NewGuide Transformation Analyst (AI & Governance) Pinnacle Technical ResourcesGuide Transformation Analyst (AI & Governance)McLean, Virginia$50–$55 / hourContractorThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. Successfully placed or hired candidates would only be asked for banking details after accepting an offer from us during our official onboarding processes as part of payroll setup.
NewSenior Programmer Analyst (AI/ML, GenAI) Pinnacle Technical ResourcesSenior Programmer Analyst (AI/ML, GenAI)Richmond, Virginia$65–$70 / hourContractorThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. This includes evaluating new tools and technologies, developing proof of value (POV) solutions, and implementing AI solutions within a private cloud environment.
Senior Data Science Analyst Pinnacle Technical ResourcesSenior Data Science AnalystRichmond, Virginia$57–$61 / hourContractorThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. The role involves collaborating with cross-functional teams to ensure high-quality data solutions that meet business needs while adhering to best practices in data governance, security, and performance.
NewIT Consultant III PlanIT GroupIT Consultant IIIArlington, VAConduct analysis of open sources to identify fraudulent communication channels and techniques, including, but not limited to forums, social media, dark/deep web, news media, public records, and geospatial data. • Ability to produce high-quality intelligence products (threat assessments, trend analyses, profiles, timelines, geo-based heat maps) with clear analytical rigor and defensible findings.
Epic Resolute Professional Billing (PB) & Claims Analyst InterscriptsEpic Resolute Professional Billing (PB) & Claims AnalystChantilly, VirginiaThe ideal candidate will have hands-on experience in implementing, configuring, supporting, and optimizing the Epic Resolute Professional Billing (PB) module, with expertise in claims management and physician revenue cycle workflows. The candidate will collaborate with billing, coding, revenue cycle, and operational teams to enhance billing accuracy, streamline claims processing, and improve reimbursement outcomes.
Epic HB/PB Resolute Claims Analyst InterscriptsEpic HB/PB Resolute Claims AnalystChantilly, VirginiaWe are seeking an experienced Epic Resolute Hospital Billing (HB),or Professional Billing (PB), and Claims Analyst to support, maintain, and optimize Epic Revenue Cycle applications. The ideal candidate will have hands-on experience with Epic Resolute HB, PB, Claims, and Revenue Cycle workflows, along with strong analytical and troubleshooting skills.
Claims Analyst - REMOTE Ryder System IncClaims Analyst - REMOTERichmond, VARemoteCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( https://wd5.myworkday.com/ryder/d/task/2998$46522.htmld ) to log in to Workday to apply using the internal application process.
Business Claims Analyst II - Wellpoint Federal Elevance HealthBusiness Claims Analyst II - Wellpoint FederalRichmond, VirginiaBA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
NewEntry Level - Claims Analyst - Motor Vehicle Accident - Hybrid AspirionEntry Level - Claims Analyst - Motor Vehicle Accident - HybridCastlewood, COFrom challenging denials and zero balance reviews to aged accounts receivable, motor vehicle accident claims, workers’ compensation, Veterans Affairs, and out of state Medicaid, we take on the work that others cannot solve and deliver real results for our clients. With more than 1,400 individuals across the organization, we are united by a shared commitment to delivering exceptional outcomes and creating meaningful impact for the hospitals and health systems we serve.
Senior Construction Claims Analyst (Full Time) Mcdonough Bolyard Peck IncSenior Construction Claims Analyst (Full Time)Vienna, VA$107,000–$150,000 / yearMBP is looking for Senior Construction Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration.
Construction Claims Analyst/Lead Construction Claims Analyst (Full Time) Mcdonough Bolyard Peck IncConstruction Claims Analyst/Lead Construction Claims Analyst (Full Time)Richmond, VA$82,000–$115,000 / yearMBP is looking for Construction Claims Analyst/Lead Construction Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration.
