MDR Analyst - Shift Position (Unit 42) - US Citizen - Hybrid CA HQ
Remote job
Our Mission At Palo Alto Networks everything starts and ends with our mission: Being the cybersecurity partner of choice, protecting our digital way of life. Our vision is a world where each day is safer and more secure than the one before. We are a company built on the foundation of challenging and disrupting the way things are done, and we're looking for innovators who are as committed to shaping the future of cybersecurity as we are.
Who We Are
This role is remote, but distance is no barrier to impact. Our hybrid teams collaborate across geographies to solve big problems, stay close to our customers, and grow together. You will be part of a culture that values trust, accountability, and shared success where your work truly matters.
Job Description
Your Career
We are seeking a driven problem solver to join our Unit 42 MDR team. Our team is responsible for customers internal security monitoring, threat hunting and incident response. As a MDR Analyst, we will rely on you to detect and respond to cyber incidents facing customers' internal business.
The ideal candidate is a quick learner and good communicator who will be able to follow established processes for analyzing threat alerts that fire from our Cortex XDR. The candidate should be a creative thinker who takes pride in solving tough problems.
Your Impact
Join a new emerging team who is going to be part of Palo Alto's Unit 42, Working closely with global customers providing the best security in the market
Own an incident lifecycle from outbreak to full remediation
Provide critical feedback to the different product, research and engineering and threat hunting teams to help improve the products for the entire Palo Alto Networks' customer base
Work closely with Security Research, Threat Intelligence and Threat Hunting teams to remediate and detect new emerging threats
This position is a Shift Position (Saturday / Sunday shifts are expected to be part of the role). Shift time consists of US time, EMEA time and APAC time.
Qualifications
Your Experience
1+ years of experience in a multi tiered SOC/IR is a must
Experienced with Technologies such as EDR, SIEM, SOAR, FW
A well established familiarity with attack trends and vectors
Excellent written and oral communication skills in English
Some degree of Malware Analysis - An advantage
CEH / CompTIA CYSA+ certifications - An advantage
Hands-on experience with Cortex XSOAR or Cortex XDR - An advantage
Additional Information
The Team
Unit 42 is the global threat intelligence team at Palo Alto Networks. We believe threat intelligence should be shared and available to all within the industry. We deliver high-quality, in-depth research on adversaries, malware families, and attack campaigns. Our analysts uncover and document adversary behaviors and then share playbooks that give insight into the various tools, techniques, and procedures threat actors execute to compromise organizations.
If you're looking for a career with access to the brightest minds in cybersecurity, you've found it. We have a hunger for researching, hunting out the world's newest threats and sharing them with our industry to make the digital world a safer place.
You will be part of a growing, passionate, and dynamic team with an opportunity to work on challenging and exciting projects - centered on what we believe is one of the most significant mission statements in the world. We also strive to be the most people-centric company ever! That means we're constantly working to make your experience amazing, and you are part of the team breaking boundaries of what the workplace can be!
Compensation Disclosure
The compensation offered for this position will depend on qualifications, experience, and work location. For candidates who receive an offer at the posted level, the starting base salary (for non-sales roles) or base salary + commission target (for sales/commissioned roles) is expected to be between $87000 - $139500/YR. The offered compensation may also include restricted stock units and a bonus. A description of our employee benefits may be found here.
Our Commitment
We're problem solvers that take risks and challenge cybersecurity's status quo. It's simple: we can't accomplish our mission without diverse teams innovating, together.
We are committed to providing reasonable accommodations for all qualified individuals with a disability. If you require assistance or accommodation due to a disability or special need, please contact us at accommodations@paloaltonetworks.com.
Palo Alto Networks is an equal opportunity employer. We celebrate diversity in our workplace, and all qualified applicants will receive consideration for employment without regard to age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran status, race, religion, sex (including pregnancy), sexual orientation, or other legally protected characteristics.
All your information will be kept confidential according to EEO guidelines.
Is role eligible for Immigration Sponsorship? No. Please note that we will not sponsor applicants for work visas for this position.
People Insights Analyst 2/3
Remote job
At Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advancements in our nation's history - from the first flight across the Atlantic Ocean, to stealth bombers, to landing on the moon. We look for people who have bold new ideas, courage and a pioneering spirit to join forces to invent the future, and have fun along the way. Our culture thrives on intellectual curiosity, cognitive diversity and bringing your whole self to work - and we have an insatiable drive to do what others think is impossible. Our employees are not only part of history, they're making history.
We are seeking a People Insights Analyst to join Northrop Grumman's People AI & Analytics organization. This position will support the Mission Systems sector, and the selected candidate will report to the Manager, NGMS People Analytics. We will consider hybrid or fully remote arrangements for this position, with preference for candidates located near Mission System sites in Falls Church, VA, Linthicum, MD, Rolling Meadows, IL, Salt Lake City, UT, Woodland Hills, Sunnyvale, and San Diego, CA.
At Northrop Grumman, People AI & Analytics is a core domain within our Insights & Intelligence (i2) organization. As part of our Chief Information & Digital Office (CIDO), i2 works with all enterprise domains and businesses to drive our data, analytics & AI transformation.
As a People Insights Analyst, you will conduct quantitative analyses and develop innovative data products that help to answer challenging workforce questions. Through these efforts, you will enable HR leaders and business partners to make informed decisions across multiple areas of human capital including, but not limited to talent acquisition, culture, talent management, compensation and retention.
**Keys to success:**
+ Being curious, detail-oriented, and ethically conscious.
+ You seek to ask the right questions about our strategies, the business, and how we can use data to find solutions.
+ You are a strategic thinker who can translate data to create well-informed decisions to enable better business outcomes.
+ You want to drive positive change for our organizations, are candid and collaborative in taking on our most difficult analytics projects as well as the process and culture changes that accompanies them.
+ You build deep and trusted partnerships at the working and organizational levels.
**Responsibilities will include, but are not limited to:**
+ Creating strategic analyses by forming structured hypotheses, identifying patterns in data using quantitative methods and effective data visualizations, and deriving insights that drive decision making.
+ Authoring rigorous, data-driven, and peer reviewed reports (white papers and briefs) that inform and enable HR leaders and executives.
+ Developing and maintaining innovative products that leverage data and advanced analytics.
+ Defining data requirements, gathering and validating information, while also applying sound judgment for people-related business problems and workforce management decisions.
+ Driving projects from initial concept through deployment, leveraging opportunities for automation.
+ Working directly with a wide range of stakeholders, including executive leaders and HR partners, to understand organizational needs and business questions.
+ This role can be performed by a level 2 (early career) or level 3 (mid-career) professional.
As a full-time employee of Northrop Grumman, you are eligible for our robust benefits package including:
+ Medical, Dental & Vision coverage
+ 401k
+ Educational Assistance
+ Life Insurance
+ Employee Assistance Programs & Work/Life Solutions
+ Paid Time Off
+ Health & Wellness Resources
+ Employee Discounts
This position's standard work schedule is a 9/80. The 9/80 schedule allows employees who work a nine-hour day Monday through Thursday to take every other Friday off.
**Basic Qualifications:**
+ Level 2: Bachelor's degree with 2 years of related professional experience - OR - a Master's degree with 0 years of related professional data analytics experience.
+ Level 3: Bachelor's degree with 5 years of related professional experience - OR - a Master's degree with 3 years of related professional data analytics experience - OR - a PhD with 1 year of related professional data analytics experience
+ Must have a degree in a quantitative field (engineering, mathematics, economics, business analytics, statistics, computer science, etc.)
+ Must have the ability to extract and manipulate data from databases using SQL and write custom queries. Familiarity with common table expressions and building views.
+ Ability to apply quantitative and statistical approaches to answer questions using data.
+ Proficient using an object-oriented programming language (e.g., Python or R) to conduct analysis and create visualizations.
+ Experience in data storytelling through building compelling, concise, and insightful white papers and presentations to communicate developed insights.
+ Proficient in data visualization using Tableau or similar dashboarding tools.
+ Experience collaborating on projects across teams, managing relationships, and communicating findings to audiences.
