Top 4210 Claim Process Analyst Jobs

Reimbursement Analyst
ProCare Rx —Gainesville, GA
- Writing skills
- Mid-level
- Finance
- Wellness program
- Paid holidays
Quick Apply
Insurance Analyst – Riskonnect Implementation Support (Remote)
Motus Recruiting and Staffing —Houston, TX
- $70 - $80 an hour
- Full-time
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- Dental insurance
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11d
Revenue Cycle Analyst
Omada Health —Remote
- $79,200 - $103,500 a year
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- HIPAA
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Pharmacy Reporting Analyst
WellDyne —Remote
- Remote
- Bachelor of Science
- Mid-level
- Office
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Remote Automotive Claims Analyst
Dealer Owned Warranty Company —Remote
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- Full-time
- Spanish
- English
- Mid-level
- Health insurance
- Dental insurance
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13d
Healthcare Claims Quality Analyst
Integra Partners —Remote
- $24 an hour
- Full-time
- Remote
- Spanish
- English
- Mid-level
- Paid parental leave
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Medical Billing Specialist - In Person
Ortho Montana —Billings, MT
- From $18 an hour
- Full-time
- Background check
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- Office
- Health savings account
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Payroll Analyst
The State Group —Louisville, KY
- Full-time
- Mid-level
- Office
- Finance
- Health insurance
- Dental insurance
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Supply Chain Manager
Amphenol DC Electronics —San Jose, CA
- $100,000 - $150,000 a year
- Full-time
- ERP systems
- Bachelor's degree
- Travel
- Health savings account
- Health insurance
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Hospital Revenue Recovery Analyst, Level 1
Audley Revenue Solutions, LLC —Pittsburgh, PA
- $55,000 - $62,000 a year
- Full-time
- Microsoft PowerPoint
- Microsoft Word
- Background check
- Free parking
- Health insurance
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Marketing Business Analyst
Wellborn Cabinet, Inc. —Ashland, AL
- From $44,513.70 a year
- Full-time
- Background check
- Microsoft Excel
- Mid-level
- Health savings account
- Health insurance
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Customer Service Process & VOC Analyst / Customer Experience Process Optimization Specialist/Supervi
Speed Express —Montebello, CA
- $60,000 - $90,000 a year
- Full-time
- Writing skills
- English
- Mid-level
- Health insurance
- 401(k)
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6d
Claims Adjudication Analyst - AI Trainer
DataAnnotation —Pittsburgh, PA
- From $20 an hour
- Overtime
- Remote
- Medicine
- Writing skills
- English
Quick Apply
Human Resources Business Analyst III
Benton County Oregon —Corvallis, OR
- $74,085.86 - $109,107.65 a year
- Online Application
- Office
- Bachelor's degree
- Driving
- Wellness program
- Health savings account
Director - Pharmacy Network Contracting & Public Payer Relations
Hemophilia Alliance —Remote
- $130,000 - $170,000 a year
- Full-time
- Background check
- Up to 50% travel
- 5 years
- Health savings account
- Health insurance
Quick Apply
9d
Quality Engineer/Data Analyst
ESTIS MANAGEMENT LLC —Midland, TX
- 5 years
- Bachelor of Science
- Engineering
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HRIS Analyst
RideNow Powersports —Chandler, AZ
- $58,000 - $66,000 a year
- Full-time
- Mid-level
- Office
- US work authorization
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5d
Senior HEDIS Analyst/ Technical Lead - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)
Denver Health —Denver, CO
- $91,000 - $141,000 a year
- Full-time
- Hybrid work
- Computer science
- Computer Science
- Pass drug screening
- Paid parental leave
- Paid holidays
Assistant Medical Director
Medical Mutual of Ohio —Ohio
- Remote
- Medicine
- 5 years
- Word processing
- Health savings account
- Disability insurance
Human Resources and Documentation Analyst
Vista Paint Corporation —Fullerton, CA
- $20 - $23 an hour
- Full-time
- Mid-level
- Office
- Administrative experience
- Health savings account
- Health insurance
Quick Apply
9d

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Reimbursement Analyst

ProCare Rx -
Gainesville, GA

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Job Details

Benefits

Wellness program
Paid holidays
Disability insurance
Health insurance
Dental insurance
Employee assistance program
Vision insurance
401(k) matching
Life insurance
Referral program

Qualifications

Appeals
Contract documentation review
Contract review
Economics
Health data analysis
Legal analysis
Finance
SAS
Bachelor's degree in finance
Spreadsheets
Writing skills
Data quality assurance
Contract performance monitoring
Bachelor's degree in economics
Mid-level
State healthcare regulations
Contract management experience in healthcare
Trend analysis
Finance
SQL
Analysis skills
Bachelor's degree
Pricing analysis experience within healthcare industry
Data-driven problem-solving
Profitability analysis
Contract management support tasks
Query management
Business
Financial data analysis tools
Health economics data analysis

Full Job Description

PRINCIPLE RESPONSIBILITIES (include but are not limited to):

Analyze pharmacy claims data utilization to identify financial trends, opportunities, and potential risks, including changes to profit margins.
Work with Pharmacy Network to identify new contract requirements and methods to validate set up in the system.
Perform scheduled review and quality assurance of reimbursement in the system.
Assist the legal team by monitoring, understanding, and acting on state MAC laws.
Monitor and maintain contractual Generic Effective Rate agreements.
Assist with implementation of new MAC tables for new clients.
Assist with MAC review appeals from pharmacies & clients.
Communicate MAC prices of new drugs with other team members.

REQUIREMENTS

Bachelor’s degree in Finance, Economics or other business-related field, or 4+ years of financial or pricing analysis experience in PBM or Healthcare related field preferred.
Demonstrate expanded understanding of advanced Excel functionality preferred.
Aptitude to learn or demonstrated understanding of databases and query languages (e.g., SQL, DBF, Access, SAS, etc.) preferred.
Ability to effectively communicate, verbally and in writing, potentially technical information to a non-technical audience preferred.
Ability to work independently and in a fast-paced environment preferred.
Strong analytical and problem-solving skills preferred.

PHYSICAL DEMANDS

Requires sitting, standing, and occasional light lifting.

The Perks of Joining Our Team:

We believe in taking care of our team. You'll enjoy a comprehensive benefits package designed to support your well-being and financial future:

Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
Time to Recharge: Paid vacation and holiday pay.
Focus on Your Wellness: We offer a robust Employee Wellness Program.
Invest in Your Future: 401 k with a company match.
Support System: Employee Assistance Program provides confidential support and counseling.
Get Rewarded for Referring Great People: Employee referral program.

ProCare Rx will never ask for a financial commitment from an applicant, as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our official recruitment team at [email protected] (mailto:[email protected]).

ProCare Rx is an Equal Opportunity Employer.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

Claim Process Analyst jobs

Reimbursement Analyst

Insurance Analyst – Riskonnect Implementation Support (Remote)

Revenue Cycle Analyst

Pharmacy Reporting Analyst

Remote Automotive Claims Analyst

Healthcare Claims Quality Analyst

Medical Billing Specialist - In Person

Payroll Analyst

Supply Chain Manager

Hospital Revenue Recovery Analyst, Level 1

Marketing Business Analyst

Customer Service Process & VOC Analyst / Customer Experience Process Optimization Specialist/Supervi

Claims Adjudication Analyst - AI Trainer

Human Resources Business Analyst III

Director - Pharmacy Network Contracting & Public Payer Relations

Quality Engineer/Data Analyst

HRIS Analyst

Senior HEDIS Analyst/ Technical Lead - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Assistant Medical Director

Human Resources and Documentation Analyst

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