Data analyst [h1.location_city]
[job_alerts.create_a_job]
Data analyst • springfield ma
[last_updated.last_updated_variable_hours]
We are seeking a Claims Compliance Analyst to join our client’s team! This is a fully remote position with a great company offering fantastic benefits.
The Claims Compliance Analyst is respons...[show_more][last_updated.last_updated_variable_days]
Join a team focused on the success of our customers, the success of our communities, and the success of each other.Farm Credit East (FCE) is the leading provider of loans and farm advisory services...[show_more][last_updated.last_updated_1_day]
Part-time Research Study Personnel (Pay up to $790 / wk.Due to demand, we are now accepting applications for personnel to participate in our local in-person and nationwide remote research studies.Thi...[show_more][last_updated.last_updated_variable_days]
Does this sound like you? If so, we'd love to talk!.See why joining our team could be the perfect fit for you : .BCI is hiring a full-time Board Certified Behavior Analyst Specialist (BCBA) to join t...[show_more][last_updated.last_updated_1_day]
Advance your career with Mindlance!.We have been connecting talented IT professionals with world-class companies since 1999.
Mindlance is here to help you to find the perfect fit with just the right...[show_more][last_updated.last_updated_variable_days]
About Baltimore City Community College.Founded in 1947, Baltimore City Community College (BCCC) is comprehensive, urban institution accredited by the Middle States Commission on Higher Education.Th...[show_more][last_updated.last_updated_variable_days]
Director of Diversity, Equity, and Inclusion (ODEI), the Diversity, Equity, and Inclusion Data Analyst will have the principal responsibility for collecting, extracting, managing, reporting, and an...[show_more][last_updated.last_updated_30]
These positions are available throughout various USMS Districts in the Continental US (CONUS).The selectee of this position serves as an Investigative Analyst.
You will be responsible for collecting...[show_more][last_updated.last_updated_variable_days]
Integrated Business Planning Analyst.OMG Building Products LLC is a leading manufacturer of fastening products and technologies for the commercial roofing and construction industries worldwide.Head...[show_more][last_updated.last_updated_variable_days]
We are currently seeking an enthusiastic, experienced, full-time.Vaupell designs, engineers, and produces custom, high performance engineered plastic and composite components and assemblies for dem...[show_more][last_updated.last_updated_variable_days]
Imagen Technologies is building the AI-enabled teleradiology practice of the future.We operate the first vertically integrated medical practice and AI development platform focused on reducing diagn...[show_more][last_updated.last_updated_variable_days]
As a Business Systems Analyst within the Business Data Strategy & Business Technology (BDSBT) team, you will play a pivotal role in enabling governed, actionable insights that improve...[show_more][last_updated.last_updated_variable_days]
Exciting Opportunity for Licensed Applied Behavior Analysts in Western Massachusetts!!!.Creative Interventions (CI) is committed to a work environment that nurtures our employees’ best qualit...[show_more][last_updated.last_updated_30]
Exciting Opportunity for Licensed Applied Behavior Analysts in Western Massachusetts!!!.Creative Interventions (CI) is committed to a work environment that nurtures our employees' best qualities to...[show_more][last_updated.last_updated_variable_hours]
Behavioral Health Network (BHN) is the largest provider of behavioral health services in Western Massachusetts and was recently recognized by.
The Boston Globe as the 10th best employer in Massachus...[show_more][last_updated.last_updated_1_day]
The Massachusetts Municipal Wholesale Electric Company (MMWEC) is the backbone of Massachusetts’ municipal utilities — empowering local communities with reliable, affordable, and increasingly innov...[show_more][last_updated.last_updated_variable_days]
Maroc et en France, depuis la réflexion stratégique jusqu'à l’exécution technologique et opérationnelle, en faisant appel aux expertises de tous ses experts.
Un Investissement dans le bien être.La g...[show_more][last_updated.last_updated_30]
THIS POSITION REQUIRES AN ENLISTMENT IN THE U.As an Intelligence Analyst, you’ll be responsible for providing the Army with crucial and reliable information about enemy forces and potential areas o...[show_more][last_updated.last_updated_variable_days]
By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected.