**Preferred Qualifications:**
+ Experience with people- or talent-related data
+ Familiarity with Workday
+ Experience with lightweight markup languages like Quarto Markdown
+ Proficient using version control software and source code editors (e.g. git, VSCode)
+ Experience interfacing with and presenting to executive audiences
+ Experience with data storage and retrieval techniques, ETL, and databases
+ Familiarity with UX design principles
Primary Level Salary Range: $72,100.00 - $125,200.00
Secondary Level Salary Range: $89,400.00 - $155,400.00
The above salary range represents a general guideline; however, Northrop Grumman considers a number of factors when determining base salary offers such as the scope and responsibilities of the position and the candidate's experience, education, skills and current market conditions.
Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay. Annual bonuses are designed to reward individual contributions as well as allow employees to share in company results. Employees in Vice President or Director positions may be eligible for Long Term Incentives. In addition, Northrop Grumman provides a variety of benefits including health insurance coverage, life and disability insurance, savings plan, Company paid holidays and paid time off (PTO) for vacation and/or personal business.
The application period for the job is estimated to be 20 days from the job posting date. However, this timeline may be shortened or extended depending on business needs and the availability of qualified candidates.
Northrop Grumman is an Equal Opportunity Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. For our complete EEO and pay transparency statement, please visit *********************************** U.S. Citizenship is required for all positions with a government clearance and certain other restricted positions.
Reimbursement Analyst
Remote job
Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. The primary focus of this position is to design reports and analyze data from various sources in order to prepare cost reports and other reimbursement filings as required by regulatory agencies. Extensive knowledge of third-party reimbursement regulations is required in order to file reports accurately and to inform management and other areas of the organization of the impact of changing reimbursement regulations, filings, etc. Excellent communication skills are imperative to coordinate information from various levels of the organization, with Medicare and Medicaid auditors, external vendors, etc. Must be able to use critical thinking and analysis skills, experience, and insight to promptly, accurately, and effectively address issues, questions, complete projects, meet deadlines, etc. without direct management or other leadership involvement. Must be able to operate independently in highly efficient and effective manner.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor's Degree.
OR
2. HFMA Certified Hospital Cost Report Specialist (CHCRS).
EXPERIENCE:
1. Successful completion and submission of Medicare Cost reports for two or more (2+) years for Critical Access and/or Acute/IPPS facilities and successful navigation of at least two (2+) years of corresponding reviews, surveys, and audits (Interim rate reviews, S-10, Bad Debt, Charity Care, DSH, Wage Index, Occupational Mix, desk review, etc.)
2. Experience with hospital electronic health record systems (EPIC, Cerner, etc.), Cost Reporting applications, general ledger/accounting systems, and CMS/MAC cost reporting procedure, process, completion, submission, supporting schedules and documentation requirements, regulation, strategy, and audit.
3. Advanced computer and spreadsheet skills, primarily in Excel.
PREFERRED QUALIFICATIONS:
EXPERIENCE:
1. Three (3) experience in healthcare accounting (general ledger, trial balance, income statement, balance sheet, cash flow, etc.), finance, revenue cycle, data analysis, and/or reimbursement.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Prepares and/or supports all third party cost reports (Medicare, WV Medicaid, PA Medicaid, Ohio Medicaid, Champus/Tricare, etc.) and performs any analysis, updates, changes, etc. to facilitate any necessary amendments as needed. Assists and supports with the audits of these reports and any other associated audits (including but not limited to Wage Index, Occupational Mix, DSH, S-10, Bad Debt, Charity Care, NAHE, and DGME/IME) on an as needed basis where facility specific knowledge, experience, etc. will improve efficiency and effectiveness.
2. Coordinates compiling of all data required for completion of cost reports from various departments systems and external sources. Provides updates on status and monetary impact of all filings/deadlines, settlements, amendments, audits, etc. and regularly tracks, updates, and communicates with necessary parties regarding any and all reimbursement items.
3. Conducts research and provides documentation and explanations for all necessary workpapers, schedules, and forms and updates workpapers, schedules, applications and software( including but not limited to Absolute, and HFS systems/files) promptly and accurately. Performs all necessary variance analysis, reimbursement impact analysis, technical completion/submission review, analysis, and strategy and identifies strategy. methodology, and efficiencies to minimize losses and improve reimbursement as well as regulatory/audit risk and/or opportunity.
4. Analyzes data from all sources to ensure accuracy and consistency.
5. Assists with and prepares reimbursement budget models with accuracy using the most current, proposed and final regulations.
6. Assists with and prepares the Uniform Report for the WV Healthcare Authority annually.
7. Analyzes current rate structure for accuracy and potential opportunities/risk and completes Interim rate request forms as required (including discussion with department and facility leadership). Conducts analysis of all rate changes including estimated impact and identification of potential risk and/or opportunity. Responsible for distributing updated rates and estimated impact to internal departments.
8. Maintain and continually improve on technical skills needed to manipulate data.
9. Utilize and develop database report writing skills in Strata and other systems as needed. Analyze current report setup/processes for accuracy and efficiency.
10. Maintains all third-party cost report computer software systems, including installing all updates.
11. Compiles and submits all data for the Medicaid DSH Survey and DSH audit annually. Conducts all necessary analysis and opportunity/risk assessment.
12. Prepares and analyzes data and compiles supporting documentation for Wage Index and Occupational Mix submissions and identify specific areas for risk and/or opportunity. Assists in answering questions during the review of these items, providing supporting documentation and rationale, and other support as needed.
13. Provides necessary data and support to the reimbursement team to calculate third party receivables and payables as needed but at least monthly.
14. Provide analytical interpretation and substantiation during the Hospital's annual financial audit and annual governmental audits as needed in addition to any other support that be required
15. Coordinates reimbursement projects with various consultants as dictated by the needs and requirements of the project and the department.
16. Participates in meeting the objectives of the work unit and goals of the department.
17. Promotes and contributes positively to the teamwork of the department by assisting co-workers, contributing ideas and problem-solving with co-workers.
18. Participates in performance improvement through planning and implementing change and maintaining and improving productivity through attendance and participation in staff meetings, committees, task forces, cross functional groups, projects and discussion with hospital management and staff.
19. Identifies and addresses problems, questions, concerns, analysis, etc. in a timely manner so that proper actions can be implemented to prevent losses, maximize reimbursement, and meet deadlines, to facilitate the growth and stability of the organization.
20. Provides any other support to the Finance and Reimbursement Department as needed and coordinates activity with department leadership
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Frequent walking, standing, stooping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.
2. Must be able to sit for extended periods of time.
3. Must be able to read and write legibly in English.
4. Visual acuity must be within normal range.
5. Must have hearing abilities in order to communicate effectively via telephone and in person.
6. Must have reading and comprehensive ability.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Office type environment.
2. Ability to work remotely.
SKILLS AND ABILITIES:
1. Extensive experience in financial analysis and interpretation of federal and state regulations.
2. Specialized knowledge of hospital healthcare reimbursement, including but not limited to cost reporting, bad debt (including the reserve and posting process), S-10, Wage Index/Occupational Mix, DSH, 340b, and rate setting,
3. Strong communication skills are necessary to interact effectively with management, staff and external auditors.
4. Excellent analytical, critical thinking, and problem-solving abilities with the ability to manipulate and understand complex information and robust data sets and calculations
5. Effective organizational and time management skills with the proven ability to meet deadlines with precision, intention, and efficiency
6. Proficiency in Microsoft Office Suite (Excel, Access, Word, Outlook) and other fundamental computer skills
7. Ability to work effectively and independently managing tasks in a fast-paced environment
Additional Job Description:
Scheduled Weekly Hours:
40
Shift:
Exempt/Non-Exempt:
United States of America (Exempt)
Company:
SYSTEM West Virginia University Health System
Cost Center:
540 SYSTEM Finance and Reimbursement
Auto-ApplyMedical Coding & Reimbursement Analyst
Remote job
Guided by our core values and commitment to your success, we provide health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some of our offerings include:
Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute
Annual incentive bonus plan based on company achievement of goals
Time away from work including paid holidays, paid time off and volunteer time off
Professional development courses, mentorship opportunities, and tuition reimbursement program
Paid parental leave and adoption leave with adoption financial assistance
Employee discount program
Summary: The Medical Coding and Reimbursement Analyst researches, coordinates, analyzes, and provides coding expertise in the application of medical and reimbursement contracting, configuration, and benefit mapping. Follows company guidelines and refers issues to appropriate coding, billing, and coverage requirements, as necessary. Acts as a coding subject matter expert resource to internal customers. Able to perform all duties with limited supervision.Job Description
Provides analysis and recommendations to Contracting, Provider Payment, Provider Solutions, and Medical Policy team as it relates to coding, bundling, modifiers, clinical edits, benefits, and enforcements
Participates in provider / client / network meetings, which may include provider education through written communication.
