729 coder jobs found

Quality Review and Audit Senior Analyst - RADV Job Summary: Responsible for coordination and implementation of daily processes related to IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis program. Responsible for liaising with the Initial Validation Audit Entity to ensure compliant, efficient, and successful audit processes, including but not limited to file reconciliation and appeals processes. Responsible for coordinating with Quality Mgmt to effectively and compliantly execute daily RA program operations, as identified. Participates in coding reviews of medical documentation for RA programs, as needed. Responsible for communication and reporting of daily productivity and risks associated with IFP RADV audits and other RA programs, as needed, and collaborates with internal educational team to develop necessary curriculum to ensure compliance and program excellence. Contributes to Cigna IFP...

Join Us in Shaping the Future of Health Care At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team. What's in it for you: Growth opportunities to uplevel your career A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team Competitive compensation and comprehensive benefits focused on well-being An opportunity to...

Company Description Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! Learn more about our unique benefit offerings here. Job Description As a Health Services Coding Analyst, you will provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance. You will ensure the accurate implementation of medical policies, review criteria, and...

Company Description Why Wellmark : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today! Learn more about our unique benefit offerings here. Job Description As a Health Services Coding Analyst, you will provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance. You will ensure the accurate implementation of medical policies, review criteria, and...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for UnitedHealth Group. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together....

Building Code & Zoning Specialist New York, NY | Hybrid | Full-Time Build Your Career While We Build the Future About Us At Milrose Consultants, LLC, we build more than buildings—we build trust, expertise, and lasting partnerships. As leaders in building code and zoning consulting, we help shape the skylines of tomorrow through excellence in compliance and development strategy. Position Overview We’re seeking a Building Code & Zoning Specialist to join our Code & Zoning team. In this role, you’ll serve as a subject matter expert, guiding clients through complex building code and zoning requirements. You’ll collaborate with design professionals, project teams, and regulatory agencies to ensure compliance and support successful project outcomes. What You’ll Do Review design plans for compliance with NYC and regional zoning and building codes. Conduct due diligence for proposed developments and prepare technical documentation. Advise clients on...

Location: 4900 Tiedeman Road, Brooklyn Ohio Job Summary The Brokerage & Capital Markets Lead Operations Analyst assists Key Investment Services ("KIS") New Accounts, Annuities, and Cashiering and KeyBanc Capital Markets ("KBCM") Account Services with short and long-term assignments during high volume and staff shortages. The Operations Analyst assists in special projects, desk coverage and workflow processes, including review of desktop procedures. Additionally, the Operations Analyst analyzes and recommends solutions, working with manager to evaluate and implement. Assignments or projects could involve direct contact with management, and Lines of Business. Essential Functions Assist in covering open desks for the areas noted above due to absence in operationally high risk areas. Desk coverage could include, but is not limited to, opening/maintaining accounts, processing customer check deposits, confirming settlement instructions, updating cost basis,...

It's fun to work in a company where people truly BELIEVE in what they're doing! Job Description Summary: The Principal Financial Analyst role is a Revenue Operations position. In this role, you will be the owner of the revenue planning model and support several key business partners across Rocket. This includes working closely with other members of Revenue Operations, partnering with the SVP of Enterprise Sales and VP of Customer Success. You will be responsible for ensuring data flows seamlessly from the various systems connected to planning and reporting and managing access and rights. You will have a key role in decision making processes and helping to ensure we are prepared for the future. Other critical areas of focus for the group include M&A (assisting with both diligence and integration) and data reporting & analytics (leading the effort to get reporting out of excel and into new visualization tools). This is a key position in the Revenue Operations team,...

Company : Highmark Health Job Description : JOB SUMMARY This job supports one or more analytical aspects of the product management lifecycle, within a sub-product scope (one or more business application components). Uses regular judgement and discretion to collaborate with customers and business stakeholders in order to: Understand customer and stakeholder needs, business capability needs; Identity opportunities and create business cases and cost sheet analysis to support the product strategy and evolve the product roadmap; Translate high-level business needs into detailed business requirements for new / modified business capabilities; Perform research, analyze data to determine business problems and trends, assess business processes and business rules to identify/recommend opportunities for process improvements and / or recommendation new / modified business capabilities; Work with business stakeholders and delivery partners to prioritize business capabilities in...

It's fun to work in a company where people truly BELIEVE in what they're doing! Job Description Summary: The Principal Financial Analyst role is a Revenue Operations position. In this role, you will be the owner of the revenue planning model and support several key business partners across Rocket. This includes working closely with other members of Revenue Operations, partnering with the SVP of Enterprise Sales and VP of Customer Success. You will be responsible for ensuring data flows seamlessly from the various systems connected to planning and reporting and managing access and rights. You will have a key role in decision making processes and helping to ensure we are prepared for the future. Other critical areas of focus for the group include M&A (assisting with both diligence and integration) and data reporting & analytics (leading the effort to get reporting out of excel and into new visualization tools). This is a key position in the Revenue Operations team,...