We invite you to grow your c...[show_more][last_updated.last_updated_1_day]
- [promoted]
Claims Compliance Analyst
The MH GroupEast Longmeadow, MA, US[job_card.full_time]
- [promoted]
Quantitative Risk Analyst
Farm Credit EastEnfield, CT, United States[job_card.full_time] +1
- [promoted]
Flexible Remote Data Analyst (Hiring Immediately)
Maxion ResearchChicopee, Massachusetts, US[filters.remote]
[job_card.full_time] +1
- [promoted]
Behavior Analyst Specialist
Behavioral ConceptsChicopee, MA, United States[job_card.full_time] +1
- [promoted]
Business Analyst
MindlanceSpringfield, Massachusetts, United States[job_card.full_time]
- [promoted]
Senior Budget Analyst
Baltimore City Community CollegeSpringfield, MA, United States[job_card.full_time] +1
Diversity Equity Inclusion Data Analyst
Baystate HealthHolyoke, Massachusetts[job_card.full_time]
- [promoted]
Investigative Analyst
US Government JobsSpringfield, MA, US[job_card.full_time]
- [promoted]
IBP Forecasting Analyst
Steel Partners HoldingsFeeding Hills, MA, US[job_card.full_time]
Accounting Analyst
VAUPELL INDUSTRIALSpringfield, MA, US[job_card.full_time] +1
Clinical Operations Analyst
Imagen TechnologiesSpringfield, MA, United States[job_card.full_time]
- [promoted]
Business Systems Analyst
MassMutualSpringfield, MA, US[job_card.full_time]
Behavior Analyst
Creative Interventions LLCFeeding Hills, MA, US[job_card.full_time]
- [promoted]
- [new]
Behavior Analyst
Creative InterventionsFeeding Hills, MA, United States[job_card.full_time]
- [promoted]
Behavior Analyst
Behavioral Health NetworkSpringfield, MA, United States[job_card.full_time]
- [promoted]
Lead Commodities Analyst
Massachusetts Municipal WholesaleLudlow, MA, United States[job_card.full_time]
Data Analyst
Altados TousAutre ville, MA[job_card.full_time]
- [promoted]
INTELLIGENCE ANALYST
US ArmySpringfield, MA, United States[job_card.full_time] +1
- [promoted]
Pricing Analyst
Massachusetts StaffingSpringfield, MA, US[job_card.full_time]
Claims Compliance Analyst
The MH GroupEast Longmeadow, MA, US[job_card.variable_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]A minimum of 5 years of experience in health insurance claim processing is required . Capacity to plan, carry out, and document compliance self-monitoring initiatives. Ability to comprehend complex laws / regulations. Ability to assess, prioritize, and communicate claims risk. Ability to understand complex problems, identify root causes, and remain goal-oriented. Strong analytical skills, with the ability to effectively identify, communicate, and address potential issues. Strong written / verbal communication, interpersonal, and presentation skills. Ability to work in a fast-paced environment, prioritize multiple assignments simultaneously, think quickly, meet deadlines, and adapt to various situations. Ability to work independently, with peers, and with departments in business areas at all levels of the organization.
Job Description
Job Description
Description :
We are seeking a Claims Compliance Analyst to join our client’s team! This is a fully remote position with a great company offering fantastic benefits. The Claims Compliance Analyst is responsible for maintaining a deep knowledge of the claim processes, can process claims, and is expected to comply with internal company policies and procedures. The ideal candidate is responsible for the entire claims process from beginning to end and the implementation, auditing, and execution of compliance activities regarding claims. The Claims Compliance Analyst will work collaboratively with different departments to assess compliance risks, controls, and implement new regulations that affect the claims team. In this role, you will…
- Navigate different claims systems.
- Work within systems like RegEd to review assigned tasks and implement new laws, rules, and regulations.
- Work cross-departmentally to understand and implement new and / or existing regulations utilizing systems such as RegEd.
- Maintain an in-depth understanding of the claim adjudication process.
- Process claims by all regulations in a timely and accurate manner, including analyzing the submitted medical treatment and investigating the coverage terms.
- Maintain a strong understanding of state and federal health insurance regulations and mandates.
- Strong knowledge of products / systems, and a subject matter expert (SME).
- Create, carry out, and audit compliance items linked to claims, including risk assessment, testing, and monitoring of important laws & regulations, rules & processes, help with exam preparation, issue reporting & escalation, training materials, and remedial measures.
- Assist in market conduct exams by reviewing claim-related tasks.
- Create and implement procedures for regulatory items impacting claims that require special handling.
- Regularly partake in compliance-related meetings.
- Review all claim-related compliance reports to ensure accuracy.
- Scrub pay-related reports to accurately determine the clean claim date and proper penalties / interest.
- Handle claim adjustments related to regulatory requirements.
- Perform other duties as assigned.
Requirements :
Our ideal candidate will have…