Reviews complex operative reports and provider information regarding procedures, clinical edits, and fee schedules. Reviews appropriate use of modifiers and codes being submitted by providers to ensure appropriate reimbursement and billing practices.
Interprets state and federal mandates, applicable benefit language, medical & reimbursement policies, coding requirements and consideration of relevant clinical information to develop coding recommendations and payment policies.
Timely and accurate publishing of Payment Policies to Blue KC website
Evaluates process outcomes, provides recommendations from a code perspective for improvements across multiple lines of business.
Educates, investigates and assists internal customers regarding correct procedural coding for benefit, claim and system questions.
Requests and reviews claims/analytical reports; provide utilization summaries on coding/provider billing practices that may result in an enforcement, benefit, or payment policy change(s).
Develop proactive and positive working relationships with other departments within Blue KC to successfully drive accurate and timely initiatives related to medical codes, contracting, and reimbursement.
Communicates effectively with team members, team leadership, and other management.
Minimum Qualifications
Bachelor's degree from an accredited university or college in Healthcare Administration, Business, Information Systems or a related academic field; OR five (5) years of relevant experience providing the types and levels of knowledge, skills, and abilities required by the job.
Certified Coder with AHIMA or AAPC
3 years of professional experience working with operational and/or analytical processes, preferably within the healthcare industry or managed care payer.
Must be task oriented and able to meet designated deadlines; productivity standards and able to work independently.
Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, operative reports or governmental regulations.
Ability to write reports, business correspondence and business manuals.
Ability to effectively present information in one-on-one and small group situations to customers, clients and other employees of the organization.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages.
Ability to define problems, collect data, establish facts and draw valid conclusions.
Ability to interpret an extensive variety of technical instructions and deal with several abstract and concrete variables.
Intermediate knowledge of medical claims processing.
Intermediate level knowledge of Microsoft Office Word, Excel, and Access, or similar PC-based programs.
Preferred Qualifications
5 years of professional experience working with operational and/or analytic processes, preferably within the healthcare industry or managed care payer.
Strong understanding of Blue KC core systems (including Facets, Claims Xten, and NetworX)
Strong understanding of Blue KC claims, reimbursement, and benefit structures.
Blue Cross and Blue Shield of Kansas City is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability.
Auto-ApplyEPIC Payor Reimbursement Analyst - FT - Days - Remote Optional
Remote job
Start the day excited to make a difference…end the day knowing you did. Come join our team. EPIC Payor Reimbursement Analyst must have strong proficiency and knowledge application of providing analytic expertise in the following areas: Epic HB/PB contract build and modeling functions, healthcare financial and payor software systems, payor financial impact/trend analysis reports and managed care contracting knowledge. This role will require extensive knowledge of internal financial systems, ability to manipulate/present a wide data range upon request and understanding of financial impacts of managed care contracting to organization budgets. This position must demonstrate a commitment of quality service to our patients, the community, and our internal/external customers.
* At this time, this position is open to candidates located in and authorized to work in the United States who reside in one of the following states:
VA, NC, SC, GA, FL, NE, TX, WI, LA, ME, WV, TN, LA, NH, IA and OH*
Essential Functions & Responsibilities
Epic HB Resolute Function:
* Understanding and analysis of contracts, components, component groups, selection extensions, pricing extensions, hospital billing rules and many more items within the resolute
* Interpretation and loading of multiple fee schedules used within HB contracting
Epic PB Resolute Function:
* Interpretation and loading multiple fee schedules used within PB contracting
Epic HB/PB Resolute Function:
* Optimization of previously built contracts and creation of "new" contracts within the epic Contract Maintenance
* Build contracts within Epic that reimburse by DRG, percentage of billed charges, grouper rates, case rates, global case rates, per diem and contain lesser of and stop bill language, for utilization in expected reimbursement calculations
* Analyze, build, test, deploy and maintain Payor Relations contracts/fee schedules and system related functions
* Monitor, analyze and test interface projects and upgrades to ensure contract pricing and language are appropriate
* Utilizes contract modeling/cost accounting software to analyze/model the impact of contract rate proposals between MWHC and Payors
* Maintain knowledge in technical workflow and identify/communicate trends
Payor Relations Function:
* Analyzes and produces payor financial impact analysis for all contract proposals for HB/PB
* Performs retrospective impact analysis against organization budget to ensure contractual financial results meet set financial targets
* Analyzes the reimbursement impact of changes in government regulations, regulatory code changes/deletions/revisions, key managed care contracts, and third-party billing policies or requirements and reports financial impact to Manager.
* Utilize Excel to do the data analysis; data comes from Epic
* Performance of other duties assigned
Qualifications and Certifications:
Required
* Minimum 3 years relevant experience
* Certified in applicable Epic application and/or certified within six months of hire
* Strong understanding of payor reimbursement coding (e.g., DRG, CPT, RC, HCPCS, OPPS, APC)
* Strong understanding of HB/PB workflows, analytics and technology
* Ability to prioritize multiple projects
* Strong verbal, written and presentation skills
* Ability to maintain professionalism and work within a team environment across multiple disciplines and teams
Preferred
* Certified in Healthcare Financial Professional (CHFP)
* Strong understanding of HB/PB revenue cycle functions and payor contracting
* Strong computer skills relevant to position; extensive experience using Excel, Access Database, knowledge of Lawson and Siemen's systems and DSS/Managed Care contract modeling software
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
Auto-ApplySenior Reimbursement Analyst
Remote job
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Residency in or relocation to Louisiana is preferred for all positions.
POSITION PURPOSE
Independently researches, analyzes, develops and maintains new and existing, complex reimbursement programs. Designs system specifications that support claims payment and criteria for data bases that support analysis as well as training documentation describing programming, billing and payment guidelines for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business.
NATURE AND SCOPE
This role does not manage people
This role reports to this job: MANAGER, PROVIDER REIMBURSEMENT
Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with:
All levels of internal personnel, with primary contacts in Network Administration, IT, Medical Management, Benefits Administration, Actuarial, Legal, Executive, Marketing, and Underwriting. Providers, provider representatives, consultants, provider specialty organizations, AMA, vendor reps, and hospital administrators to exchange or review program information. Other data sources are market research consultants, AMA, St. Anthony, Relative Value Studies for Dentists, Dun and Bradstreet and HIAA, CMS, Blue Cross and Blue Shield Association, Blue Cross and Blue Shield Plans, CMS, DHS, sales and marketing regional offices.
QUALIFICATIONS
Education
Bachelor's degree in statistics, accounting, finance, math or related field is required
Prefer a Master's Degree or pursuit of a Master's degree in Business, Information System and Decision Sciences, Healthcare Administration or Public Health.
Four years of related experience can be used in lieu of a Bachelor's degree.
Work Experience
4 years of experience in the health industry accounting functions including billing, coding, Medicare or statistical analysis of financial information is required
Provider contract analysis and/or reimbursement program implementation experience is strongly is preferred
Skills and Abilities
Must have acquired sufficient knowledge to function autonomously and to know the appropriate contacts within departments to resolve specific issues for all lines of business.
Excellent analytical, oral and written communication, and report preparation skills with highest degree of accuracy are required. Must have the ability to effectively present information to Executive Management and all levels of employees.