["Senior Construction Claims Analyst (Full-Time)","Senior Construction Claims Analyst (Full-Time)"] MBP["Senior Construction Claims Analyst (Full-Time)","Senior Construction Claims Analyst (Full-Time)"]Vienna$107,000–$150,000 / yearMBP is looking for Senior Construction Claims Analyst * in Tampa, FL, Raleigh, NC, or Washington DC areas, with significant experience developing and/or providing review and analysis of construction claims, specifically related to delay, productivity, and cost impacts. Additional experience in one or more of the following desired: construction management, cost estimating, value engineering, risk management, constructibility review, and/or contract administration.
Business Analyst CMdS Claims, Member & Finance Implementation (MES) The Computer Merchant, LtdBusiness Analyst CMdS Claims, Member & Finance Implementation (MES)Richmond, VARemote$50–$60 / hourFunctional design (Claims, Member, Finance) Claims: Lead functional design for claim intake, claim type assignment, validity/pricing edits, adjustment/void, crossover, encounters, remittance, and related edit disposition behavior; map legacy rules to CMdS configuration and customizations. * While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and business considerations.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeVAEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Lead Decision Science Analyst - P&C Claims GenAI USAALead Decision Science Analyst - P&C Claims GenAIVA$143,320–$273,930 / yearFinally, the candidate must possess strong Business Translation & Decision Intelligence capabilities, enabling them to translate complex business problems into AI-driven decision strategies, define key success metrics, and integrate GenAI seamlessly into operational workflows. Researches and pursues the latest and/or industry leading practices in data and analytics, (Ex: Cloud, Data Mining, Python, Neural Networks, Sensor data, IoT, Streaming/NRT data) to advance the overall DSA community knowledge.
Senior Decision Science Analyst - P&C Claims GenAI USAASenior Decision Science Analyst - P&C Claims GenAIVA$114,080–$218,030 / yearWhat you have: 6 years of data & analytics experience OR a minimum of 4 years of data & analytics experience and up to 2 years of progressive functional business relevant experience within the respective industry of responsibility (i.e. P&C, Bank, Finance, Marketing etc.) for a total of 6 years combined experience OR advanced degree in quantitative analytics field such as Economics, Finance, Statistics, Mathematics, Actuarial Sciences, Operations Research, Data and/or Business Analysis, Data Science or other quantitative discipline and 4 years of experience in data/analytics or functional business experience within the respective industry of responsibility (i.e. P&C, Bank, Finance, Marketing, etc.). Finally, the candidate must possess strong Business Translation & Decision Intelligence capabilities, enabling them to translate complex business problems into AI-driven decision strategies, define key success metrics, and integrate GenAI seamlessly into operational workflows.
Lead Business Strategy Analyst - P&C Claims GenAI USAALead Business Strategy Analyst - P&C Claims GenAIVA$127,310–$243,340 / year8 years of data and/or analytics or strategy consulting experience; OR a minimum of 6 years of data and/or analytics or strategy consulting experience and up to 2 years of progressive functional business relevant experience for a total of 8 years of combined experience; OR Advanced Degree in Business, Science, Finance, Economics or related discipline and 6 years of experience in data and/or analytics or strategy consulting. A strong Technical & Analytical Acumen is essential, encompassing a deep understanding of GenAI concepts, data and analytics architectures, AI solution design, and performance measurement to effectively guide both technical teams and business stakeholders.
IT Product Owner / Lead Business Analyst (Staff) - Incurred Cost Claim Lockheed Martin CorpIT Product Owner / Lead Business Analyst (Staff) - Incurred Cost ClaimManassas, VA$114,700–$198,720 / yearPay Rate: The annual base salary range for this position in California, Massachusetts, and New York (excluding most major metropolitan areas), Colorado, Hawaii, Illinois, Maryland, Minnesota, New Jersey, Vermont, Washington or Washington DC is $99,700 - $175,835. You will be responsible for system design, development, configuration, spec generation, unit testing, and operational assessment readiness; scrum master tasks; and the following: Authoring functional specifications for enhancements, conversions, interfaces, reports, and custom transactions.
