Claims Analyst jobs at Zelis

Epic Professional Billing certification required 100% remote up to $115k DOE The PB/HB Analyst is responsible to resolve technical and application issues and support ongoing workflow and optimization issues. This position oversees the design, configuration, testing and support of Epic Patient Billing. Responsibilities Design, build and test Epic Patient/Hospital Billing software, including current- and future-state workflows Troubleshoot and resolve issues, conforming to client change control and change management policies Work in a complex and quick-moving client environment, meeting all project timelines and critical path requirements. May be required to participate in 24-hour on-call rotations Participate in project planning and manage applicable responsibilities Facilitate and participate in team meetings and work groups Minimum Requirements BA with 5+ years' revenue cycle operational experience in healthcare setting 3+ years Epic HB/PB Analyst experience with current Epic certification

The Risk, Claims & Carrier Qualifications Specialist plays a critical role in protecting Patterson Companies from operational, financial, and reputational risk. This position is responsible for managing all Overages, Shortages, and Damages (OS&D), processing and resolving freight claims, qualifying and onboarding carriers, maintaining carrier insurance compliance, and overseeing organizational risk management procedures. This role ensures that Patterson Companies operate within industry regulations while building strong partnerships with carriers and safeguarding our customers' freight. Key Responsibilities Claims & OS&D Management Serve as the first point of contact for all OS&D and freight claims from shippers, carriers, and internal teams. Investigate, document, and process claims in compliance with company policies, federal regulations, and industry best practices. Communicate with carriers, customers, and internal stakeholders to resolve disputes promptly and fairly. Maintain detailed claim files, documentation, and reporting for trend analysis and process improvement. Carrier Vetting & Qualification Conduct thorough vetting of new carriers, including verifying MC/DOT authority, safety ratings, insurance coverage, and operational capabilities. Ensure carriers meet Patterson Companies' safety and compliance standards before onboarding. Monitor ongoing carrier compliance, including insurance renewals, safety performance, and regulatory changes. Manage the carrier onboarding process in collaboration with the operations team, utilizing TMS-integrated vetting tools (e.g., Highway). Insurance & Compliance Management Track and verify carrier insurance policies, ensuring timely renewals and appropriate coverage. Coordinate with carriers and insurance providers to update coverage documents in company systems. Monitor regulatory requirements and ensure company compliance with FMCSA, DOT, and other governing bodies. Organizational Risk Management Identify operational risks and recommend preventive strategies to mitigate exposure. Develop and update company policies related to risk, claims, and carrier compliance. Provide regular risk and claim trend reports to leadership to inform decision-making. Collaborate with sales, operations, and leadership to ensure contractual agreements protect company interests. Other duties as assigned Qualifications Required: Minimum 3 years of experience in transportation, logistics, risk management, or claims processing. Strong knowledge of carrier vetting, insurance requirements, OS&D processes, and freight claims procedures. Proficient in using TMS platforms and compliance monitoring tools. Excellent communication, negotiation, and problem-solving skills. Ability to manage multiple priorities and meet deadlines in a fast-paced environment. Preferred: Experience in a 3PL or freight brokerage environment. Operations experience is preferred. Familiarity with Highway, RMIS, SaferWatch, Carrier411, or equivalent compliance software. Knowledge of cargo insurance policies, Carmack Amendment, and freight claim regulations. To apply online, please visit: *********************************

If you are considering sending an application, make sure to hit the apply button below after reading through the entire description. The Clinical Informatics Systems Analyst II is primarily responsible for assisting in the operation and administration of clinical information systems, collaborating with clinical and technical associates to enhance workflow methodology and tools. Support responsibilities include application support of medium to high complexity for acute and non-acute care clinical applications for a large, multi-regional healthcare system; provides incident, change and problem management support following the outlined ITIL processes. This position must possess sufficient detailed healthcare knowledge and systems expertise to support assigned clinical application(s). This position requires the ability to work with minimal supervision. This position is exempt. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Collaborate with Clinical Informatics colleagues across the enterprise to drive strategic goals and vision for the department and CHRISTUS Health. Collaborate with Clinical Informatics colleagues to focus on standardized best practice workflow processes and clinical content to ensure alignment across all ministries in order to create efficiencies that improve patient safety. Collaborate with technical colleagues to help identify any infrastructure related issues that have resulted in clinical application issues. Develop, test, implement, support, and maintain assigned clinical applications, solutions and business processes to meet operational and technical requirements. Demonstrates strong communication and interpersonal skills when interacting with other people, both individually and in groups. Demonstrate sound understanding of clinical practice as it pertains to the integration of clinical information systems and impact on end users. Assist in reporting any identified clinical information systems compliance issues/concerns and escalate utilizing proper chain of command. Provide on-going end user clinical information systems support with all upgrades, new releases and enhanced functionality. Assist with communication to clinical end user system changes, new functionality, workflow process changes, and downtime procedures as they relate to the electronic medical record. Foster relationships with ministry leadership and departments such as Information Services, Quality, Case Management, Revenue Cycle, and Finance to ensure effective communication, to meet business and financial requirements. Prioritize, coordinate, and implement updates and requested changes to clinical information systems. Provides effective customer service by being courteous, polite and friendly at all times. May be required to work additional hours as needed during critical problems. Responsible for other duties and special projects as assigned. Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with clinical information systems. Troubleshoot and/or resolve application issues and escalate more complex issues as appropriate. Proactively takes action without additional direction taking tasks/projects to completion. Identifies and seizes new opportunities. Displays can-do attitude in good and bad times. Steps up to handle tough issues. Through knowledge and understanding of operations, can proactively identify opportunities to enhance customer usability, efficiency and/or experience. Represents user needs and expectations in larger, more complex system updates and enhancements. Maintains relationship with end user leadership post-engagement. Proactively addresses end user conflicts. Provides clear and organized status reporting on key project areas to be used as external communications to stakeholders. Provides insight and recommendations on application/system analysis in assigned area(s). Demonstrates a solid/working level of subject matter expertise in providing support to projects, customers, and other teams while proactively working to improve and obtain new expertise in applications, including areas beyond assigned module. Utilizes application training, application web site and application resource materials regularly and effectively and is able guide newer team members in utilizing these resources. Associate periodically reviews and auto-corrects his/her skills, habits, work ethic, and behaviors and manages his/her work in an effective and agreeable way among peers. Strong technical proficiency in application-specific design and configuration. Ability to clearly articulate and communicate core design, configuration concepts to end users. Able to independently analyze, design, and configure the application. Able to teach design, configuration concepts to new team members. Proactively and independently troubleshoot and resolve moderate incidents and requests without direction. Demonstrates a working level understanding of information technology, including systems, applications, operations, and support. Adheres to standards/protocols. Maintains high standards for quality of work for self and others. Provides oversight and feedback on team member design, configuration and deliverables. Manages medium complexity projects/requests. Collaborates with team members as needed. Proactively evaluates all new release and functionality of applications. Performs working level process and requirement analysis, including process mapping though current flow charts, documents, future needs/plans, requirement elicitation, stakeholder analysis, and specification gathering to deliver cross team solutions. Responsible for completing working level gap analysis, and providing recommendations. Must have strong knowledge of clinical information systems, clinical informatics, data management and administration. Must have advance knowledge of Microsoft Office products. Must have excellent verbal and written skills, strong interpersonal skills, and the ability to work independently and as a member of a team. xevrcyc Requirements: Education/Skills Bachelor's degree or 4 years of clinical/technical application experience in lieu of degree, strongly preferred Experience Preferred 3-5 years previous clinical information systems experience or equivalent Licenses, Registrations, or Certifications Valid Driver's License Epic certification/accreditation/self-proficiency preferred (may be required to certify in relevant application within first 6 months of hire) Note: Once achieved, must be maintained. Work Type: Full Time