Why UKG: At UKG, the work you do matters. The code you ship, the decisions you make, and the care you show a customer all add up to real impact. Today, tens of millions of workers start and end their days with our workforce operating platform. Helping people get paid, grow in their careers, and shape the future of their industries. That's what we do. We never stop learning. We never stop challenging the norm. We push for better, and we celebrate the wins along the way. Here, you'll get flexibility that's real, benefits you can count on, and a team that succeeds together. Because at UKG, your work matters-and so do you. About the Team The Security Research & Innovation (SRI) team within Global Security is a high-impact, automation-first security organization responsible for vulnerability management, security research, and red team operations. This team has an exceptional automation culture - all team members build production automation that eliminates manual work at...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job builds and maintains hospital, professional, and ASC contracts in Epic. Identifies underpaid accounts and articulates the source of the processing error to the payor. ESSENTIAL RESPONSIBILITIES Provides support to senior analysts in building hospital, professional, and ASC contracts in Epic. (40%) Manages underpayment AR for assigned payors including successfully recovering on underpaid accounts. (25%) Collaborates with Revenue Cycle and Finance Teams on contract building and analysis requests. (25%) Provides assistance in performing analyses to support reimbursement impact analysis. (10%) Perform other duties as assigned or required. QUALIFICATIONS: Minimum Associate's degree in Finance, Accounting, Business Administration, Economics, Statistics, or Related Field Experience in finance, contracting, or data analysis Microsoft...

Why UKG: At UKG, the work you do matters. The code you ship, the decisions you make, and the care you show a customer all add up to real impact. Today, tens of millions of workers start and end their days with our workforce operating platform. Helping people get paid, grow in their careers, and shape the future of their industries. That's what we do. We never stop learning. We never stop challenging the norm. We push for better, and we celebrate the wins along the way. Here, you'll get flexibility that's real, benefits you can count on, and a team that succeeds together. Because at UKG, your work matters-and so do you. About the Team The Security Research & Innovation (SRI) team within Global Security is a high-impact, automation-first security organization responsible for vulnerability management, security research, and red team operations. This team has an exceptional automation culture - all team members build production automation that eliminates manual work at...

Why UKG: At UKG, the work you do matters. The code you ship, the decisions you make, and the care you show a customer all add up to real impact. Today, tens of millions of workers start and end their days with our workforce operating platform. Helping people get paid, grow in their careers, and shape the future of their industries. That's what we do. We never stop learning. We never stop challenging the norm. We push for better, and we celebrate the wins along the way. Here, you'll get flexibility that's real, benefits you can count on, and a team that succeeds together. Because at UKG, your work matters-and so do you. About the Team The Security Research & Innovation (SRI) team within Global Security is a high-impact, automation-first security organization responsible for vulnerability management, security research, and red team operations. This team has an exceptional automation culture - all team members build production automation that eliminates manual work at...

Why UKG: At UKG, the work you do matters. The code you ship, the decisions you make, and the care you show a customer all add up to real impact. Today, tens of millions of workers start and end their days with our workforce operating platform. Helping people get paid, grow in their careers, and shape the future of their industries. That's what we do. We never stop learning. We never stop challenging the norm. We push for better, and we celebrate the wins along the way. Here, you'll get flexibility that's real, benefits you can count on, and a team that succeeds together. Because at UKG, your work matters-and so do you. About the Team The Security Research & Innovation (SRI) team within Global Security is a high-impact, automation-first security organization responsible for vulnerability management, security research, and red team operations. This team has an exceptional automation culture - all team members build production automation that eliminates manual work at...

Company : Highmark Health Job Description : JOB SUMMARY This job supports one or more analytical aspects of the product management lifecycle, within a sub-product scope (one or more business application components). Uses regular judgement and discretion to collaborate with customers and business stakeholders in order to: Understand customer and stakeholder needs, business capability needs; Identity opportunities and create business cases and cost sheet analysis to support the product strategy and evolve the product roadmap; Translate high-level business needs into detailed business requirements for new / modified business capabilities; Perform research, analyze data to determine business problems and trends, assess business processes and business rules to identify/recommend opportunities for process improvements and / or recommendation new / modified business capabilities; Work with business stakeholders and delivery partners to prioritize business capabilities in...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Pharmacy Trade Relations Analyst Sr - Remote Job Description The Senior Trade Relations Analyst is responsible for performing multifaceted financial analyses to assess manufacturer contract performance, plan performance and to develop rebate estimates related to pharmaceutical rebate agreements. This position is also responsible for developing recommendations based on financial analysis results. Responsibilities Assist the contract negotiators in providing financial analyses of manufacturer rebate proposals and operations including sensitivity analyses, competitive offer assessments, performance tracking and scenario building Research, compile, and analyze rebate pricing and trending data for client facing...