Auto Claims Adjuster Allstate Insurance CompanyAuto Claims AdjusterVA$47,500–$69,800 / yearThrough our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products. National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers' evolving needs.
NewPrincipal Data Scientist, Customer Protection Agentic Claims Data Science Capital OnePrincipal Data Scientist, Customer Protection Agentic Claims Data ScienceMcLean, VirginiaCurrently has, or is in the process of obtaining one of the following with an expectation that the required degree will be obtained on or before the scheduled start date: A Bachelor's Degree in a quantitative field (Statistics, Economics, Operations Research, Analytics, Mathematics, Computer Science, or a related quantitative field) plus 5 years of experience performing data analytics. As a Data Scientist at Capital One, you’ll be part of a team that’s leading the next wave of disruption at a whole new scale, using the latest in computing and machine learning technologies and operating across billions of customer records to unlock the big opportunities that help everyday people save money, time and agony in their financial lives.
["Director of Claims Product Management","Director of Claims Product Management"] Saxon Global["Director of Claims Product Management","Director of Claims Product Management"]ManassasDemonstrated ability to lead cross-functional teams and manage complex projects. Proven experience managing a team of Product Managers and Business Analysts.
Manager, Claims Data Analytics GEICO GENERAL INSURANCE COMPANYManager, Claims Data AnalyticsFredericksburg, VAGEICO is looking for a highly motivated, innovative, and detailed leader to fill the role as a SIU Manager in enterprise fraud analytics who has a passion for managing individuals and building a best-in-class analytics and reporting suite. Must have the following education and experience: Must have 3+ years experience managing leadership associates while being responsible for the development, execution and outcomes of business plan initiatives.
Director, Risk Management - Property and Casualty Claims Marriott Vacations Worldwide CorpDirector, Risk Management - Property and Casualty ClaimsVAThe Director is responsible for resolution of claims to achieve the best possible financial conclusion, working closely with corporate leadership providing guidance and assistance in all claims-related matters. This includes coverage review and analysis, claim preparation, tendering of the claim, management of the claim to resolution and depending on the claim, trial monitoring, settlement concurrence and trial strategy.
Epic Revenue Cycle Application Analyst (Hospital Billing & Professional Billing) InterscriptsEpic Revenue Cycle Application Analyst (Hospital Billing & Professional Billing)Chantilly, VirginiaThe ideal candidate will have hands-on experience in implementing, configuring, supporting, and optimizing Epic Revenue Cycle applications , with expertise in Resolute Hospital Billing (HB) and Resolute Professional Billing (PB) . The candidate will collaborate with revenue cycle, finance, billing, coding, and operational teams to enhance billing accuracy, claims processing, reimbursement, and overall revenue cycle performance.
Benefits Coding Analyst Sentara HospitalsBenefits Coding AnalystRichmond, VirginiaRemote2+ years of medical coding or billing experience specifically within reimbursement, coding, claims processing, claims auditing and /or various payment methodologies (required)• Experience in both established benefit coding environments as well as experience in determination of coding requirements for new benefits (preferred)• Experience resolving billing and claims issues related to benefit to code assignment.•Thorough knowledge of anatomy and medical terminology• Expertise with NCCI (National Correct Coding Initiative) guidelines• Knowledge or direct experience processing Government program or commercial health claims for an MCO• Experience with ICD-10 CM, CPT, HCPCS, QNXT. • Certified Professional Coder certification (CPC) (required)• Certified Inpatient Coder (CIC) (preferred)• Medical Assistant Certification (preferred)Note: CIC is required for advancement to Level 2 and Level 3. Experience:
Senior Analyst, Insurance and Risk QTS Realty Trust LLCSenior Analyst, Insurance and RiskAshburn, VA$112,612.50–$172,214.54 / yearCollaborate with internal teams such as Real Estate Program Management, Legal, Finance, Accounting, Development, EHS, and Procurement to execute on the coordinated approach to insurance management during the development cycle of campus infrastructure and ongoing operation of data center assets. Who You Are: The Senior Analyst, Insurance and Risk Management will serve as a key contributor responsible for executing development insurance and risk management activities supporting large-scale data center campuses.