Performs the essential duties and responsibilities and the primary functions of the Clinical Informatics Analyst. Responsible for the coordination and oversight of all activities associated with the implementation and application of the organization's clinical software and the medical data gathered by that software. Responsible for coordinating the creation of continuous value in the application of clinical software and data to clinical practice, in response to the needs of the organization's various practitioners and caregivers, as well as overall organizational goals specific to the application of clinical practice. Responsible for promoting team work with co-workers, subordinates and personnel of other departments. Responsible for solving nonroutine problems, dealing with a variety of non-routine issues and interpreting a variety of instructions furnished in written or oral form. The application support analyst will communicate effectively verbally and via written forms. Additionally, analyst will demonstrate and maintain industry specific knowledge and judgment associated with the specific area of expertise. SHIFT AND SCHEDULE Full Time: 8:00 AM - 5:00 PM; scheduled on-call (This is an on-site position) ESSENTIAL FUNCTIONS/PERFORMANCE EXPECTATIONS General Responsibilities: Install, configure, support, and maintain software applications and tools as assigned. Cultivate and maintain excellent relationship with clinical staff and leadership in pursuit of constant improvement in the application of clinical IT assets, as defined by appropriate quality measures and objectives. Work with hospital departmental staff and super-users to continuously optimize and improve the functionality of the hospital application and clinical practice in general Develop and maintain documentation of all clinical applications as assigned, including that specific to the implementation, maintenance, end-user training, departmental workflows, quality measures, and other associated performance indicators associated with the successful use of the clinical tool or software package. Develop and maintain adequate configuration documentation to ensure rapid deployment or repair of existing software components to ensure business continuity. Work to ensure excellent application security of all protected information in accordance with hospital policies and procedures, including those defined by HIPAA and other industry standards. Monitor software capacity, performance, and lifecycle to ensure continuity of adequate functionality. Research and recommend new technologies to facilitate the performance of the hospital's business objectives. Ensure that all software and associated workflows meet hospital and industry standards. Undertake routine preventative measures to implement, maintain, and monitor software security and performance. Provide input to projects, training or information to individuals on tasks and projects which include a software component. Analyze and resolve faults, including those of both major and minor impact to the clinical application, utilizing the tools and documentation standards defined by HIS departmental policies and procedures. Work with other departments, including those within and outside the HIS department, in fulfillment of hospital tasks and projects. Monitor the use, by hospital employees, of software resources to ensure compliance of hospital standard use policies. Daily Operations: Resolve assigned support and service requests in a timely, effective, and courteous manner; utilizing tools and documentation as defined by HIS policy. Perform maintenance activities in pursuit of all general responsibilities specific to position. Participate in assigned meetings, committees, etc. in accordance with assigned responsibilities. Participate in projects at a level in accordance with respective job responsibilities. Contribute to the departmental knowledge base, in order to improve documentation of existing systems and problem resolutions. Coordinate productively with other hospital employees, including those within and outside the HIS department. Provide routine updates on ongoing tasks and projects to stakeholders, in accordance with HIS policies and procedures. Identify, research, and work to implement on areas of improvement within the assigned areas of expertise. Provide excellent customer service to all stakeholders who rely on service from the HIS department. Maintain excellent industry knowledge respective to the area of expertise EDUCATION AND EXPERIENCE Bachelor's degree in a relevant field (Computer Science, Life Science, Business or Informatics) required; will consider analyst and/or healthcare experience in lieu of degree. Registered Nurse with current Texas license preferred. Healthcare Informatics experience or equivalent clinical knowledge and\or licensure may be considered. 1-4 years of experience as a clinical informatics analyst required; consideration given for industry specific training. Preferred 4-10 yrs as a Clinical Informatics Analyst. Demonstrated skillset in Cerner Millennium, Nursing and Physician Documentation systems, Pharmacy and Medication Administration system. Demonstrated customer-service and communication skills required PHYSICAL REQUIREMENTS To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The individual must be able to: Stand, walk, sit, stoop, reach, lift, see, speak and hear. Lifting is limited to 35 lbs. for clinical staff and to 50 lbs. for non-clinical staff. The individual must use an assisted-lift device or get another individual(s) to assist with the lift that is over these maximum limits.

