RTR Analyst at Cargill responsible for financial data processes and ensuring compliance with standards. Collaborating with businesses to support operational procedures and enhance data management.
About the role
- Senior Clinical Analyst at SmartLight Analytics combining clinical data expertise with relationship management. Analyzing healthcare data to identify improper payments and driving resolutions through insights.
Responsibilities
- Possess a clear understanding of the identification and investigation of issues and billing activities leading to improper payments
- Review medical records and compare to claims data to review for billing accuracy and savings opportunities
- Utilize information from claims data analysis, plan representatives and other sources to accurately present the company’s findings to carriers
- Identify, analyze, and interpret trends or patterns in complex data sets
- Leverage available resources and systems (both internal and external) to analyze claim information and take appropriate action for payment resolution
- Perform review of claims resulting from overpayments related to benefits and policies
- Communicate and document findings, including trends and recommendations
- Ability to review and analyze medical records.
Requirements
- Bachelor's degree in healthcare or related field, preferred
- At least one of: RN, CPC, CCS or other relevant clinical/coding certifications required
- Minimum of 5 years of work experience in healthcare administration, billing, claims adjudication, clinical auditing, payment integrity operations and/or healthcare reimbursement
- Strong knowledge of clinical terminology, medical procedures, and healthcare workflows
- Ability to be concise, independent and provide defensible decisions in writing
- Detail-oriented with excellent communication skills (oral presentations and written) and interpersonal skills
- Experience in commercial payer environments
- Strong critical-thinking, communication and attention to detail skills
Benefits
- Health insurance
- 401(k) matching
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
Quick Response Analyst resolving client requests and triaging tickets for Thriveon. Working in a hybrid remote and office setup in Minnesota serves.
Trading Analyst role at SSW - Trading, linking trading and analysis departments and optimizing performance. Seeking proactive individuals with trading experience and expertise in market dynamics.
Principal Commercial Analyst focusing on UK trading performance and insights at Moonpig Group. Leading commercial decision - making while coaching a small team of analysts for high standards.
M&A Analyst at Pharmacy2U, involved in the entire acquisition lifecycle and financial due diligence. Working with finance leadership and external advisors to drive growth through M&A.
Senior Credit Analyst analyzing corporate credit markets and leading analyst training at 9fin, enhancing decision - making in debt capital markets.
Total Rewards Analyst managing APAC benefits and compensation programs for employees in a global analytics company. Supporting compliance and vendor management in a hybrid work environment.
Workday HCM Functional Analyst responsible for supporting and configuring Workday HCM system. Collaborating with teams to ensure system meets business needs and enhances employee experience.
Infrastructure Analyst providing support and troubleshooting for Cisco datacenter network equipment. Focus on technical tasks and incident resolution in a hybrid work environment.
Join GBE Alliance as a Board - Certified Behavior Analyst (BCBA) to empower children and families. Drive behavioral interventions and collaborate with a multidisciplinary team to enhance lives.