NewSr. Medical Economics Analyst Ennoble CareSr. Medical Economics AnalystArlington, VARemoteEnnoble Care offers a variety of programs including, remote patient monitoring, behavioral health management, and chronic care management, to ensure that our patients receive the highest quality of care by a team they know and trust. Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in New York, New Jersey, Maryland, DC, Virginia, Oklahoma, Kansas, Pennsylvania, Texas, Florida, and Georgia.
Benefits Coding Analyst Sentara Healthcare IncBenefits Coding AnalystRichmond, VARemoteNote: CIC is required for advancement to Level 2 and Level 3. Experience: • 2+ years of medical coding or billing experience specifically within reimbursement, coding, claims processing, claims auditing and /or various payment methodologies (required) • Experience in both established benefit coding environments as well as experience in determination of coding requirements for new benefits (preferred) • Experience resolving billing and claims issues related to benefit to code assignment. • Thorough knowledge of anatomy and medical terminology • Expertise with NCCI (National Correct Coding Initiative) guidelines • Knowledge or direct experience processing Government program or commercial health claims for an MCO • Experience with ICD-10 CM, CPT, HCPCS, QNXT.
Insurance Underpayments Analyst University Health Services IncInsurance Underpayments AnalystRICHMOND, VAResponsibilities Atlantic Region CBO: The Atlantic Region Central Billing Office ("ARCBO") or ("CBO") provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
Commercial Insurance Analyst - Remote CSAA Insurance GroupCommercial Insurance Analyst - RemoteVARemote$110,700–$123,000 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers, Nebraska - Home Teleworkers {+ 20 more}. Pursuit or completion of industry-relevant continuing education, including graduate degrees, MBS, risk and insurance designations from The Institutes (AINS, AIC, ARM, CPCU, etc.), or actuarial exams and designations (ACAS, FCAS, CERA).
Technical Data Analyst Argo Group International Holdings IncTechnical Data AnalystRichmond, VA$111,384–$132,498 / yearQualifications / Experience Required: A working knowledge of the claims business environment in order to effectively discuss and prioritize reporting needs through: A minimum of five years' experience focused on data and compliance in a claims environment or other equivalent experience working with data gathering and analysis. Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers' ability to be profitable).
Senior Analyst, Insurance And Risk QTS Realty Trust, Inc.Senior Analyst, Insurance And RiskAshburn, VA$112,612.50–$172,214.54 / yearCollaborate with internal teams such as Real Estate Program Management, Legal, Finance, Accounting, Development, EHS, and Procurement to execute on the coordinated approach to insurance management during the development cycle of campus infrastructure and ongoing operation of data center assets. Who You Are: The Senior Analyst, Insurance and Risk Management will serve as a key contributor responsible for executing development insurance and risk management activities supporting large-scale data center campuses.
SCB - C# Developer/Programmer Analyst 3 Ampcus IncorporatedSCB - C# Developer/Programmer Analyst 3Richmond, VAYou will work closely with lead developers and take ownership of specific modules, providing technical direction and guidance to other team members throughout the migration process. We are undertaking a strategic modernization of our flagship cloud-hosted (OCI) application, BADGE , transitioning it from a legacy desktop-based architecture to a scalable, web-based platform.
Epic Revenue Cycle Systems Analyst - Back End Chesapeake Regional HealthcareEpic Revenue Cycle Systems Analyst - Back EndChesapeake, VirginiaThe analyst partners closely with Revenue Cycle leadership, Revenue Integrity, Patient Access, Patient Financial Services, HIM, Compliance, and IT to ensure Epic revenue cycle applications are aligned with operational needs, regulatory requirements, and organizational financial goals. This role reports directly to the Senior Director of Revenue Cycle and operates as a trusted subject matter expert (SME) within the Revenue Cycle organization, while maintaining strong partnership with Information Technology.