Experience, qualification, and soft skills, have you got everything required to succeed in this opportunity Find out below. The Clinical Informatics Systems Analyst II is primarily responsible for assisting in the operation and administration of clinical information systems, collaborating with clinical and technical associates to enhance workflow methodology and tools. Support responsibilities include application support of medium to high complexity for acute and non-acute care clinical applications for a large, multi-regional healthcare system; provides incident, change and problem management support following the outlined ITIL processes. This position must possess sufficient detailed healthcare knowledge and systems expertise to support assigned clinical application(s). This position requires the ability to work with minimal supervision. This position is exempt. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Collaborate with Clinical Informatics colleagues across the enterprise to drive strategic goals and vision for the department and CHRISTUS Health. Collaborate with Clinical Informatics colleagues to focus on standardized best practice workflow processes and clinical content to ensure alignment across all ministries in order to create efficiencies that improve patient safety. Collaborate with technical colleagues to help identify any infrastructure related issues that have resulted in clinical application issues. Develop, test, implement, support, and maintain assigned clinical applications, solutions and business processes to meet operational and technical requirements. Demonstrates strong communication and interpersonal skills when interacting with other people, both individually and in groups. Demonstrate sound understanding of clinical practice as it pertains to the integration of clinical information systems and impact on end users. Assist in reporting any identified clinical information systems compliance issues/concerns and escalate utilizing proper chain of command. Provide on-going end user clinical information systems support with all upgrades, new releases and enhanced functionality. Assist with communication to clinical end user system changes, new functionality, workflow process changes, and downtime procedures as they relate to the electronic medical record. Foster relationships with ministry leadership and departments such as Information Services, Quality, Case Management, Revenue Cycle, and Finance to ensure effective communication, to meet business and financial requirements. Prioritize, coordinate, and implement updates and requested changes to clinical information systems. Provides effective customer service by being courteous, polite and friendly at all times. May be required to work additional hours as needed during critical problems. Responsible for other duties and special projects as assigned. Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with clinical information systems. Troubleshoot and/or resolve application issues and escalate more complex issues as appropriate. Proactively takes action without additional direction taking tasks/projects to completion. Identifies and seizes new opportunities. Displays can-do attitude in good and bad times. Steps up to handle tough issues. Through knowledge and understanding of operations, can proactively identify opportunities to enhance customer usability, efficiency and/or experience. Represents user needs and expectations in larger, more complex system updates and enhancements. Maintains relationship with end user leadership post-engagement. Proactively addresses end user conflicts. Provides clear and organized status reporting on key project areas to be used as external communications to stakeholders. Provides insight and recommendations on application/system analysis in assigned area(s). Demonstrates a solid/working level of subject matter expertise in providing support to projects, customers, and other teams while proactively working to improve and obtain new expertise in applications, including areas beyond assigned module. Utilizes application training, application web site and application resource materials regularly and effectively and is able guide newer team members in utilizing these resources. Associate periodically reviews and auto-corrects his/her skills, habits, work ethic, and behaviors and manages his/her work in an effective and agreeable way among peers. Strong technical proficiency in application-specific design and configuration. Ability to clearly articulate and communicate core design, configuration concepts to end users. Able to independently analyze, design, and configure the application. Able to teach design, configuration concepts to new team members. Proactively and independently troubleshoot and resolve moderate incidents and requests without direction. Demonstrates a working level understanding of information technology, including systems, applications, operations, and support. Adheres to standards/protocols. Maintains high standards for quality of work for self and others. Provides oversight and feedback on team member design, configuration and deliverables. Manages medium complexity projects/requests. Collaborates with team members as needed. Proactively evaluates all new release and functionality of applications. Performs working level process and requirement analysis, including process mapping though current flow charts, documents, future needs/plans, requirement elicitation, stakeholder analysis, and specification gathering to deliver cross team solutions. Responsible for completing working level gap analysis, and providing recommendations. Must have strong knowledge of clinical information systems, clinical informatics, data management and administration. Must have advance knowledge of Microsoft Office products. Must have excellent verbal and written skills, strong interpersonal skills, and the ability to work independently and as a member of a team. xevrcyc Requirements: Education/Skills Bachelor's degree or 4 years of clinical/technical application experience in lieu of degree, strongly preferred Experience Preferred 3-5 years previous clinical information systems experience or equivalent Licenses, Registrations, or Certifications Valid Driver's License Epic certification/accreditation/self-proficiency preferred (may be required to certify in relevant application within first 6 months of hire) Note: Once achieved, must be maintained. Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

:The Precertification Specialist obtains authorizations from Insurance companies for scheduled tests/procedures providing necessary medical information for authorizations. Interprets patient medical records and reviews cases with the insurance nurse reviewer. Accurately enters information into multiple computer programs and insurance websites. Education: Want to make an application Make sure your CV is up to date, then read the following job specs carefully before applying. Required: High School Diploma or Equivalent Preferred: Medical Assistant Degree Experience: Required: 1 Year VA/TriWest Related Experience Preferred: 6 months experience with medical terminology Skills: Strong analytical/problem solving skills. Ability to communicate effectively with different levels of management, nursing, physicians, and insurance nurse reviewers. Excellent time management, Communication skills, organization, prioritizing, decision-making, and planning skills. Flexibility and ability to work in a multi-tasking environment. xevrcyc Ability to understand and interpret insurance benefits Ability to understand multiple computer programs and multiple insurance websites. Licensure/Certification/Registration: N/A

****$4,000 Sign on Bonus (external candidates only)**** Labcorp's Brentwood, Tennessee, lab is seeking a Cytogenetic Technologist/Analyst to join their team! The position will focus primarily on analysis of Oncology Cytogenetics and/or FISH. *Work schedule: HYBRID - Tuesday - Saturday, 9:30 am - 6:00 pm. * *Please note: *Candidate must meet the *Work from Home Requirements *listed below. *Benefits: *Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, please [click here]( * *Responsibilities: * * Perform routine and complex technical procedures and functions according to departmental Standard Operating Procedures. * Monitor, operate and troubleshoot equipment, software and applications to ensure proper functionality. * Demonstrate the ability to make technical decisions regarding testing and problem solving. * Report accurate and timely test results in order to deliver quality patient care. * Perform analysis of chromosomes and/or FISH specimens, which includes imaging and karyotyping of cytogenetic specimens. * Review test requisitions to gather pertinent details for analysis. * Summarize test results utilizing ISCN nomenclature. * Distinguish between normal and abnormal test results. * Perform and evaluate troubleshooting, document all corrective actions as needed. * Comply with company policies and procedures. * Maintain a safe work environment. *Requirements:* * Bachelor's degree in Chemical or Biological science, Clinical Laboratory Science, Medical Technology or meet local regulatory (CLIA & State) requirements. * Minimum 2 years of clinical laboratory testing experience is required. * ASCP certification in Cytogenetics (ASCP CG) is highly preferred. * Experience working in a Cytogenetics clinical laboratory is highly preferred. * Previous experience with cytogenetic analysis of metaphase spreads via computerized images is highly preferred. * Ability to work independently and within a team environment * Proficient with computers; Familiarity with laboratory information systems is a plus * High level of attention to detail along with strong communication and organizational skills * Must be able to pass a standardized color vision screen * Flexibility to work overtime or other shifts depending on business needs *Work From Home Requirements: * * The candidate must have a home office space that is a dedicated room, not shared with other people, and meets HIPAA compliance. * Wired or wireless internet at a minimum speed of 100 mb/sec is required. * The candidate must have the ability to work remotely effectively as required in a fast-paced, multi-site environment with a demonstrated ability to juggle competing priorities and demands. *If you're looking for a career that offers opportunities for growth, continual development, professional challenge and the chance to make a real difference, apply today!* *Labcorp is proud to be an Equal Opportunity Employer:* Labcorp strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law. *We encourage all to apply* If you are an individual with a disability who needs assistance using our online tools to search and apply for jobs, or needs an accommodation, please visit our [accessibility site]( or contact us at [Labcorp Accessibility.](mailto:...@LabCorp.com) For more information about how we collect and store your personal data, please see our [Privacy Statement](