Requires strong math/analytical skills including variance analysis, statistical formulas, algebraic formulas, percentages, multiplication and division, fractions and reasonableness tests.
Excellent attention to detail, research, and documentation skills are required.
Proficiency with commonly used database, spreadsheet and word processing software is required. Must have extensive knowledge to select the appropriate database format and structure for the type of information to be captured and reported. Familiarity with relational database software, mainframe capabilities, FOCUS and SQL programming is helpful and preferred. Must be able to create and maintain required databases as determined by supervisor.
A strong understanding of physician charge practices and billing methodologies is helpful.
Minimal travel is required. Travel may involve going to regional offices and/or conferences and exhibits.
Staff dedicated to supporting Medicare Advantage must have working knowledge of Medicare enrollment guidelines and reimbursement.
Licenses and Certifications
Pursuit of coding (CPC or CPHC) designation is preferred
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Serves as provider reimbursement technical advisor and/or committee participant to Information Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by developing and implementing project/program narratives and responding to concerns on new and existing reimbursement programs, billing guidelines, and system requirements to ensure accurate implementation and maintenance of provider reimbursement programs.
Identifies claims and provider reimbursement related system problems, including claims coding and processing issues, coordinates research, audit, and recommendations with Provider Audit, and implements and monitors system changes to resolve any problems.
Researches, designs, implements, and maintains complex hospital or professional provider reimbursement programs for traditional and managed care programs and Medicare Advantage. Contact other plans, consultants, and local providers to assist in program specifications. Proactively monitors health care and health industry developments, including CMS/Medicare eligibility, EGWP and methodology changes. Analyzes and produces management reports to monitor effectives and identify and resolve deficiencies of reimbursement programs in comparison to industry benchmarks, competitors, and Medicare.
Leads in the development of complex financial pricing models and financial data analysis to support modifications to reimbursement programs and monitor effectiveness of pricing logic.
Provides statistical reports to Network Administration, Medical Management, Marketing and Medicare Advantage to support internal strategies and external customer needs, such as contract negotiations and marketing efforts.
Complies with Corporate Objectives on project implementation and schedule deadlines. Ensures proper workflow by assessing reimbursement processes and recommending improvement as well as coordinating projects and time frames with less senior reimbursement staff.
Accountable for complying with all laws and regulations associated with duties and responsibilities.
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
#LI_CB1
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
Additional Information
Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance.
In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
Auto-ApplyRemote Cerner Oracle EMR EHR Business Analyst. Remote Part time or Full time
Remote job
For one of our ongoing project, we are looking for a Business analyst experienced on Cerner / Oracle EMR EHR. This is a 100% Remote role and can be done on a Part Time or Full time Basis. Only Local Wisconsin residents will be considered.
Job Description
Good understanding of Scheduling and Registration, HIM, Provider, Pharmacy, lab and · Nursing Workflows is needed.
B.A. shall have experience with the ability to understand and document business requirements for reporting in a HIPAA regulated environment.
Good business process mapping and process capture through Visio flow diagrams is also required.
Experience in change management systems.
Knowledge of vendor-based application release cycle and ticket management.
Ability to identify integration points.
Knowledge of reporting and dashboard maintenance.
Experience in process improvements and I.T. systems integration.
Ability to work with cross-functional teams.
Ability to work with business teams and good communication and presentation skills.
Experience in User Acceptance Testing (UAT), running regression tests on systems, and · identifying, designing, and optimizing new and existing test cases.
JIRA tool experience. (nice to have)
Experience with SQL, PL SQL and CCL code writing.
Existing knowledge of Discern Reporting Portal (Static and Interactive Reporting)
Existing Knowledge of Business Objects Reporting Solution.
EPIC Payor Reimbursement Analyst - FT - Days - Remote Optional
Remote job
Start the day excited to make a difference…end the day knowing you did. Come join our team.
EPIC Payor Reimbursement Analyst must have strong proficiency and knowledge application of providing analytic expertise in the following areas: Epic HB/PB contract build and modeling functions, healthcare financial and payor software systems, payor financial impact/trend analysis reports and managed care contracting knowledge. This role will require extensive knowledge of internal financial systems, ability to manipulate/present a wide data range upon request and understanding of financial impacts of managed care contracting to organization budgets. This position must demonstrate a commitment of quality service to our patients, the community, and our internal/external customers.
***At this time, this position is open to candidates located in and authorized to work in the United States who reside in one of the following states:
VA, NC, SC, GA, FL, NE, TX, WI, LA, ME, WV, TN, LA, NH, IA and OH***
Essential Functions & Responsibilities
Epic HB Resolute Function:
Understanding and analysis of contracts, components, component groups, selection extensions, pricing extensions, hospital billing rules and many more items within the resolute
Interpretation and loading of multiple fee schedules used within HB contracting
Epic PB Resolute Function:
Interpretation and loading multiple fee schedules used within PB contracting
Epic HB/PB Resolute Function:
Optimization of previously built contracts and creation of “new” contracts within the epic Contract Maintenance
Build contracts within Epic that reimburse by DRG, percentage of billed charges, grouper rates, case rates, global case rates, per diem and contain lesser of and stop bill language, for utilization in expected reimbursement calculations
Analyze, build, test, deploy and maintain Payor Relations contracts/fee schedules and system related functions
Monitor, analyze and test interface projects and upgrades to ensure contract pricing and language are appropriate
Utilizes contract modeling/cost accounting software to analyze/model the impact of contract rate proposals between MWHC and Payors
Maintain knowledge in technical workflow and identify/communicate trends
Payor Relations Function:
Analyzes and produces payor financial impact analysis for
all
contract proposals for HB/PB
Performs retrospective impact analysis against organization budget to ensure contractual financial results meet set financial targets
Analyzes the reimbursement impact of changes in government regulations, regulatory code changes/deletions/revisions, key managed care contracts, and third-party billing policies or requirements and reports financial impact to Manager.
Utilize Excel to do the data analysis; data comes from Epic
Performance of other duties assigned
Qualifications and Certifications:
Required
Minimum 3 years relevant experience
Certified in applicable Epic application and/or certified within six months of hire
Strong understanding of payor reimbursement coding (e.g., DRG, CPT, RC, HCPCS, OPPS, APC)
Strong understanding of HB/PB workflows, analytics and technology
Ability to prioritize multiple projects
Strong verbal, written and presentation skills
Ability to maintain professionalism and work within a team environment across multiple disciplines and teams
Preferred
Certified in Healthcare Financial Professional (CHFP)
Strong understanding of HB/PB revenue cycle functions and payor contracting
Strong computer skills relevant to position; extensive experience using Excel, Access Database, knowledge of Lawson and Siemen's systems and DSS/Managed Care contract modeling software
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
Auto-ApplyCSOC Analyst (Remote)
Remote job
Tier One Technologies is looking for a Cyber Security Operations Center (CSOC) Analyst to work with our direct US Government client.
.
SELECTED CANDIDATES WITHOUT REQUIRED CLEARANCE WILL BE SUBJECT TO A FEDERAL GOVERNMENT BACKGROUND INVESTIGATION TO RECEIVE IT.
Responsibilities
Identification of Cybersecurity problems which may require mitigating controls.
Analyze network traffic to identify exploit or intrusion related attempts.
Recommend detection mechanisms for exploit and or intrusion related attempts.
Provide subject matter expertise on network-based attacks, network traffic analysis, and intrusion methodologies.
Escalate items which require further investigation to other members of the Threat Management team.
Execute operational processes in support of response efforts to identify security incidents.
Responsible for monitoring, reviewing, and responding to security alerts and incidents across multiple platforms including Microsoft Defender for Cloud Apps, Defender for Endpoint, Defender XDR, Defender for Office 365, Azure Entra ID, and Google Cloud Security Command Center (SCC). Duties include performing threat detection and analysis, investigating suspicious activity, coordinating incident response efforts, and implementing remediation actions.
Participate in a team of Security operations engineers investigating alerts, anomalies, errors, intrusions, malware, etc. to identify the responsible, determine remediation, and recommend security improvements.
