Claims Analyst

5 days ago


San Antonio, United States University Health Full time

POSITION SUMMARY/RESPONSIBILITIES
Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff in complex claim issue resolution. Work cooperatively with Configuration in testing of contracts used in business operations and reporting to assure auto adjudication. Perform in accordance with company standards and policies. Promote harmonious relationships within own department, with other departments and within CFHP. Operate under limited supervision.

EDUCATION/EXPERIENCE
High school diploma or GED equivalent is required. Five years HMO/PPO claims experience required. Amisys claims processing system experience preferred. Knowledgeable of all benefit programs offered by the CFHP, Medicaid, HMO, PPO, ASO.



  • San Antonio, Texas, United States Diverse Lynx Full time

    Job Title: Business AnalystLocation: Remote OpportunityJob Type: Contract RoleJob Description: We are seeking a highly skilled Business Analyst with expertise in P&C Claims systems. The ideal candidate will have a deep understanding of Guidewire Claims Center and be able to analyze business processes to identify areas for improvement. The successful...

  • Claims Analyst

    4 weeks ago


    San Antonio, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff on complex claim issue resolutions. Work cooperatively with configuration...

  • Claims Analyst

    6 days ago


    San Antonio, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff on complex claim issue resolutions. Work cooperatively with configuration...

  • Claims Analyst

    2 months ago


    San Diego, United States KellyMitchell Group Full time

    $21.00 - $30.00 (est. hourly)Job Summary:Our client is seeking a Claims Analyst to join their team! This position is located in San Diego, California.Duties:Investigate and analyze recovery/subrogation and liability/property damage claims filed by or against the companyAdjust and settle claims as appropriateGather evidence for hearings, trials, and other...

  • Claims Analyst

    4 weeks ago


    San Antonio, TX, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff on complex claim issue resolutions. Work cooperatively with configuration...

  • Senior Claims Analyst

    4 weeks ago


    San Antonio, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES Acts as Claims Department resource to coordinate, analyze and improve departmental performance. Identifies areas for improvement, documents business processes, researches best practices, compiles information and assists process owners to implement change and monitor performance. Responsible for providing project...


  • San Antonio, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES Acts as Claims Department resource to coordinate, analyze and improve departmental performance. Identifies areas for improvement, documents business processes, researches best practices, compiles information and assists process owners to implement change and monitor performance. Responsible for providing project...

  • Claims Analyst

    3 days ago


    San Antonio, TX, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff in complex claim issue resolution. Work cooperatively with Configuration...

  • Claims Analyst

    2 days ago


    San Antonio, TX, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES Analyze complex problems pertaining to claim payments, eligibility, other insurance, transplants and system issues that are beyond the scope of claim examiners and senior claim examiners that affect claims payment. Act as consultant to claims staff on complex claim issue resolutions. Work cooperatively with configuration...

  • Claims Examiner

    4 weeks ago


    San Diego, California, United States TPS Group LLC Full time

    Claims Analyst OpportunityTPS Group LLC is seeking a skilled Claims Analyst to support their public utilities and energy client. The ideal candidate will have experience in claims investigation, liability analysis, and case management.Key Responsibilities:Investigate and analyze recovery/subrogation and/or liability and property damage claims.Adjust and...


  • San Antonio, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES The Senior Information Systems (IS) Business Analyst will have enterprise-level experience supporting IS application development teams and mapping of claims and clinical data. The Senior IS Business Analyst will be seen as a change leader across Community First, lead, and provide guidance to Health Care Analysts. This...

  • Claims analyst

    3 weeks ago


    san diego, United States Insight Global Full time

    Must-haves:Bachelor’s Degree3+ years experience Expert level in Excel – ability to create Pivot Tables, Vlookups, HlookupsMedicare/Medicaid experience Plusses:Experience with Epic SystemsExperience with EDI834Experience with Power BI Job Description:A large Healthcare company is seeking a Technical Data Analyst to join their team. They will be...

  • Claims analyst

    3 weeks ago


    San Diego, United States Insight Global Full time

    Must-haves:Bachelor’s Degree3+ years experience Expert level in Excel – ability to create Pivot Tables, Vlookups, HlookupsMedicare/Medicaid experience Plusses:Experience with Epic SystemsExperience with EDI834Experience with Power BI Job Description:A large Healthcare company is seeking a Technical Data Analyst to join their team. They will be...

  • Claims analyst

    3 weeks ago


    san diego, United States Insight Global Full time

    Must-haves:Bachelor’s Degree3+ years experience Expert level in Excel – ability to create Pivot Tables, Vlookups, HlookupsMedicare/Medicaid experience Plusses:Experience with Epic SystemsExperience with EDI834Experience with Power BI Job Description:A large Healthcare company is seeking a Technical Data Analyst to join their team. They will be...


  • San Antonio, TX, United States University Health Full time

    POSITION SUMMARY/RESPONSIBILITIES The Senior Information Systems (IS) Business Analyst will have enterprise-level experience supporting IS application development teams and mapping of claims and clinical data. The Senior IS Business Analyst will be seen as a change leader across Community First, lead, and provide guidance to Health Care Analysts. This...


  • San Antonio, United States Jobot Full time

    Job DescriptionJob DescriptionHypergrowth Healthcare Company, Top Pay, Full Benefits, Incredible TEAM & CULTURE!This Jobot Job is hosted by: Courtney LabonteAre you a fit? Easy Apply now by clicking the "Apply Now" buttonand sending us your resume.Salary: $65,000 - $65,000 per yearA bit about us:We are a new, dynamic, private equity backed healthcare...

  • Business Analyst

    2 days ago


    San Diego, United States K2 Claims Services, LLC Full time

    Job DescriptionJob DescriptionBusiness AnalystFull TimeSan Diego, CA, USSalary Range: $115,000 To $135,000 AnnuallyBusiness Analyst – K2 Insurance ServicesK2 Insurance Services, LLC seeks a full-time Business Analyst who will play a key role in bridging the gap between business needs and technical execution. Working closely with insurance business leaders...

  • Business Analyst

    4 weeks ago


    San Ramon, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are offering a long term contract employment opportunity for a Business Analyst in the heart of San Ramon, California. As a Business Analyst, you will be primarily involved in bridging the gap between IT and the business using data analytics to assess processes, determine requirements and deliver data-driven recommendations...

  • Business Analyst

    4 weeks ago


    San Ramon, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are offering a long term contract employment opportunity for a Business Analyst in San Ramon, California. The successful candidate will have the opportunity to work in an exciting environment, focusing on analyzing our business processes and functions. Responsibilities:• Analyzing and interpreting data using Microsoft Excel...


  • San Francisco, United States San Francisco Health Plan Full time

    Reporting to the Supervisor of Quality Assurance, the Quality Assurance Analyst performs intermediate and advanced level daily quality assurance reviews to ensure and report on the accuracy of claims processing end-to-end and other important business processes.Please note that while SFHP supports a hybrid work environment, you are required to be onsite and...