Experience, qualification, and soft skills, have you got everything required to succeed in this opportunity Find out below. The Clinical Informatics Systems Analyst II is primarily responsible for assisting in the operation and administration of clinical information systems, collaborating with clinical and technical associates to enhance workflow methodology and tools. Support responsibilities include application support of medium to high complexity for acute and non-acute care clinical applications for a large, multi-regional healthcare system; provides incident, change and problem management support following the outlined ITIL processes. This position must possess sufficient detailed healthcare knowledge and systems expertise to support assigned clinical application(s). This position requires the ability to work with minimal supervision. This position is exempt. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Collaborate with Clinical Informatics colleagues across the enterprise to drive strategic goals and vision for the department and CHRISTUS Health. Collaborate with Clinical Informatics colleagues to focus on standardized best practice workflow processes and clinical content to ensure alignment across all ministries in order to create efficiencies that improve patient safety. Collaborate with technical colleagues to help identify any infrastructure related issues that have resulted in clinical application issues. Develop, test, implement, support, and maintain assigned clinical applications, solutions and business processes to meet operational and technical requirements. Demonstrates strong communication and interpersonal skills when interacting with other people, both individually and in groups. Demonstrate sound understanding of clinical practice as it pertains to the integration of clinical information systems and impact on end users. Assist in reporting any identified clinical information systems compliance issues/concerns and escalate utilizing proper chain of command. Provide on-going end user clinical information systems support with all upgrades, new releases and enhanced functionality. Assist with communication to clinical end user system changes, new functionality, workflow process changes, and downtime procedures as they relate to the electronic medical record. Foster relationships with ministry leadership and departments such as Information Services, Quality, Case Management, Revenue Cycle, and Finance to ensure effective communication, to meet business and financial requirements. Prioritize, coordinate, and implement updates and requested changes to clinical information systems. Provides effective customer service by being courteous, polite and friendly at all times. May be required to work additional hours as needed during critical problems. Responsible for other duties and special projects as assigned. Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with clinical information systems. Troubleshoot and/or resolve application issues and escalate more complex issues as appropriate. Proactively takes action without additional direction taking tasks/projects to completion. Identifies and seizes new opportunities. Displays can-do attitude in good and bad times. Steps up to handle tough issues. Through knowledge and understanding of operations, can proactively identify opportunities to enhance customer usability, efficiency and/or experience. Represents user needs and expectations in larger, more complex system updates and enhancements. Maintains relationship with end user leadership post-engagement. Proactively addresses end user conflicts. Provides clear and organized status reporting on key project areas to be used as external communications to stakeholders. Provides insight and recommendations on application/system analysis in assigned area(s). Demonstrates a solid/working level of subject matter expertise in providing support to projects, customers, and other teams while proactively working to improve and obtain new expertise in applications, including areas beyond assigned module. Utilizes application training, application web site and application resource materials regularly and effectively and is able guide newer team members in utilizing these resources. Associate periodically reviews and auto-corrects his/her skills, habits, work ethic, and behaviors and manages his/her work in an effective and agreeable way among peers. Strong technical proficiency in application-specific design and configuration. Ability to clearly articulate and communicate core design, configuration concepts to end users. Able to independently analyze, design, and configure the application. Able to teach design, configuration concepts to new team members. Proactively and independently troubleshoot and resolve moderate incidents and requests without direction. Demonstrates a working level understanding of information technology, including systems, applications, operations, and support. Adheres to standards/protocols. Maintains high standards for quality of work for self and others. Provides oversight and feedback on team member design, configuration and deliverables. Manages medium complexity projects/requests. Collaborates with team members as needed. Proactively evaluates all new release and functionality of applications. Performs working level process and requirement analysis, including process mapping though current flow charts, documents, future needs/plans, requirement elicitation, stakeholder analysis, and specification gathering to deliver cross team solutions. Responsible for completing working level gap analysis, and providing recommendations. Must have strong knowledge of clinical information systems, clinical informatics, data management and administration. Must have advance knowledge of Microsoft Office products. Must have excellent verbal and written skills, strong interpersonal skills, and the ability to work independently and as a member of a team. xevrcyc Requirements: Education/Skills Bachelor's degree or 4 years of clinical/technical application experience in lieu of degree, strongly preferred Experience Preferred 3-5 years previous clinical information systems experience or equivalent Licenses, Registrations, or Certifications Valid Driver's License Epic certification/accreditation/self-proficiency preferred (may be required to certify in relevant application within first 6 months of hire) Note: Once achieved, must be maintained. Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