The mission (https://www.nytco.com/company/mission-and-values/) of The New York Times is to seek the truth and help people understand the world. That means independent journalism is at the heart of all we do as a company. It's why we have a world-renowned newsroom that sends journalists to report on the ground from nearly 160 countries. It's why we focus deeply on how our readers will experience our journalism, from print to audio to a world-class digital and app destination. And it's why our business strategy centers on making journalism so good that it's worth paying for. About the Role, Mission or Department Overview The New York Times is looking for a Senior Analyst to join our Enterprise Analytics Team within the Data and Insights Group (DIG). As part of the Enterprise Analytics team, you will work with teams across DIG, Data Platforms, and Strategy. You will uncover meaningful patterns from our data, automate reporting, create consistent metric definitions, in support...

Point72 Asset Management, L.P. has an opening for a Research Analyst in New York, New York. This position is hybrid; may work at home up to 2 days per week, as permitted. Build and backtest trade ideas across global FX markets. Develop and implement strategies for FX and rates. Develop trading systems using object-oriented programming. Work with the Senior PM to build quantitative tools and models that assist with trade ideas, portfolio construction and risk management for FX and rates. Help manage a portfolio of fixed income trades and investments. Develop and maintain sell-side relationships. Conduct ongoing, fundamental, and technical research to support and enhance the investment activities of the group. Work on numerous ad-hoc projects to enhance the trade identification and management process. Perform post-trade management. Must possess at least a masters degree or its equivalent in Economics, Finance, or a related field and at least three years of experience as Research...

NY HELP No Agency Corrections and Community Supervision, Department of Title Investigative Analyst Occupational Category Enforcement or Protective Services Salary Grade NS Bargaining Unit M/C - Managerial/Confidential (Unrepresented) Salary Range From $69887 to $85151 Annually Employment Type Full-Time Appointment Type Permanent Jurisdictional Class Competitive Class Travel Percentage 35% Workweek Mon-Fri Hours Per Week 40 Workday From 8 AM To 4 PM Flextime allowed? No Mandatory overtime? No Compressed workweek allowed? No Telecommuting allowed? No County Erie Street Address NYS Department of Corrections and Community Supervision Buffalo Area Office City Alden State NY Zip Code 14004 Duties Description The Office of Special Investigations (OSI) is seeking qualified candidates for consideration to serve as an Investigative Analyst (IA) in the Analysis Unit (AU). The OSI Analysis Unit specializes in tactical intelligence analysis...

Company : Highmark Health Job Description : JOB SUMMARY This job supports one or more analytical aspects of the product management lifecycle, within a sub-product scope (one or more business application components). Uses regular judgement and discretion to collaborate with customers and business stakeholders in order to: Understand customer and stakeholder needs, business capability needs; Identity opportunities and create business cases and cost sheet analysis to support the product strategy and evolve the product roadmap; Translate high-level business needs into detailed business requirements for new / modified business capabilities; Perform research, analyze data to determine business problems and trends, assess business processes and business rules to identify/recommend opportunities for process improvements and / or recommendation new / modified business capabilities; Work with business stakeholders and delivery partners to prioritize business capabilities in...

Location: Avera Health Plans Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $53,040.00 - $79,560.00 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview The Avera Health Plan Configuration Analyst is responsible for the design, implementation, and support of the Epic Tapestry module, which manages health plan administration, benefits, fee schedules, claims, enrollment, care coordination, clinical/authorizations and provider data. This role ensures that managed care workflows are optimized and aligned with organizational goals, regulatory requirements, and member-centered care initiatives. As a Configuration Analyst you will work closely with clinical, operational,...

Why UKG: At UKG, the work you do matters. The code you ship, the decisions you make, and the care you show a customer all add up to real impact. Today, tens of millions of workers start and end their days with our workforce operating platform. Helping people get paid, grow in their careers, and shape the future of their industries. That's what we do. We never stop learning. We never stop challenging the norm. We push for better, and we celebrate the wins along the way. Here, you'll get flexibility that's real, benefits you can count on, and a team that succeeds together. Because at UKG, your work matters-and so do you. About the Team The Security Research & Innovation (SRI) team within Global Security is a high-impact, automation-first security organization responsible for vulnerability management, security research, and red team operations. This team has an exceptional automation culture - all team members build production automation that eliminates manual work at...

NY HELP Yes Agency Aging, Office for the Title Aging Services Program Analyst 2 (NY HELPS) - VID 212916 Occupational Category Health Care, Human/Social Services Salary Grade 18 Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF) Salary Range From $66951 to $85138 Annually Employment Type Full-Time Appointment Type Contingent Permanent Jurisdictional Class Non-competitive Class Travel Percentage 20% Workweek Mon-Fri Hours Per Week 37.5 Workday From 9 AM To 5 PM Flextime allowed? No Mandatory overtime? No Compressed workweek allowed? No Telecommuting allowed? Yes County Albany Street Address 2 Empire State Plaza, 4th Floor City Albany State NY Zip Code 12223 Duties Description Under the general supervision of the Division Supervisor, the Aging Services Program Analyst 2 (ASPA 2) will focus on a variety of programs and populations, including but not limited to NY Connects, Health Insurance Information,...