Epic Revenue Cycle Systems Analyst - Front End Chesapeake Regional HealthcareEpic Revenue Cycle Systems Analyst - Front EndChesapeake, VirginiaThe analyst partners closely with Revenue Cycle leadership, Revenue Integrity, Patient Access, Patient Financial Services, HIM, Compliance, and IT to ensure Epic revenue cycle applications are aligned with operational needs, regulatory requirements, and organizational financial goals. This role reports directly to the Senior Director of Revenue Cycle and operates as a trusted subject matter expert (SME) within the Revenue Cycle organization, while maintaining strong partnership with Information Technology.
SCB - C# Developer/Programmer Analyst 3 - PeopleNTech LLCSCB - C# Developer/Programmer Analyst 3 -1390 Ridgeview Drive Allentow, VAThe candidate will be knowledgeable in transferring data between application screens, selecting and scrolling through large amounts of data, add/update/delete order-entry type of transactions, and building new screens and reports. Candidates must describe experience with large menu driven business systems, such as claims processing, payroll, medical, or insurance type applications.
SCB - C# Developer/Programmer Analyst 3 Nleague Services IncSCB - C# Developer/Programmer Analyst 3Richmond, Virginia$80.96 / hourContractorC# Developer RequirementsC#, NET 3.1 (or higher)Angular (gRPC would be a plus)SQL ServerVisual Studio/Visual Studio CodeKnowledge of build and deployment repositories such as Azure Dev Ops or Git Hub. The candidate will be knowledgeable in transferring data between application screens, selecting and scrolling through large amounts of data, add/update/delete order-entry type of transactions, and building new screens and reports.
Entry-Level Insurance and Revenue Cycle Analyst Ally Behavior CentersEntry-Level Insurance and Revenue Cycle AnalystMcLean, VA$50,000–$60,000 / yearThe department is responsible for ensuring that all clients are authorized for therapeutic services, all clinicians and center locations are credentialed with insurance payors, and is responsible for maintaining a healthy revenue cycle and cash flow. Our mission is to deliver the highest quality therapy to help our early learners reach their potential to communicate, improve social skills, and prepare for academic success.
Bilingual Disability Case Analyst/Case Manager ManulifeBilingual Disability Case Analyst/Case ManagerAlberta, VARemoteYou'll use your healthcare knowledge, emotional intelligence, and problem-solving skills to assess medical, functional, vocational, and psychosocial factors, design recovery and return-to-work strategies, balance compassion with sound decision-making, and partner with clients, employers, and healthcare providers to achieve sustainable outcomes. Developing positive relationships through frequent collaboration with plan sponsors, plan members, treatment providers and internal partners (i.e., disability specialists, rehabilitation specialists and medical consultants) to drive cases to a successful return to work or job resolution ready.
NewCase Management Analyst - Field in Northern VA CVS HealthCase Management Analyst - Field in Northern VAVirginiaCase Manager Analyst is responsible for face to face and telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
Senior Benefit Configuration Analyst QNXT Sentara HospitalsSenior Benefit Configuration Analyst QNXTRichmond, VirginiaRemote$69,867.20–$116,438.40 / yearThe senior analyst serves as a business and technical expert in QNXT benefit build and plays a key role in supporting new plan implementations, annual updates, and ongoing configuration maintenance. This role works closely with Product, Compliance, IT, Network and Claim’s teams to ensure benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements.
Senior Benefit Configuration Analyst QNXT - Remote Sentara Healthcare IncSenior Benefit Configuration Analyst QNXT - RemoteRichmond, VARemote$69,867.20–$116,438.40 / yearThe senior analyst serves as a business and technical expert in QNXT benefit build and plays a key role in supporting new plan implementations, annual updates, and ongoing configuration maintenance. This role works closely with Product, Compliance, IT, Network and Claim's teams to ensure benefit plans are implemented accurately, timely, and in accordance with regulatory and contractual requirements.