Experience, qualification, and soft skills, have you got everything required to succeed in this opportunity Find out below. The Clinical Informatics Systems Analyst II is primarily responsible for assisting in the operation and administration of clinical information systems, collaborating with clinical and technical associates to enhance workflow methodology and tools. Support responsibilities include application support of medium to high complexity for acute and non-acute care clinical applications for a large, multi-regional healthcare system; provides incident, change and problem management support following the outlined ITIL processes. This position must possess sufficient detailed healthcare knowledge and systems expertise to support assigned clinical application(s). This position requires the ability to work with minimal supervision. This position is exempt. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Collaborate with Clinical Informatics colleagues across the enterprise to drive strategic goals and vision for the department and CHRISTUS Health. Collaborate with Clinical Informatics colleagues to focus on standardized best practice workflow processes and clinical content to ensure alignment across all ministries in order to create efficiencies that improve patient safety. Collaborate with technical colleagues to help identify any infrastructure related issues that have resulted in clinical application issues. Develop, test, implement, support, and maintain assigned clinical applications, solutions and business processes to meet operational and technical requirements. Demonstrates strong communication and interpersonal skills when interacting with other people, both individually and in groups. Demonstrate sound understanding of clinical practice as it pertains to the integration of clinical information systems and impact on end users. Assist in reporting any identified clinical information systems compliance issues/concerns and escalate utilizing proper chain of command. Provide on-going end user clinical information systems support with all upgrades, new releases and enhanced functionality. Assist with communication to clinical end user system changes, new functionality, workflow process changes, and downtime procedures as they relate to the electronic medical record. Foster relationships with ministry leadership and departments such as Information Services, Quality, Case Management, Revenue Cycle, and Finance to ensure effective communication, to meet business and financial requirements. Prioritize, coordinate, and implement updates and requested changes to clinical information systems. Provides effective customer service by being courteous, polite and friendly at all times. May be required to work additional hours as needed during critical problems. Responsible for other duties and special projects as assigned. Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with clinical information systems. Troubleshoot and/or resolve application issues and escalate more complex issues as appropriate. Proactively takes action without additional direction taking tasks/projects to completion. Identifies and seizes new opportunities. Displays can-do attitude in good and bad times. Steps up to handle tough issues. Through knowledge and understanding of operations, can proactively identify opportunities to enhance customer usability, efficiency and/or experience. Represents user needs and expectations in larger, more complex system updates and enhancements. Maintains relationship with end user leadership post-engagement. Proactively addresses end user conflicts. Provides clear and organized status reporting on key project areas to be used as external communications to stakeholders. Provides insight and recommendations on application/system analysis in assigned area(s). Demonstrates a solid/working level of subject matter expertise in providing support to projects, customers, and other teams while proactively working to improve and obtain new expertise in applications, including areas beyond assigned module. Utilizes application training, application web site and application resource materials regularly and effectively and is able guide newer team members in utilizing these resources. Associate periodically reviews and auto-corrects his/her skills, habits, work ethic, and behaviors and manages his/her work in an effective and agreeable way among peers. Strong technical proficiency in application-specific design and configuration. Ability to clearly articulate and communicate core design, configuration concepts to end users. Able to independently analyze, design, and configure the application. Able to teach design, configuration concepts to new team members. Proactively and independently troubleshoot and resolve moderate incidents and requests without direction. Demonstrates a working level understanding of information technology, including systems, applications, operations, and support. Adheres to standards/protocols. Maintains high standards for quality of work for self and others. Provides oversight and feedback on team member design, configuration and deliverables. Manages medium complexity projects/requests. Collaborates with team members as needed. Proactively evaluates all new release and functionality of applications. Performs working level process and requirement analysis, including process mapping though current flow charts, documents, future needs/plans, requirement elicitation, stakeholder analysis, and specification gathering to deliver cross team solutions. Responsible for completing working level gap analysis, and providing recommendations. Must have strong knowledge of clinical information systems, clinical informatics, data management and administration. Must have advance knowledge of Microsoft Office products. Must have excellent verbal and written skills, strong interpersonal skills, and the ability to work independently and as a member of a team. xevrcyc Requirements: Education/Skills Bachelor's degree or 4 years of clinical/technical application experience in lieu of degree, strongly preferred Experience Preferred 3-5 years previous clinical information systems experience or equivalent Licenses, Registrations, or Certifications Valid Driver's License Epic certification/accreditation/self-proficiency preferred (may be required to certify in relevant application within first 6 months of hire) Note: Once achieved, must be maintained. Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

If you are considering sending an application, make sure to hit the apply button below after reading through the entire description. The Clinical Informatics Systems Analyst II is primarily responsible for assisting in the operation and administration of clinical information systems, collaborating with clinical and technical associates to enhance workflow methodology and tools. Support responsibilities include application support of medium to high complexity for acute and non-acute care clinical applications for a large, multi-regional healthcare system; provides incident, change and problem management support following the outlined ITIL processes. This position must possess sufficient detailed healthcare knowledge and systems expertise to support assigned clinical application(s). This position requires the ability to work with minimal supervision. This position is exempt. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Collaborate with Clinical Informatics colleagues across the enterprise to drive strategic goals and vision for the department and CHRISTUS Health. Collaborate with Clinical Informatics colleagues to focus on standardized best practice workflow processes and clinical content to ensure alignment across all ministries in order to create efficiencies that improve patient safety. Collaborate with technical colleagues to help identify any infrastructure related issues that have resulted in clinical application issues. Develop, test, implement, support, and maintain assigned clinical applications, solutions and business processes to meet operational and technical requirements. Demonstrates strong communication and interpersonal skills when interacting with other people, both individually and in groups. Demonstrate sound understanding of clinical practice as it pertains to the integration of clinical information systems and impact on end users. Assist in reporting any identified clinical information systems compliance issues/concerns and escalate utilizing proper chain of command. Provide on-going end user clinical information systems support with all upgrades, new releases and enhanced functionality. Assist with communication to clinical end user system changes, new functionality, workflow process changes, and downtime procedures as they relate to the electronic medical record. Foster relationships with ministry leadership and departments such as Information Services, Quality, Case Management, Revenue Cycle, and Finance to ensure effective communication, to meet business and financial requirements. Prioritize, coordinate, and implement updates and requested changes to clinical information systems. Provides effective customer service by being courteous, polite and friendly at all times. May be required to work additional hours as needed during critical problems. Responsible for other duties and special projects as assigned. Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with clinical information systems. Troubleshoot and/or resolve application issues and escalate more complex issues as appropriate. Proactively takes action without additional direction taking tasks/projects to completion. Identifies and seizes new opportunities. Displays can-do attitude in good and bad times. Steps up to handle tough issues. Through knowledge and understanding of operations, can proactively identify opportunities to enhance customer usability, efficiency and/or experience. Represents user needs and expectations in larger, more complex system updates and enhancements. Maintains relationship with end user leadership post-engagement. Proactively addresses end user conflicts. Provides clear and organized status reporting on key project areas to be used as external communications to stakeholders. Provides insight and recommendations on application/system analysis in assigned area(s). Demonstrates a solid/working level of subject matter expertise in providing support to projects, customers, and other teams while proactively working to improve and obtain new expertise in applications, including areas beyond assigned module. Utilizes application training, application web site and application resource materials regularly and effectively and is able guide newer team members in utilizing these resources. Associate periodically reviews and auto-corrects his/her skills, habits, work ethic, and behaviors and manages his/her work in an effective and agreeable way among peers. Strong technical proficiency in application-specific design and configuration. Ability to clearly articulate and communicate core design, configuration concepts to end users. Able to independently analyze, design, and configure the application. Able to teach design, configuration concepts to new team members. Proactively and independently troubleshoot and resolve moderate incidents and requests without direction. Demonstrates a working level understanding of information technology, including systems, applications, operations, and support. Adheres to standards/protocols. Maintains high standards for quality of work for self and others. Provides oversight and feedback on team member design, configuration and deliverables. Manages medium complexity projects/requests. Collaborates with team members as needed. Proactively evaluates all new release and functionality of applications. Performs working level process and requirement analysis, including process mapping though current flow charts, documents, future needs/plans, requirement elicitation, stakeholder analysis, and specification gathering to deliver cross team solutions. Responsible for completing working level gap analysis, and providing recommendations. Must have strong knowledge of clinical information systems, clinical informatics, data management and administration. Must have advance knowledge of Microsoft Office products. Must have excellent verbal and written skills, strong interpersonal skills, and the ability to work independently and as a member of a team. xevrcyc Requirements: Education/Skills Bachelor's degree or 4 years of clinical/technical application experience in lieu of degree, strongly preferred Experience Preferred 3-5 years previous clinical information systems experience or equivalent Licenses, Registrations, or Certifications Valid Driver's License Epic certification/accreditation/self-proficiency preferred (may be required to certify in relevant application within first 6 months of hire) Note: Once achieved, must be maintained. Work Type: Full Time