Follow precise analytical paths to determine the nature and extent of problems being reported by tools, e-mails, etc.
Follow strict guidance on reporting requirements.
Keep management informed with precise, unvarnished information about security posture and events.
Promote standards-based workflow both internally and in coordinating with CISA.
Engage with other internal and external parties to get and share information to improve processes and security posture.
Communicate to CISO leadership.
The role also involves tuning security policies, maintaining visibility into cloud and endpoint environments, and supporting continuous improvement of the organization's security posture.
Qualifications
Bachelor's OR Master's Degree in Computer Science, Information Systems, or other related fields, or equivalent work experience.
3+ years of IT security experience.
2+ years of experience in network traffic analysis.
Strong working knowledge of TCP/IP Fundamentals and Network Level Exploits.
CERTIFICATIONS: (One or more required):
CompTIA Security+
CISSP - Certified Information System Security Professional
CEH - Certified Ethical Hacker
CISA - Certified Information Systems Auditor
CISM (Certified Information Security Manager)
GIAC (Global Information Assurance Certification)
RHCE (Red Hat Certified Engineer)
Strong understanding of IDS/IPS technologies, trends, vendors, processes and methodologies.
Familiarity with IDS/IPS architectures, implementations, signatures, content creation and signature characteristics including both signature and anomaly-based analysis and detection.
Prior Azure and GCP O365/Microsoft 365 experience.
Excellent communication skills.
Must be able to obtain a Position of Public Trust Clearance.
Be able to pass a drug screening, criminal history, and credit checks.
Must be a US Citizen or Green Card holder.
Must have lived in the United States for the past 5 years.
Cannot have more than 6 months travel outside the United States within the last five years. Military Service excluded. (Exception does not include military family members.)
Auto-ApplyAnalyst I, Full Stack
Remote job
Affirm is reinventing credit to make it more honest and friendly, giving consumers the flexibility to buy now and pay later without any hidden fees or compounding interest.
What You'll Do:
Perform advanced data analysis to derive critical insights and develop credit strategies;
Utilize data modeling techniques to manage the profitability and resilience of Affirm by assessing and managing risk through analysis and development of portfolio models by using statistics to quantify risk;
Collaborate with Data Science and Engineering teams to build our new underwriting models and risk management capabilities for Affirm's consumer finance platform;
Explore business data by using statistical and data modeling to develop robust lifetime valuation infrastructure and capabilities;
Collaborate with the Merchant Pricing team to value different merchants and use advanced data analytics to derive insights and optimize credit strategies;
Develop credit policies for new initiatives and products;
Develop effective risk management strategies and capabilities by analyzing business data sets and using Structured Query Language (SQL) to perform ongoing data testing and experimentation;
Monitor portfolio as well as macroeconomic trends impacting loan performance; and
Improve end-to-end product analytics workflows using quantitative techniques including linear and logistic regression, classification, clustering and other data modeling and mining methods to deeply understand and analyze data that will improve underwriting solutions.
May telecommute.
Position requires 5% of travel to various unanticipated worksites nationally.
What we look for:
Master's degree (or foreign equivalent) in Business Analytics, Financial Engineering or related field & one year of experience in the following:
Economic and accounting principles and practices, including: the financial markets, banking, and the analysis and reporting of financial data;
SQL, Python, R, Matlab, or AWS;
Looker or Tableau;
Risk modeling including both credit and market risk, assessing macroeconomic trends and financial performance, enabling evaluation of industry risk trends;
Using advanced machine learning techniques to develop quantitative models to predict probability of default with financials and macroeconomic indicators;
Data analytics, financial modeling, model validation, and risk analytics.
Base Pay Grade - K
Equity Grade - 4
Employees new to Affirm typically come in at the start of the pay range. Affirm focuses on providing a simple and transparent pay structure which is based on a variety of factors, including location, experience and job-related skills.
Base pay is part of a total compensation package that may include equity rewards, monthly stipends for health, wellness and tech spending, and benefits (including 100% subsidized medical coverage, dental and vision for you and your dependents.)
USA base pay range (CA, WA, NY, NJ, CT) per year: $140,000-$190,000
USA base pay range (all other U.S. states) per year: $128,398-$174,000
#LI-DNI
Affirm is proud to be a remote-first company! The majority of our roles are remote and you can work almost anywhere within the country of employment. Affirmers in proximal roles have the flexibility to work remotely, but will occasionally be required to work out of their assigned Affirm office. A limited number of roles remain office-based due to the nature of their job responsibilities.
We're extremely proud to offer competitive benefits that are anchored to our core value of people come first. Some key highlights of our benefits package include:
Health care coverage - Affirm covers all premiums for all levels of coverage for you and your dependents
Flexible Spending Wallets - generous stipends for spending on Technology, Food, various Lifestyle needs, and family forming expenses
Time off - competitive vacation and holiday schedules allowing you to take time off to rest and recharge
ESPP - An employee stock purchase plan enabling you to buy shares of Affirm at a discount
We believe It's On Us to provide an inclusive interview experience for all, including people with disabilities. We are happy to provide reasonable accommodations to candidates in need of individualized support during the hiring process.
[For U.S. positions that could be performed in Los Angeles or San Francisco] Pursuant to the San Francisco Fair Chance Ordinance and Los Angeles Fair Chance Initiative for Hiring Ordinance, Affirm will consider for employment qualified applicants with arrest and conviction records.
By clicking "Submit Application," you acknowledge that you have read Affirm's Global Candidate Privacy Notice and hereby freely and unambiguously give informed consent to the collection, processing, use, and storage of your personal information as described therein.
Auto-ApplyTotal Rewards Analyst (Hospitality Solutions)
Remote job
Sabre is a technology company that powers the global travel industry. By leveraging next-generation technology, we create global technology solutions that take on the biggest opportunities and solve the most complex challenges in travel.
Positioned at the center of the travel, we shape the future by offering innovative advancements that pave the way for a more connected and seamless ecosystem as we power mobile apps, online travel sites, airline and hotel reservation networks, travel agent terminals, and scores of other solutions.
Simply put, we connect people with moments that matter.
NOTE:
TPG Capital, a global alternative asset management firm, recently acquired Hospitality Solutions. Over the coming months, Sabre is working with TPG to formally separate the Hospitality Solutions business from Sabre. It is important to understand that while you will be employed by a Sabre legal entity, your role will be to support the Hospitality Solutions business, which is now owned by TPG.
Hospitality Solutions, formerly part of Sabre Holdings, is a global leader at the forefront of hospitality technology powering over 40,000 properties across 174 countries. Celebrated for our innovative and customer-centric approach, we deliver integrated platforms for distribution, reservations, retailing, and guest experience to both renowned hotel brands and independent properties worldwide.
About the Role
The Total Rewards Analyst will play a key role in the support of the design, implementation, and optimization of our compensation and benefits programs globally. This is an exciting opportunity to join a small, high-impact team and contribute directly to building scalable, data-driven programs that attract and retain top talent.
You'll combine analytics and creativity by helping define frameworks, evaluate markets, administer benefits, and create an exceptional employee experience through rewards.
What You'll Do
Support the development and execution of global compensation and benefits programs
Conduct job evaluations, market pricing, and compensation benchmarking using external survey data
Assist with annual compensation review cycles, including salary structure updates, merit increases, and bonus calculations
Partner with HRBP's and Finance to ensure consistent and compliant pay practices across geographies
Administer employee benefits plans, supporting renewals, vendor relationships, and employee communications
Analyze reward program data and prepare insights and recommendations for leadership
Contribute to global Total Rewards projects and collaborate with Employee Experience team (e.g., equity programs, recognition platforms, or wellness initiatives)
Help build and document processes, tools, and best practices as the function matures
What We're Looking For
5+ years of experience in compensation and benefits (global experience a plus)
Strong analytical and Excel skills; experience with HRIS and compensation benchmarking tools preferred
Understanding of core compensation principles, job evaluation, and market analysis
Experience supporting benefits administration and vendor management
Ability to work independently in a fast-paced, growing environment
Strong attention to detail, curiosity, and a builder's mindset. You should be someone who loves solving problems and improving processes
Excellent communication and collaboration skills across teams and cultures
Outstanding Benefits
Very competitive compensation
Generous Paid Time Off (25 PTO days)
4 days (one day/quarter) Volunteer Time Off (VTO)
5 days off annually for Year-End Break
We offer a comprehensive medical, dental and Wellness Program
12 weeks paid parental leave
An infrastructure that allows flexible working arrangements
Formal and informal reward, recognition and acknowledgement programs
Lots of fun and engaging employee development events
Reasonable Accommodation
Sabre is committed to working with and providing reasonable accommodation to applicants with disabilities. Applicants applying for a Sabre position with a disability who require a reasonable accommodation for any part of the application or hiring process may contact Sabre at ****************************.