Health Information Management (HIM) Analyst – Epic HIM / Solventum / Payor Platform InterscriptsHealth Information Management (HIM) Analyst – Epic HIM / Solventum / Payor PlatformChantilly, VirginiaThe ideal candidate will possess strong knowledge of health information management processes, medical records management, coding workflows, regulatory compliance, and healthcare technology systems. We are seeking a detail-oriented Health Information Management (HIM) Analyst with experience supporting HIM operations, Solventum (formerly 3M Health Information Systems), and healthcare payor platform workflows.
Grievance and Appeals Analyst I Elevance HealthGrievance and Appeals Analyst INorfolk, VirginiaThe Grievance/Appeals Analyst I will be this is an entry level position in the Enterprise Grievance & Appeals Department that reviews, analyzes and processes non-complex pre service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (i.e. HMO, POS, PPO, EPO, CDHP, and indemnity) related to clinical and non clinical services, quality of service, and quality of care issues to include executive and regulatory grievances. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
GBD Ops Analyst Elevance HealthGBD Ops AnalystNorfolk, VirginiaRequires a BA/BS degree and a minimum of 5 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry; or any combination of edu Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Benefits Analyst Rocket SoftwareBenefits AnalystRichmond, VARemote$73,000–$90,000 / yearThe analyst collaborates with internal teams, vendors, and carriers to maintain accurate systems, resolve employee inquiries, and contribute to continuous improvement initiatives. The Benefits Analyst supports the administration, and analysis of U.S. and global benefit programs to enhance the employee experience and align with the company’s total rewards philosophy.
Business Information Analyst II - Pharmacy, Compliance And Operations Reporting Elevance HealthBusiness Information Analyst II - Pharmacy, Compliance And Operations ReportingRichmond, VA$67,360–$111,144 / yearWorks collaboratively with stakeholders to develop automated reporting solutions, create and enhance business intelligence dashboards, validate complex healthcare data, and support ongoing reporting needs across the pharmacy compliance and pharmacy operations organizations. The Business Information Analyst II - Pharmacy, Compliance and Operations Reporting is part of the Pharmacy Compliance and Operations Reporting (COPR) team and is responsible for developing reporting and analytics solutions that support pharmacy operations, regulatory compliance, and business decision-making.
Business Analyst III- Medicaid Overpayment Recovery Elevance HealthBusiness Analyst III- Medicaid Overpayment RecoveryNorfolk, VirginiaThe Business Analyst III is responsible for leading complex data analysis and mining efforts using claims data and coding methodologies (CPT, HCPCS, DRG, ICD-9, ICD-10) to identify overpayment recovery opportunities, validate findings, and complete supporting documentation. Primary duties may include, but are not limited to: Collaborate with internal business partners to gather requirements, lead stakeholder discussions, research Medicare and Medicaid reimbursement guidelines, and request or execute data queries to support recovery initiatives and business decisions.
Systems Analyst Advisor - Commercial Reinsurance Elevance HealthSystems Analyst Advisor - Commercial ReinsuranceRichmond, VirginiaThis role requires working with multiple enterprise data sources-including claims systems, operational databases, and enterprise data warehouses-to ensure complete and accurate data is available for regulatory reporting. The ideal candidate is a self-directed, innovative problem solver who takes ownership, drives process improvements, embraces Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health.
Reimbursement Specialist / Analyst University Health Services IncReimbursement Specialist / AnalystRICHMOND, VAResponsibilities Atlantic Region CBO: The Atlantic Region Central Billing Office ("ARCBO") or ("CBO") provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals. Strong Microsoft Office skills (Excel, Word, Outlook); customer focused both internally and externally, strong attention to detail, the ability to multi-task, strong 10 key data entry, and excellent written and oral communication skills are required.