If you are considering sending an application, make sure to hit the apply button below after reading through the entire description. The Clinical Informatics Systems Analyst II is primarily responsible for assisting in the operation and administration of clinical information systems, collaborating with clinical and technical associates to enhance workflow methodology and tools. Support responsibilities include application support of medium to high complexity for acute and non-acute care clinical applications for a large, multi-regional healthcare system; provides incident, change and problem management support following the outlined ITIL processes. This position must possess sufficient detailed healthcare knowledge and systems expertise to support assigned clinical application(s). This position requires the ability to work with minimal supervision. This position is exempt. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Collaborate with Clinical Informatics colleagues across the enterprise to drive strategic goals and vision for the department and CHRISTUS Health. Collaborate with Clinical Informatics colleagues to focus on standardized best practice workflow processes and clinical content to ensure alignment across all ministries in order to create efficiencies that improve patient safety. Collaborate with technical colleagues to help identify any infrastructure related issues that have resulted in clinical application issues. Develop, test, implement, support, and maintain assigned clinical applications, solutions and business processes to meet operational and technical requirements. Demonstrates strong communication and interpersonal skills when interacting with other people, both individually and in groups. Demonstrate sound understanding of clinical practice as it pertains to the integration of clinical information systems and impact on end users. Assist in reporting any identified clinical information systems compliance issues/concerns and escalate utilizing proper chain of command. Provide on-going end user clinical information systems support with all upgrades, new releases and enhanced functionality. Assist with communication to clinical end user system changes, new functionality, workflow process changes, and downtime procedures as they relate to the electronic medical record. Foster relationships with ministry leadership and departments such as Information Services, Quality, Case Management, Revenue Cycle, and Finance to ensure effective communication, to meet business and financial requirements. Prioritize, coordinate, and implement updates and requested changes to clinical information systems. Provides effective customer service by being courteous, polite and friendly at all times. May be required to work additional hours as needed during critical problems. Responsible for other duties and special projects as assigned. Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with clinical information systems. Troubleshoot and/or resolve application issues and escalate more complex issues as appropriate. Proactively takes action without additional direction taking tasks/projects to completion. Identifies and seizes new opportunities. Displays can-do attitude in good and bad times. Steps up to handle tough issues. Through knowledge and understanding of operations, can proactively identify opportunities to enhance customer usability, efficiency and/or experience. Represents user needs and expectations in larger, more complex system updates and enhancements. Maintains relationship with end user leadership post-engagement. Proactively addresses end user conflicts. Provides clear and organized status reporting on key project areas to be used as external communications to stakeholders. Provides insight and recommendations on application/system analysis in assigned area(s). Demonstrates a solid/working level of subject matter expertise in providing support to projects, customers, and other teams while proactively working to improve and obtain new expertise in applications, including areas beyond assigned module. Utilizes application training, application web site and application resource materials regularly and effectively and is able guide newer team members in utilizing these resources. Associate periodically reviews and auto-corrects his/her skills, habits, work ethic, and behaviors and manages his/her work in an effective and agreeable way among peers. Strong technical proficiency in application-specific design and configuration. Ability to clearly articulate and communicate core design, configuration concepts to end users. Able to independently analyze, design, and configure the application. Able to teach design, configuration concepts to new team members. Proactively and independently troubleshoot and resolve moderate incidents and requests without direction. Demonstrates a working level understanding of information technology, including systems, applications, operations, and support. Adheres to standards/protocols. Maintains high standards for quality of work for self and others. Provides oversight and feedback on team member design, configuration and deliverables. Manages medium complexity projects/requests. Collaborates with team members as needed. Proactively evaluates all new release and functionality of applications. Performs working level process and requirement analysis, including process mapping though current flow charts, documents, future needs/plans, requirement elicitation, stakeholder analysis, and specification gathering to deliver cross team solutions. Responsible for completing working level gap analysis, and providing recommendations. Must have strong knowledge of clinical information systems, clinical informatics, data management and administration. Must have advance knowledge of Microsoft Office products. Must have excellent verbal and written skills, strong interpersonal skills, and the ability to work independently and as a member of a team. xevrcyc Requirements: Education/Skills Bachelor's degree or 4 years of clinical/technical application experience in lieu of degree, strongly preferred Experience Preferred 3-5 years previous clinical information systems experience or equivalent Licenses, Registrations, or Certifications Valid Driver's License Epic certification/accreditation/self-proficiency preferred (may be required to certify in relevant application within first 6 months of hire) Note: Once achieved, must be maintained. Work Type: Full Time

**** $4,000 Sign on Bonus (external candidates only) **** Are you an experienced Clinical Lab Professional? Are you looking to embark on a new challenge in your career, or start your career in Clinical Lab Science? If so, Labcorp wants to speak with you about exciting opportunities to join our team as a Flow Cytometry Analyst in Brentwood, TN. In this position you will work in a fast paced, customer focused, and challenging environment, and will be a part of our overall mission at Labcorp: “Improving Health, Improving Lives”. *Work Schedule: Monday - Friday, 9:00 am - 5:30 pm, with rotating Saturdays* *Benefits: *Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, please [click here]( * *Job Responsibilities* * Perform routine and complex technical procedures and functions according to departmental Standard Operating Procedures. * Monitor, operate and troubleshoot equipment, software and applications to ensure proper functionality. * Demonstrate the ability to make technical decisions regarding testing and problem solving. * Report accurate and timely test results in order to deliver quality patient care. * Perform analysis of flow processed specimens, which includes screening and ordering additional testing to flow specimens. * Review test requisitions and previous analysis to gather pertinent details for analysis. * Write cases for in-house pathologists to interpret and render a diagnosis for our client and patients. * Distinguish between normal and abnormal test results. * Perform and evaluate troubleshooting, document all corrective actions as needed. * Comply with company policies and procedures. * Maintain a safe work environment. *Requirements* * Bachelor's degree in Chemical or Biological science, Clinical Laboratory Science, Medical Technology or a non-traditional Bachelor's degree that meets local regulatory (CLIA & State) requirements * Minimum 1 year of clinical laboratory testing experience is required OR a MLS degree * Minimum 2 years of experience in Flow Cytometry and/or flow cytometry analysis experience preferred * ASCP or AMT certification is preferred * Ability to work independently and within a team environment * Proficient with computers; Familiarity with laboratory information systems is a plus * High level of attention to detail along with strong communication and organizational skills * Must be able to pass a standardized color vision screen * Flexibility to work overtime or other shifts depending on business needs *If you're looking for a career that offers opportunities for growth, continual development, professional challenge and the chance to make a real difference, apply today!* *Labcorp is proud to be an Equal Opportunity Employer:* Labcorp strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law. *We encourage all to apply* If you are an individual with a disability who needs assistance using our online tools to search and apply for jobs, or needs an accommodation, please visit our [accessibility site]( or contact us at [Labcorp Accessibility.](mailto:...@LabCorp.com) For more information about how we collect and store your personal data, please see our [Privacy Statement](