Determinations on requests for reasonable accommodation will be made on a case-by-case basis.
Affirmative Action
Sabre is an equal employment opportunity/affirmative action employer and is committed to providing employment opportunities to minorities, females, veterans and disabled individuals. EEO IS THE LAW
#LI-Hybrid#LI-TJ1
Auto-ApplyStaff Analyst, Marketing
Remote job
At Angi , we've had one simple mission for 30 years: get jobs done well. We make it happen by connecting homeowners with reliable pros who have the skills they need - and connecting pros with homeowners who have the jobs they want.
Angi at a glance:
Homeowners have turned to Angi for more than 300 million projects
1,000+ home service tasks covered
2,800 employees worldwide
Why join Angi:
Angi is defining the future of the home services industry, creating an environment where homeowners, pros, and employees benefit from more jobs done well.
For homeowners, our platform is a reliable way to find skilled pros. For pros, we're a reliable business partner who helps them find the winnable work they want, when they want. For employees, we're an amazing place to call home. We can't wait to welcome you.
The Role:
We are seeking an experienced and data-driven Staff Analyst to join our team as a senior individual contributor. This role will focus on optimizing the performance of our home repair and online marketplace platform by leveraging advanced analytics to drive strategic business decisions. You will work closely with product managers, marketing, and operations teams to analyze consumer behavior, market trends, service provider performance, and platform efficiency. As a key contributor, you will provide data-backed insights to enhance the user experience, increase platform engagement, and improve operational efficiency.
What you'll do:
Analyze user behavior, marketplace dynamics, and service provider performance to identify growth opportunities and areas for improvement.
Develop predictive models to enhance marketplace matching (e.g., home repair service providers to customers), pricing optimization, and user retention strategies.
Work cross-functionally to provide data-driven insights for feature enhancements, platform updates, and A/B testing initiatives.
Present findings and recommendations to senior leadership, contributing to overall business strategy and platform growth.
Create dashboards and reports to monitor key marketplace metrics (e.g., response times, job completions, user satisfaction) in real-time.
Ensure data integrity by collaborating with data engineering teams to maintain accurate, scalable data solutions.
Mentor junior analysts and assist in refining analytics processes, models, and reporting tools.
Stay current with trends in the home services industry, online marketplace developments, and emerging data tools to keep our platform competitive.
Who you are
Bachelor's degree in Data Science, Economics, Statistics, Business, or a related field (Master's degree preferred).
8+ years of analytical experience in an e-commerce, marketplace, or home services-related field.
Strong proficiency in SQL as well as data analysis tools such as Python or R.
Expertise in data visualization tools such as Tableau, Power BI, or Looker.
Proven ability to develop and apply predictive models to enhance marketplace performance.
Strong communication skills to present complex data to cross-functional teams and non-technical stakeholders.
Ability to manage multiple projects independently in a fast-paced environment.
Experience in coaching or mentoring junior team members.
We value diversity
We know that the best ideas come from teams where diverse points of view uncover new solutions to hard problems. We welcome and value individuals who bring diverse life experiences, educational backgrounds, cultures, and work experiences.
Compensation & Benefits
The salary band for this position ranges $125,000 - $200,000 commensurate with experience and performance. Compensation may vary based on factors such as cost of living.
This position will be eligible for a competitive year end performance bonus & equity package.
Full medical, dental, vision package to fit your needs
Flexible vacation policy; work hard and take time when you need it
Pet discount plans & retirement plan with company match (401K)
The rare opportunity to work with sharp, motivated teammates solving some of the most unique challenges and changing the world
#LI-Remote
Auto-ApplyReimbursement Specialist/Medical Coder - Surgery
Remote job
Reimbursement Specialist/Medical Coder - Surgery - (909360) Description WHY UT SOUTHWESTERN?With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees.
Ranked as the number 1 hospital in Dallas-Fort Worth according to U.
S.
News & World Report, we invest in you with opportunities for career growth and development to align with your future goals.
Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more.
We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! JOB SUMMARYWorks under moderate supervision to provide policy analysis and recommendations to management related to reimbursement projects and functions.
BENEFITSUT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees.
Our benefits are designed to support your overall wellbeing, and include:PPO medical plan, available day one at no cost for full-time employee-only coverage100% coverage for preventive healthcare-no copay Paid Time Off, available day one Retirement Programs through the Teacher Retirement System of Texas (TRS) Paid Parental Leave BenefitWellness programs Tuition ReimbursementPublic Service Loan Forgiveness (PSLF) Qualified EmployerLearn more about these and other UTSW employee benefits!Work Schedule: Monday-Friday (8am-5pm).
This position is 100% remote.
Candidate must live in Texas.
EXPERIENCE AND EDUCATIONRequiredEducationHigh School Diploma or equivalent Experience4 years of progressively responsible experience in medical insurance, medical billing or medical reimbursement.
PreferredLicenses and Certifications(CPC) CERT PROFESSIONAL CODER Upon Hire or Advanced Records Technician (ART) Upon Hire or(RRA) REGISTERED RECORDS ADMIN Upon Hire JOB DUTIESPerforms policy analysis for managed care issues by reviewing contracts, writing clause revisions, making recommendations for reimbursement policy changes, reviewing reports and financial data, and analyzing fee schedules, encounter forms, diagnosis, and procedure codes; ensures contracts reflect appropriate business decisions.
Ensures projects related to reimbursement issues are completed on time and changes are implemented appropriately by conducting meetings, organizing activities, reviewing data analyses and reports, and creating reimbursement policies and procedures.
Documents findings by writing inquiry letters, constructing opinion letters, maintaining contract files, and maintaining files for research documents.
Performs other duties as assigned.
SECURITY AND EEO STATEMENTSecurityThis position is security-sensitive and subject to Texas Education Code 51.
215, which authorizes UT Southwestern to obtain criminal history record information.
EEOUT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community.
As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.
Primary Location: Texas-Dallas-5323 Harry Hines BlvdWork Locations: 5323 Harry Hines Blvd 5323 Harry Hines Blvd Dallas 75390Job: Insurance/BillingOrganization: 429001 - SY-Clinical Revenue CycleSchedule: Full-time Shift: Day JobEmployee Status: RegularJob Type: StandardJob Posting: Dec 18, 2025, 3:04:12 AM
Auto-ApplyPayment Cycle Analyst III
Remote job
The Payment Cycle Analyst III is responsible for conducting both systemic and targeted analysis to identify reimbursement errors and to determine root cause. As well as collaborating with Configuration, Configuration UAT, Enterprise UAT, IT Claims, and Payment Cycle Team members to ensure test scripts are comprehensive.
