representative Job DescriptionWe are seeking a skilled Insurance Claims Representative to join our team at Cincinnati Insurance Company, Inc. As a Field Claims Representative, you will be responsible for investigating and evaluating multi-line insurance claims, ensuring accurate settlements, and providing exceptional customer service.Key...
-
Field Claims Representative
6 days ago
Manchester, New Hampshire, United States Cincinnati Insurance Company, Inc. Full timeInsurance Claims Representative Job DescriptionWe are seeking a skilled Insurance Claims Representative to join our team at Cincinnati Insurance Company, Inc. As a representative, you will be responsible for investigating and evaluating insurance claims to ensure accurate settlements.Key Responsibilities:Conduct thorough claim investigations to determine the...
-
Senior Insurance Claims Specialist
4 weeks ago
Manchester, New Hampshire, United States The RiverStone Group Full timeSenior Insurance Claims Specialist - General LiabilityRemote and Hybrid Work Options AvailableAbout Us At The RiverStone Group, we pride ourselves on being a premier third-party claims administrator. Our commitment to excellence in the insurance sector allows us to manage a diverse range of claims while delivering innovative solutions tailored to our...
-
Board Certified Behavior Analyst
4 weeks ago
Manchester, United States Eastern Connecticut Health Network Full timePOSITION SUMMARY:This position reports to the Director of Education or to the Education Specialist. Provides behavioral, social-emotional, and academic support for students through the training of certified and non-certified staff, program design through the directive of the IEP and PPT process and with the collaboration of students’ teams and through...
-
Board Certified Behavior Analyst
4 weeks ago
Manchester, United States Eastern Connecticut Health Network Full timePOSITION SUMMARY:This position reports to the Director of Education or to the Education Specialist. Provides behavioral, social-emotional, and academic support for students through the training of certified and non-certified staff, program design through the directive of the IEP and PPT process and with the collaboration of students’ teams and through...
-
Field Claims Representative
1 week ago
Manchester, New Hampshire, United States Cincinnati Insurance Company, Inc. Full timeInsurance Claims Representative Job DescriptionWe are seeking a skilled Insurance Claims Representative to join our team at Cincinnati Insurance Company, Inc. As a Field Claims Representative, you will be responsible for investigating and evaluating multi-line insurance claims, providing exceptional customer service, and working collaboratively with our...
-
Field Claims Representative
1 week ago
Manchester, New Hampshire, United States Cincinnati Insurance Company, Inc. Full timeInsurance Claims Representative Job DescriptionWe are seeking a skilled Insurance Claims Representative to join our team at Cincinnati Insurance Company, Inc. As a Field Claims Representative, you will be responsible for investigating and evaluating multi-line insurance claims, providing exceptional customer service, and working collaboratively with our...
-
Field Claims Representative
1 week ago
Manchester, New Hampshire, United States Cincinnati Insurance Company, Inc. Full timeInsurance Claims Representative Job DescriptionWe are seeking a skilled Insurance Claims Representative to join our team at Cincinnati Insurance Company, Inc. As a Field Claims Representative, you will be responsible for investigating and evaluating multi-line insurance claims, providing exceptional customer service, and working collaboratively with our...
-
Field Claims Representative
1 week ago
Manchester, New Hampshire, United States Cincinnati Insurance Company, Inc. Full timeInsurance Claims Representative Job DescriptionWe are seeking a skilled Insurance Claims Representative to join our team at Cincinnati Insurance Company, Inc. As a Field Claims Representative, you will be responsible for investigating and evaluating multi-line insurance claims, providing exceptional customer service, and working collaboratively with our...
-
Senior Financial Analyst
4 weeks ago
Manchester, New Hampshire, United States Hubbell Full timePosition OverviewThe Financial Analyst III at Hubbell plays a crucial role within the finance department, providing support across multiple sites in the Burndy US division.This position reports directly to the Business Unit Controller and collaborates frequently with senior finance personnel, including the Sr. Financial Analyst and Cost Accountant.Key...
-
Network Manager
3 days ago
Manchester, New Hampshire, United States Aurora Ventures Full timeNetwork ManagerAurora Ventures is seeking a highly skilled Network Manager to join our team in Hampshire. As a key member of our organization, you will be responsible for the organizational management of the Stellwerk18 network, focusing on startup ecosystem and network activities in accordance with funding and association regulations.Key...
Provider Network Operations Claims Analyst Sr
3 months ago
**Provider Network Operations Claims Analyst Sr (hybrid)**
Location: Manchester, NH
Primary Job Function: Provider Network
ID**: 34151
**Job Brief**
The Provider Network Operations Data Analyst Sr. will be responsible for supporting Provider Enrollment and Credentialing.
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
The Provider Network Operations Data Analyst Senior supports the business goals and initiatives of the Provider Network Operations department. This role is responsible for:
+ UAT/Client Review & audit (fee schedule concentration) reviews requests prior to initial submission to EO and claims post-production
+ Capitation reconciliations building queries, comparing membership; engaging with Finance, PNM, etc.
+ Internal business report development; engagement with regulatory reporting
+ BAM/claim reporting submission and analysis, depending on complexity
+ Administrative responsibilities:
+ Performs other duties and projects as assigned
+ Adheres to Plan policies and procedures
+ Attends required training sessions on an annual basis.
**Education/ Experience:**
+ Bachelors Degree or equivalent work experience
+ 3 to 5 years Data modeling, relational databases and advanced analytics support required. Experience in healthcare industry preferred
+ 3 to 5 years exp. With data modeling, relational databases and advanced analytics support required.
+ Experience with Medicaid preferred.
+ Experience with Microsoft Excel.
+ Managed Care experience required.
#HM
**Diversity, Equity, and Inclusion**
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
**Our Comprehensive Benefits Package**
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
EOE Minorities/Females/Protected Veterans/Disabled