The Claims Management Analyst III is responsible for leading eBusiness initiatives and coordination of activities across multiple functional areas. Essential Functions: Manage the EDI (Electronic Data Interchange) trading partners and network of clearinghouses to ensure accurate and timely exchange of information Works closely with Vendor Management to improve and maintain the trading partner agreement with the trading partners. This includes cost reduction and adding services Develop and maintain a partnership with the trading partner account representatives Manage trading partner performance, establish and monitor service level agreements, regulatory requirements, and contractual metrics Provide Subject Matter Expertise (SME) to all departments regarding eBusiness specific EDI transactions Build, sustain and leverage relationships to constantly allow for continuous improvement of the EDI business process Responsible for eBusiness EDI requirements that support regulatory, compliance, and business needs And eBusiness EDI regulatory reporting Provide critical reporting and analysis of functional performance, and make recommendations for enhancements, cost savings initiatives and process improvements Review and analyze the effectiveness and efficiency of existing processes and systems, and participate in development of solutions to improve or further leverage these functions Participate in the process of estimating initiative budgets as well as developing business cases and tracking the benefits Understand business strategy, define and lead eBusiness initiatives such as working with IT and others internal departments to automate functions Understand the process to receive claims, claims rejections and denial processes, claims payment methodologies, adjudication processing, and Encounters to enable synergies among It and business groups Contribute to and/or develop user stories or provide user story guidance for sprint planning Develop, document and perform testing and validation as needed Develop and maintain an in-depth knowledge of the company's business and regulatory environments Identify issues, risks, and mitigation opportunities Perform any other job duties as requested Education and Experience: Bachelor's degree or equivalent years of relevant work experience is required Minimum of five (5) years of health care operations experience in insurance, managed care, or related industry is required Competencies, Knowledge and Skills: Advanced knowledge of healthcare EDI files (837, 277CA, 999, 270/271, 276/277, etc.) Advanced computer skills Demonstrated exceptional communication (verbal and written) and high level of professionalism Data analysis and trending skills to include query writing Knowledge of Claims IT processes and systems Working knowledge of managed care and health claims processing Ability to effectively interact with all levels of management within the organization and across multiple organizational layers Demonstrates excellent analysis, collaboration skills, facilitation and presentation skills Strong interpersonal, leadership and relationship building skills Decision making and problem solving skills Ability to work independently and within a team environment Time management skills; capable of multi-tasking and prioritizing work Attention to detail Effective decision making / problem solving skills Critical thinking and listening skills Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $70,800.00 - $113,200.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-RW1

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Claims Production Manager and Supervisor, the Claims Processor Level II will be processing outpatient professional and institutional claims. This includes but is not limited to; lab, radiology, ambulance, behavior health, outpatient COB, dialysis, oncology/chemo, hospital exclusions etc., in an accurate and expedient manner. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Telecommute schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Responsible for non-delegated provider claims verification and adjudication. Adjudicate all professional and outpatient claims including COB, denials, and reduction in service notifications. Meet Regulatory Compliance Regulations on turnaround times and claim payments. Read and interpret Medi-Cal/Medicare Fee Schedules. Must be able to make a sound determination if claim is eligible for payment or denial. Interface with other IEHP Departments, when necessary, regarding claims issues. Participate in Claims Department staff meetings, and other activities as needed. Responsible for meeting the performance measurement standards for productivity and accuracy. Any other duties as required to ensure the Health Plan operations are successful. Qualifications Education & Requirements Minimum of two (2) years of experience adjudicating outpatient professional and/or institutional claims preferably in an HMO or Managed Care setting Processing of Medicare, Medi-Cal, or Commercial claims required Proficient in rate applications for Medi-Cal and/or Medicare pricers High school diploma or GED required Key Qualifications ICD-9 and CPT coding and general practices of claims processing Prefer knowledge of capitated managed care environment Microcomputer skills, proficiency in Windows applications preferred Excellent communication and interpersonal skills, strong organizational skills Professional demeanor Must be computer literate, maintain good attendance, and have the right attitude and discipline to work from home Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership) Pay Range USD $23.98 - USD $30.57 /Hr.

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Remote Option; Available for any of Partners' NC locations Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: This position is responsible for ensuring that providers receive timely and accurate payment. Role and Responsibilities: 50%: Claims Adjudication Responsible for finalizing claims processed for payment and maintaining claims adjudication workflow, reconciliation and quality control measures to meet or exceed prompt payment guidelines. Responsible for reconciling provider claims payments through quality control measures, generally accepted accounting principles and agency's policies and procedures. Assess Title XIX and non-Title XIX claims adjustments for correction or recoupment and will coordinate the recoupment process to ensure payment is recovered for inappropriately paid claims. Provide back up for other Claims Analysts as needed. 40%: Customer Service Maintain provider satisfaction by being available during regular business hours to handle provider inquiries; interacting in a professional manner; providing information and assistance; and answering incoming calls. Assist providers in resolving problem claims and system training issues. Serve as a resource for internal staff to resolve eligibility issues, authorization, overpayments, recoupments or other provider issues related to claims payment. 10%: Compliance and Quality Assurance Review internal bulletins, forms, appropriate manuals and make applicable revisions Review fee schedules to ensure compliance with established procedures and processes. Attend and participate in workshops and training sessions to improve/enhance technical competence. Knowledge, Skills and Abilities: Working knowledge of the Medicaid Waiver requirements, HCPCS, revenue codes, ICD-10, CMS 1500/UB04 coding, compliance and software requirements used to adjudicate claims General knowledge of office procedures and methods Strong organizational skills Excellent oral and written communication skills with the ability to understand oral and written instructions Excellent computer skills including use of Microsoft Office products Ability to handle large volume of work and to manage a desk with multiple priorities Ability to work in a team atmosphere and in cooperation with others and be accountable for results Ability to read printed words and numbers rapidly and accurately Ability to enter routine and repetitive batches of data from a variety of source documents within structured time schedules Ability to manage and uphold integrity and confidentiality of sensitive data Education and Experience Required: High School graduate or equivalent and three (3) years of experience in claims reimbursement in a healthcare setting; or an equivalent combination of education and experience. Education and Experience Preferred: N/A Licensure/Certification Requirements: N/A

Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Remote Option; Available for any of Partners' NC locations Projected Hiring Range : Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: This position is responsible for ensuring that providers receive timely and accurate payment. Role and Responsibilities: 50%: Claims Adjudication Responsible for finalizing claims processed for payment and maintaining claims adjudication workflow, reconciliation and quality control measures to meet or exceed prompt payment guidelines. Responsible for reconciling provider claims payments through quality control measures, generally accepted accounting principles and agency's policies and procedures. Assess Title XIX and non-Title XIX claims adjustments for correction or recoupment and will coordinate the recoupment process to ensure payment is recovered for inappropriately paid claims. Provide back up for other Claims Analysts as needed. 40%: Customer Service Maintain provider satisfaction by being available during regular business hours to handle provider inquiries; interacting in a professional manner; providing information and assistance; and answering incoming calls. Assist providers in resolving problem claims and system training issues. Serve as a resource for internal staff to resolve eligibility issues, authorization, overpayments, recoupments or other provider issues related to claims payment. 10%: Compliance and Quality Assurance Review internal bulletins, forms, appropriate manuals and make applicable revisions Review fee schedules to ensure compliance with established procedures and processes. Attend and participate in workshops and training sessions to improve/enhance technical competence. Knowledge, Skills and Abilities: Working knowledge of the Medicaid Waiver requirements, HCPCS, revenue codes, ICD-10, CMS 1500/UB04 coding, compliance and software requirements used to adjudicate claims General knowledge of office procedures and methods Strong organizational skills Excellent oral and written communication skills with the ability to understand oral and written instructions Excellent computer skills including use of Microsoft Office products Ability to handle large volume of work and to manage a desk with multiple priorities Ability to work in a team atmosphere and in cooperation with others and be accountable for results Ability to read printed words and numbers rapidly and accurately Ability to enter routine and repetitive batches of data from a variety of source documents within structured time schedules Ability to manage and uphold integrity and confidentiality of sensitive data Education and Experience Required: High School graduate or equivalent and three (3) years of experience in claims reimbursement in a healthcare setting; or an equivalent combination of education and experience. Education and Experience Preferred: N/A Licensure/Certification Requirements: N/A

Analyze, plan, design, maintain, and provide ongoing optimization and support of medical imaging systems. Perform workflow assessments, capture business needs and analyze internal business systems to determine functional requirements for optimal utilization. Possess proficient clinical, technical, or application knowledge and experience. Perform system builds, upgrades, and system enhancements as needed. Support application through all phases of implementation, optimization, and maintenance. Work with cross-functional teams and end users to achieve application integration to meet clinical and/or business needs. Contributes to project teams and collaborates to ensure system functionality and user satisfaction. Exercise discretion and judgment in the performance of original, creative, intellectual work. Incumbent is subject to callback and on-call as required. Perform other duties as assigned. Job Responsibilities• Assist in implementation and serve as point person on assignments related to all phases of implementation of medical imaging systems and new projects used in corporate-wide Epic-related information system solutions to meet project milestones.• Analyzes problems, recommends improvement, and develops appropriate action plans utilizing Baptist Management System tools to promote transformation and ensure successful implementation.• Completes testing of software applications using established standards and protocols.• Provides ongoing support of medical imaging systems and other applications under area of responsibility.• Supports system configuration and maintenance tasks, ensuring alignment with clinical workflows and operational requirements.• Collaborates with end users and stakeholders to gather and document requirements, facilitating effective system integration.• Assists in troubleshooting and resolving technical issues in medical imaging systems, escalating complex problems as needed. • Completes assigned goals ExperienceMinimum Required 5 yrs. of relevant experience EducationMinimum Required Bachelor Degree in either Radiology, Computer Engineering or Information Technology. TrainingMinimum Required None Special SkillsMinimum Required Skill and proficiency in communicating and performing the techniques of information systems and/or telecommunications assessment. LicensureMinimum Required DRIVER'S LICENSE (CURRENT)

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ***************** How YOU will make a Difference: As a Claims Specialist, you'll be at the heart of our mission to deliver exceptional service. Working alongside a dedicated team, you'll ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims that HMA administers for our members. Your role goes beyond handling claims, you'll be a key player in shaping a positive healthcare experience for our members. Every claim you interact with helps someone navigate their healthcare journey with confidence, making your work both meaningful and impactful. What YOU will do: Carefully research discrepancies, process returned checks, issue refunds, and manage stop payments with precision. This ensures financial accuracy and builds trust with both clients and members. Manage high-importance claims and vendor billing with urgency and attention to detail. Review and reply to appeals, inquiries, and other communications related to claims. Work with third-party organizations to secure payments on outstanding balances. Process case management and utilization review negotiated claims Spot potential subrogation claims and escalate them appropriately. Actively contribute to team success by assisting colleagues when workloads peak, sharing knowledge, and fostering a collaborative environment. Requirements High school diploma required 3-5+ years of claims processing experience 2+ years of BCBS claims processing experience Strong interpersonal and communication skills Strong attention to detail, with high degree of accuracy and urgency Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving Previous success in a fast-paced environment Benefits Compensation: The base salary range for this position in the greater Seattle area is $28/hr - $32/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: *****************

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Under the direction of the Claims Production Manager and Supervisor, the Claims Processor Level II will be processing outpatient professional and institutional claims. This includes but is not limited to; lab, radiology, ambulance, behavior health, outpatient COB, dialysis, oncology/chemo, hospital exclusions etc., in an accurate and expedient manner. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. * Competitive salary * Telecommute schedule * State of the art fitness center on-site * Medical Insurance with Dental and Vision * Life, short-term, and long-term disability options * Career advancement opportunities and professional development * Wellness programs that promote a healthy work-life balance * Flexible Spending Account - Health Care/Childcare * CalPERS retirement * 457(b) option with a contribution match * Paid life insurance for employees * Pet care insurance Education & Requirements * Minimum of two (2) years of experience adjudicating outpatient professional and/or institutional claims preferably in an HMO or Managed Care setting * Processing of Medicare, Medi-Cal, or Commercial claims required * Proficient in rate applications for Medi-Cal and/or Medicare pricers * High school diploma or GED required Key Qualifications * ICD-9 and CPT coding and general practices of claims processing * Prefer knowledge of capitated managed care environment * Microcomputer skills, proficiency in Windows applications preferred * Excellent communication and interpersonal skills, strong organizational skills * Professional demeanor * Must be computer literate, maintain good attendance, and have the right attitude and discipline to work from home Start your journey towards a thriving future with IEHP and apply TODAY! Pay Range * $23.98 USD Hourly - $30.57 USD Hourly