Essential Functions:
Provide analytical support and leadership for special projects and initiatives related to reimbursement of claims for both providers and members
Research and provide recommendations to the Reimbursement Committee for reimbursement of services
Research claim results to determine potential errors/discrepancies attributed to clinical edits, claims coding, payment policies, and application of fee schedule and rates
Develop business requirements for payment decisions and manage the implementation process with Configuration, CES, IT and Market stakeholders
Lead special projects to ensure payment discrepancies are resolved and communicated to the appropriate parties
Provide payment expertise at provider meetings, Medicaid Fairs, market workgroups, and any other industry related events
Review and interpret regulatory items and policy manuals to ensure test scenarios support the requirements
Identify test result outputs and Claim SOPs that need to be modified or created to support new or changed business requirements
Build library of re-usable tests plans & scripts to support the Market
Document the status of test results and gaps in testing for future improvements
Validate Impact Reports to ensure the criteria is consistent with story and universe of claims impacted by the changes
Approve UAT test scripts and test results prior to promoting changes to production and monitor post production results
Validate MCA Tests for expected results and communicate information to Reimbursement Analysts and HP Managers for provider notification
Conduct both systemic and targeted analysis to identify issues with testing and identify process changes for improvement
Create effective written and oral communication materials that summarize findings and support fact based recommendations that can be shared with Configuration, IT, UAT, Reimbursement Committee, Payment Cycle, and Provider Groups
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 plan experience is required or equivalent experience with health plan operations and configuration
Experience with user testing is required
Experience with payment methodologies and industry pricers (ex: DRG, APC, SNF, RBRVS) is preferred
Competencies, Knowledge and Skills:
Advanced proficiency level experience in Microsoft Suite to include Word, Excel, PowerPoint, Access and Visio
Strong computer skills and abilities in Facets or equivalent claim payment system is preferred
Strong analytical skills with the ability to effectively communicate findings with the Leadership Team
Demonstrated understanding of claims operations, configuration, and testing related to managed care
Understanding of regression, unit, and user acceptance testing is required
Effective listening and critical thinking skills
Effective problem-solving skills with attention to detail
Creative thinking to develop positive and negative test scenarios
Excellent written and verbal communication skills
Ability to work independently and within a team environment
Strong interpersonal skills and high level of professionalism
Ability to develop, prioritize and accomplish goals
Understanding of the healthcare field and knowledge of Medicaid, Medicare, and Marketplace
Strong working knowledge of claims processing edits and logic
Familiar with CMS guidelines / HIPPA and Affordable Care Act
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-TS1
Auto-ApplyAnalyst (Product / Systems)
Remote job
Job Description
Discover the feelings of Camaraderie and Family while being analytically and technically challenged to grow! Responsibilities: Collaborate directly with clients' end-users and our internal teams to design and develop dynamic Enterprise Web and Mobile applications in Cyber Security, Supply Chain/Logistics, or Finance for a variety of clients like Verizon, Capital One, and Cardinal Health in small teams. Work in a fast-paced, hands-on capacity in a client-interactive role, rapidly absorbing and analyzing requirements, creating use cases and business applications requirements seeing first-hand the impact of your work on a daily basis.
Desired Skills/Traits:
Understanding/familiarity with software/technology,
Proficiency or ability to quickly learn new concepts and technologies.
High Energy / Attitude.
Creative Problem Solving.
We take care of our EAI Family:
FREE catered lunch DAILY. Stipend provided during COVID work from home.
Paid Training (CodeAcademy, Coursera, NoFluffJustStuff, Google DevFest, pre-paid courses, mentoring).
FREE snacks/drinks - Multiple varieties of soft drinks, juices, coffee, tea, Gatorade, beer, wine & regular social gatherings.
EAI has NEVER HAD LAYOFFS from its beginnings in 2001. We have carried our folks through multiple tough economic cycles (2002, 2009/10, current pandemic) and will continue to do so!
We are growing and looking for individuals who want to be part of a fun, passionate, and highly accomplished team with Hackathons and regular events like Poker and Movie Night to keep the spirits alive. Combine that with daily catered lunch from such restaurants as Cava, Chipotle, La Plaka, Jason's Deli, and Shake Shack and you can see that we strive to foster a family-friendly culture that emphasizes teamwork, camaraderie, and openness.
Come experience why so many employees have been with EAI for 5 to 10+ years and continue to make it their home as the EAI Family expands.
Powered by JazzHR
VLLLTaXOWP
Temporary Conflicts Analyst
Remote job
Dentons US LLP is currently recruiting for a Temporary Conflicts Analyst for the US Lateral Conflicts Team. This is an exciting opportunity to join a highly collaborative team, help support the firm's US Conflicts team ensuring effective compliance controls and procedures are in place in relation to supporting the recruitment process, and on-boarding of lateral and firm growth hires, particularly those involving the avoidance of conflicts of interest, protection of confidential information and to ensure compliance with applicable legislative requirements and management of risk. This position reports to the Lateral Conflicts Manager and is fully temporary remote position.
Responsibilities
Handling conflict of interest checks for lateral candidates, including partners, associates and professional administrative staff.
Conducting legal conflict of interest checks and matters specifically related to lateral hires
Organizing and tracking progress of lateral candidates through the clearance process.
Liaising with Recruitment and lateral candidates to ensure that conflict questionnaires are complete and accurate
Conducting research on business and corporate entities via online resources
Handling complexity protection of confidential information issues
Reviewing and adhering to Dentons' internal compliance policies and procedures.
Assisting the Lateral Conflicts Team with compliance projects, where appropriate
Other duties may be assigned to fully meet the requirements of the position
Experience & Qualifications
Relevant experience in an international law firm, although other professional services or financial services firms will be considered.
Prior experience analyzing and resolving conflicts of interest and managing confidential information issues specifically for lateral hires is desirable
An understanding of Elite and Intapp Open conflict checking system is desirable
Excellent analytic skills: Able to quickly identify and meticulously analyze complex issues to provide practical solutions.
Detail oriented with excellent written and verbal communication skills; strong problem solving and analytical skills
Team player able to interact positively at all levels within the firm and able to demonstrate excellent client/customer facing skills
Able to exercise tact and diplomacy and demonstrate initiative and the ability to be proactive
Ability to multitask, prioritize and meet deadlines while maintaining attention to detail and quality work product
Possess a high degree of trustworthiness and discretion, due to the highly confidential nature of the lateral conflicts process
Proficiency with Microsoft Word, Excel, and Outlook
This is an hourly position with a pay rate between $25 and $30 an hour.
Dentons US LLP offers a competitive salary and benefits package including medical, dental, vision, 401k, profit sharing, short-term/long-term disability, life insurance, tuition reimbursement, paid time off, paid holidays and discretionary bonuses.
Dentons US LLP is an Equal Opportunity Employer - Disability/Vet. Pursuant to local ordinances, we will consider for employment qualified applicants with arrest and conviction records.
If you need any assistance seeking a job opportunity at Dentons US, LLP, or if you need reasonable accommodation with the application process, please call our Talent Acquisition Specialist at *************** or contact us at *************************************.
About Dentons
Redefining possibilities. Together, everywhere. For more information visit ***************
Analyst IV, CPQ
Remote job
Plan, design, develop, and launch efficient business and operations systems in support of core organizational functions and business processes. Gather and analyze data in support of business cases, proposed projects, and systems requirements. Perform work with a high degree of latitude and handles more complex client accounts and/or configuration issues.
Partner with decision makers, systems owners, and end users to define business, financial, and operations requirements and systems goals, identify and resolve systems issues, drive new projects and initiatives, and support existing business dependency.
Develop standards, procedures, and design documents related to system architecture.
Lead internal teams and IT to gather business requirements needed for system modifications, enhancements, and implementations.
Analyze results of user testing to define interface requirements and develop specifications or prototypes.
Develop, design, and edit interface templates or interface code, following established software development and methodologies.
Serve as the subject matter expert (SME) to identify, create, and facilitate process design changes through the review and analysis of system effectiveness and efficiency; ensure data is reliable and develop strategies for improving and leveraging these systems.
Troubleshoot technical issues and lead technical investigations to identify and discover system errors, application modification, and/or functionality related issues.
Determine priority of escalated issues effectively and manage conflicting/competing priorities.
Perform in-depth tests, utilizing end-user reviews, for modified and new systems and other post-implementation support.
Lead and participate in Sprints for development cycle, define deliverables, determine improvement priorities, and provide feedback to ensure on-time delivery of project tasks and milestones.
Education Required:
Bachelor's degree in Computer Science or related discipline.
Or, any combination of education and experience which would provide the required qualifications for the position.
Experience Required:
5+ years' experience in using and implementing enterprise application solutions.
5+ years' experience in enterprise application configuration and development.
Salesforce platform experience.
