the smart solution for Grand Rapids jobs

Claims Review Analyst

Company: WalkerHealthcareIT
Location: Grand Rapids
Posted on: May 19, 2019

Job Description:

CLAIMS REVIEW ANALYST, MICHIGAN WalkerHealthcareIT is seeking a Claims Review Analyst for a healthcare client located in Michigan. This is a contract position. START DATE ASAP ON-SITE REMOTE 100 On-site WAGE TYPE 1099, W2 WalkerHealthcareIT Standard Perks Weekly pay via Direct Deposit CLAIMS REVIEW ANALYST JOB DESCRIPTION Job Overview This position would monitor all incoming and outgoing encountersclaims with the State of Michigan to ensure accuracy and troubleshoot any failures or others issues. This person will work closely with encounter team and IT staff. Our Process Our Company pay claims to Medicaid members on medical, dental and pharmacy claims. Clean and adjudicated claims call encounters. Then we submit these encounters to the State, so they can calculate the rate to reimburse us. Most of our encounters data is coming from vendors (third-party administrators) and, some, from our internal system. These vendors send us their files and we, in-turn, submit to the State s system. All these processes are automated some files involved EDI department to convert to certain formats that fit the State s requirement before sending on. Our Needs The State feels that encounters in their Data Warehouse don t match with our Data Warehouse. Audit will perform frequently to reconcile encounters between data warehouses. There is a need for someone to be able to extract data, analyze, evaluate the root cause, and summarize finding. Our data, however, are in various tables. I need someone who could write a query (SQL), to link these tables and extract data and manipulate it in various tools to arrive essential information for evaluation. Sometimes there are issues with encounter transmitting issues, so I need this person have a good understanding of FTP for file transferring troubleshooting. In addition, there are times the State implements new changes on how they want to submit encounter data. This requires involvement with IT folks, to provide assistance on codingtesting new changes. This position requires skill to facilitate staff members in different departments and able to communicate with IT folks, as well. CLAIMS REVIEW ANALYST JOB REQUIREMENTS 2 years of experience preferred Writing SQL codes Excel Intermediate to Advance Access, FTP, and Tableau reporting is a plus but not essential Experience developing PLSQL procedures in OracleSQL Server Excellent formula writing in Excel Excellent analytical and reporting skills

Keywords: WalkerHealthcareIT, Grand Rapids , Claims Review Analyst, Professions , Grand Rapids, Michigan

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Professions Jobs

CDL-A Team Owner Operator Truck Driver - $1.05-MILE + Market Premium P
Description: Call Today to Learn More About New Market Premium Pay for Owner Operator Teams Are you in it for the long haul John Christner Trucking is. 32 years in business, 1,300 mile length of haul, two
Company: John Christner Trucking
Location: South Bend
Posted on: 05/20/2019

CDL-A Owner Operator / Lease Purchase Truck Driver
Description: CDL-A OWNER OPERATOR / LEASE PURCHASE TRUCK DRIVER JOBSThe Wheels That Move Your Future.When you partner your personal trucking business with
Company: CalArk
Location: South Bend
Posted on: 05/20/2019

OTR Class A Driver - Good Pay with Benefits
Description: OTR Class A Driver Sign On Bonus Great Benefits Since 1987, Shared Imaging has provided flexible options for acquiring CT, MRI and PET/CT equipment for interim, mobile or fixed imaging solutions to (more...)
Company: Shared Imaging
Location: South Bend
Posted on: 05/20/2019

Class A Owner Operators and Fleet Owners: Sign-On Bonus
Description: CLICK THE APPLY BUTTON BELOW OR CALL 844 897-2115 TODAY Travel throughout the United States and Canada. Higher revenue on lower miles. Welcome to Panther. Panther Premium Logistics is seeking experienced (more...)
Company: Panther Premium Logistics
Location: South Bend
Posted on: 05/20/2019

OTR Class A Reefer Drivers. Full Truckload.
Description: Climate Express is Financially sound and Privately Owned One Yard with Shop and Everyone that you could Need At 220 Trucks We know our drivers They know us.We are looking for Safe, Experienced Drivers (more...)
Company: Climate Express
Location: South Bend
Posted on: 05/20/2019

Driveaway Truck Driver (Class A, B or C)
Description: Driveaway Contractor CDL Truck Driver JobsBennett: Love Country. Love Trucking in our driveaway division Our Driveaway division offers CDL A, B or C drivers the flexibility to see our great country and (more...)
Company: Bennett Motor Express
Location: South Bend
Posted on: 05/20/2019

Owner Operator to work across the Mid-West
Description: Bork Transport has a very strong presence in the Mid West. Dedicated lanes with
Company: Bork Transport
Location: South Bend
Posted on: 05/20/2019

Regional CDL - A Drivers Wanted! Your Never Far from Home!
Description: Oberg Freight offers the opportunity to work for a fantastic company that treats you like family AND gets you home to YOURS often For over 35 years Oberg Freight has built their reputation and become (more...)
Company: Oberg Freight Company
Location: South Bend
Posted on: 05/20/2019

OTR CDL-A Drivers Wanted! Weekly Home Time!
Description: Looking for Experienced OTR CDL-A Drivers to Join the Navajo Express Family Navajo Express has immediate openings for Regional, Dedicated and OTR positions throughout the US. Navajo Express also has immediate (more...)
Company: Navajo Express
Location: South Bend
Posted on: 05/20/2019

Description: Diversified Transfer Storage is hiring OTR drivers to deliver temperature controlled
Company: Diversified Transfer & Storage
Location: South Bend
Posted on: 05/20/2019

Log In or Create An Account

Get the latest Michigan jobs by following @recnetMI on Twitter!

Grand Rapids RSS job feeds