Oracle CPQ (Big Machines) or similar type of application.
Agile environment.
Experience designing and supporting large-scale technically complex solutions.
Knowledge, Skills & Abilities:
Knowledge of: Salesforce configuration and portals including but not limited to developing custom objects, work-flow business rules, and validation rules; Sarbanes Oxley (SOX) processes and Stock Keeping Unit (SKU) creation and modification processes; relational databases used at enterprise scale; Microsoft Office Suite.
Skill in: Effective relationship management, communication, and presentation; dealing effectively with customers, vendors, peers, and senior management; work in a fast-paced environment; staying organized, prioritizing workload, multi-tasking, and meeting deadlines.
Ability to: Provide orientation and training to end users; mentor and provide guidance to junior staff; work independently as a self-starter in a fast-paced environment; adapt to growing and changing environment delivering accuracy while managing multiple deliverables within a projected timeline.
The company has reviewed this to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.
NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
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For companies building financial technology and transforming the financial services space, the biggest bottleneck to their growth and innovation is often the underlying banks and infrastructure stack they rely on. We have spent our careers founding and scaling companies like Plaid, Square, Meta, Blend, and Affirm, and have seen this problem firsthand - builders and developers needing to partner with traditional banks, and creating API and abstraction layers over the patchwork that is the bank, its core, and many other vendors. All of this results in a complex (and often expensive) banking supply chain involving a user, fintech, BaaS middleware provider, bank, core and the Federal Reserve.
At Column, we set out to simplify and fix this. We are a bank and a software company built from the ground up, offering builders and developers technology-forward banking solutions that cut out the hundreds of vendors, middleware providers, and abstraction layers. This means a safer, more transparent, and less costly banking supply chain. Come build with us!
The opportunity:
Column's Financial Crimes team is responsible for protecting the Bank and its customers from money laundering, fraud, economic sanction evaluations, foreign corruption, and terrorist financing violations. Our program is designed to ensure the Bank, U. S. financial system, and our country are protected from illicit actors who exploit banking services with nefarious and criminal intent.
The AML Analyst role performs L1 triage investigations of transaction monitoring system-generated alerts and referrals, including identifying root causes of the alert, sources and uses of funds, and potentially suspicious activity. This role is a great opportunity for someone who is passionate about the world of financial crimes, and who is interested in gaining experience across a wide variety of fintech customer types, use cases, and flow of funds to accelerate their AML career.
This role is a fixed-term contract, remote position with an initial contract duration of six months and the potential to extend or convert to full-time employment based on performance.
What you'll do:
Perform extensive investigations related to transaction monitoring and customer due diligence that could implicate potential money laundering, fraud, or terrorist financing
Prepare and document triage investigations and their dispositions according to FINCEN/FFIEC expectations and Bank Procedures
Prepare detailed escalation and dismissal narratives per FFIEC expectations and Bank procedures
Maintain organized documentation related to financial crimes activities, including investigations, audits, and regulatory exams
Perform day-to-day activities consistent with safe and sound business practices and regulatory requirements
What you'll need to be successful:
Bachelor's degree and/or equivalent experience performing investigations for a regulated financial institution
2+ years of experience with BSA/AML and OFAC laws and regulations
CAMS certification preferred, but not required
Detail-oriented with excellent interpersonal, written, and verbal communication skills
Knowledge of AML typologies and red flags
Experience preparing and documenting financial crimes investigations in accordance with FFIEC expectations
What you'll get from us:
🏥 Comprehensive health, dental, and vision plans, including options that are 100% covered by Column for you
💳 FSA and HSA account options to enable use of pre-tax money for medical and dependent care expenses
🌴 Paid PTO, including 80 hours of vacation and 80 hours of sick leave each year
📈 Eligibility to participate in Column's 401k plan, including self-directed brokerage options
Pay transparency:
The US hourly rate range for this role is $30.00-$35.00. This position is non-exempt, meaning individuals in this role will be eligible for overtime pay in accordance with California labor law.
A candidate's position within this salary band will be narrowed during the interview process based on a number of factors including, but not limited to, the candidate's skill sets, experience, licensure and certifications, location, and other business and organizational needs.
We look forward to hearing from you
Column is committed to working with the best and brightest people from the broadest talent pool possible. We value bringing together a team with different perspectives, educational backgrounds, and life experiences, and believe a diversity of ideas is what allows us to develop the best solutions. All qualified individuals are encouraged to apply.
If you need assistance or a reasonable accommodation during the application and recruiting process, please reach out to accommodations@column.com.
We participate in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program here.
Auto-ApplyFulfillment Analyst
Remote job
Fulfillment Department | Fulfillment Analyst (Close-Out's)
Brookstone Management is a leader in residential and commercial property preservation and reo management solutions. Brookstone Management is seeking entry level candidates to join our team. The ideal applicant will be a self-starter with strong attention to detail. Duties and responsibilities include, but are not limited to the following:
Review and process photos provided by the vendors to determine whether the work has been completed or not
Report your production to the Fulfillment Supervisor at the end of each day
Analyze, Compile, and Submit data/photos provided by our vendors to our client
Communicate deficient work orders with the vendors
Conduct the first debris count for each Initial Service Work Order
Update client systems with status updates on each work order
Skills and Experience
High School Diploma or equivalent required (Associate's or Bachelor's degree preferred)
Computer proficiency required
Strong written and verbal communication skills required
Experience in Microsoft Office is preferred
Prior data entry experience preferred
Ability to work individually, or as part of a team
Strong Analytical skills as the majority of this position consists of reviewing photos and data provided by our vendors
Strong Organizational skills are mandatory
Knowledge of Property Preservation, REO, Mortgage industry is preferred
Benefits
Health Insurance
Dental Insurance
Vision Insurance
Paid Time Off
Retirement plan with company match
Location:
Remote Position- Work from Home
Here at Brookstone, we provide in-depth training on our industry and our internal systems. We are a growing company and have excellent advancement opportunities. Brookstone prides itself on maintaining a positive work environment, and we are dedicated towards our continued success.
Auto-ApplyAnalyst, CODISCOVR
Remote job
This role will serve as support for CODISCOVR requests and provide technical support in processing, filtering, ESI imports, load file manipulation, advanced search queries, STRs and culling measures and database design for various eDiscovery and Practice/Litigation Support tools. Note: This is a US-based remote role.
Minimum of Bachelor's degree and/or at least 2 years of relevant experience in eDiscovery or technical litigation support at either a Law Firm or Service Provider.
Ability to effectively manage technical and quality issues with eDiscovery and litigation support providers.
Excellent team work skills and strong client-service orientation.
Working knowledge of Relativity.
Understanding of other standard law firm applications.
Excellent communication skills and the ability to build effective internal and external client relationships.
The ability to work concurrently on projects and flexibility in shifting focus.
The ability to work under minimal supervision and meet case-specific deadlines.
Occasional travel may be required.
Provides regular and timely updates of all assigned projects and is expected to work outside regular business hours to adequately complete tasks as needed or directed by the case team or Department Manager.
Troubleshoots and provides support specific to litigation support applications and associated technologies to end-users.
Culls, filters and de-duplicates raw data for document review.
Creates and manipulates load files for various applications.
Processes eDiscovery for attorney review in Relativity.
Creates transcript management databases per client requests in TextMap and provide support when needed.
Manages the secure and stable transfer of client data.
Executes client data productions as requested by case team.
Provides technical support and training to attorneys, paralegals and other team members across the Firm's offices.
Communicates regularly and proactively with case teams to assess goals and set realistic expectations throughout the eDiscovery process including identification, preservation, collection, processing, analysis, review and production of ESI and paper documents.
Provides status reports and training to legal teams as needed.
Creates database/project structure used including Relativity.
Forges collaborative partnerships among the legal teams, the CODISCOVR Department, and throughout all offices.
Tracks all case-related activity utilizing project management tools and completes all relevant tracking forms.
Contributes to and enriches the knowledge base and expertise of the CODISCOVR Department as a whole.
Performs any and all duties as assigned by CODISCOVR Management in compliance with SOPs.
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