323 bill review analyst i jobs found

The Bill Review Analyst is responsible for reviewing, auditing and data-entry of medical bills for multiple states and lines of business. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts May consult reference materials in the auditing process Based upon situation or state-specific cases, meet 98% accuracy, 10,000+ keystrokes per hour Additional duties as assigned   KNOWLEDGE & SKILLS: Knowledge of medical terminology, workers’ compensation billing guidelines and fee schedules Knowledge of CPT/ICD/HCPS coding Knowledge of UBO4/DWC-9/DWC-10 and CMS 1500 form types preferred Strong interpersonal skills and commitment to customer service Ability to work independently and in a team environment Ability to identify problems and...

Responsible for receiving and entering medical claims while maintaining accuracy and meeting turnaround requirements. The Setup Analyst provides a higher level skillset, supporting the goals of the Setup department, personal growth, and of CorVel.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Ensure bill is eligible for MCS review Handle / organize bills to be entered in a timely fashion Enter bill proficiently and accurately into internal system Communicate any special handling of each claim Maintains production standards and production requirements Comply with standard protocol for processing problem claims Responsible for high profile clients, including production, QC, communications, etc. Train new employees Function as back-up for filter or filter leads Requires punctual and consistent attendance Must be willing and able to work overtime as required Assist co-workers, supervisor and management in accomplishing...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and analytical skills for...

The Professional Review Analyst analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Candidate must be located in the greater Charlotte, North Carolina Region and able to attend in office training for a minimum of 1 week at start of employment. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned   KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical...

Description The Client Service Manager is primarily assigned to key Major and Middle Market clients and agents/brokers with a focus on construction. Owns, manages, coordinates and leads the service process on assigned agents and accounts. Responsible for overall service delivery, assisting in the new business acquisition process, and supporting Division retention goals.   Responsibilities: Develops service plan with assigned agents/brokers and accounts. Monitors status of action items and makes modifications to service plan based on feedback from the agent/brokers and policyholder. Resolves service problems, answers questions, acts as a liaison with internal functional representatives and troubleshoots, routinely following up with all parties for resolution. Ensures continued compliance. Coordinates and leads review meetings with customer to ensure service results are in line with plan. Meetings may include and but not limited to Claims Reviews, LCAS...

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   This position may be filled as a Business Analyst I or Business Analyst II depending on candidate experience. The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region.   Note: Open to all those residing in the Eastern and Central Regions (following Eastern and Central Time Zone). Should candidate be near a GRS hub, they will be required to go into the office twice a month.   The Business Analyst will be responsible for the following:   Applies skills and...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity  As a dedicated Intermediate Decision Science Analyst, you will provide decision support for business areas across the association. Staff in this area will be responsible for applying mathematical and statistical techniques and/or innovative /quantitative analytical approaches to draw conclusions and make 'insight to action' recommendations to answer business objectives and drive change. The essence of work performed by the Decision Science Analyst involves gathering, manipulating and synthesizing data (e.g.,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Decision Science Analyst, you will provide decision support for business areas across the association. Staff in this area will be responsible for applying mathematical and statistical techniques and/or innovative /quantitative analytical approaches to draw conclusions and make 'insight to action' recommendations to answer business objectives and drive change. The essence of work performed by the Decision Science Analyst involves gathering, manipulating and synthesizing data (e.g., attributes,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity Within Transformation & Ventures, we are hiring a leader to shape how we test, learn, and evaluate modern distribution technical capabilities. Through structured experimentation and data-driven decisions, you will drive strategic execution across digital channels and partner platforms — validating future insurance distribution capabilities and strengthening our position as the #1 choice for the military community. This role is remote eligible in the continental U.S. with occasional business travel. However,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Audit Manager, you will lead and execute complex audit engagements throughout the audit lifecycle, to include understanding of horizontal and vertical business impacts, integrating audits with IT, analytics, and projects and reviewing work papers. May lead engagements as Auditor-In-Charge (AIC). This role maintains knowledge of financial services regulations, creates and independently performs complex work assignments and problem resolution in support of risk-based assurance and advisory engagements....

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity We have multiple exciting opportunities available on our Pricing, Indications , and Reserving teams.  As a dedicated Actuarial Analyst I , you will be a near-credentialed analyst responsible for independently applying complex technical and actuarial methodologies as well as requiring expert knowledge in one actuarial practice area (pricing, reserving, modeling, catastrophe risk, claims analytics, product management, etc.) to complete unstructured projects. This role is remote eligible in the continental U.S....

Acuity is seeking a Network Engineer II to design, configure, and maintain network infrastructure that ensures reliability, performance, security, and scalability across the organization. Building on foundational experience, this role takes ownership of system deployments, integrations, and optimizations while collaborating closely with senior engineers and cross-functional teams. The Network Engineer II actively monitors system health, troubleshoots complex issues, implements automation to improve efficiency, and ensures compliance with security and regulatory requirements. This position also contributes to documentation, disaster recovery planning, and continuous improvement initiatives while mentoring junior engineers and providing technical leadership in daily operations.   ESSENTIAL FUNCTIONS:   General System Work Collaborates with senior engineers to design and implement systems that meet performance, scalability, availability, and security requirements....

We’re thrilled that you are interested in joining us here at the Amynta Group! The Underwriter III (Senior Underwriter) is responsible for independently evaluating, selecting, pricing, and managing complex commercial risks within assigned programs and authority levels. This role serves as a technical resource to underwriting staff, supports portfolio performance objectives, and contributes to program profitability through disciplined underwriting, broker engagement, and risk analysis. The position also provides mentorship to junior underwriting staff and supports strategic underwriting initiatives. The Underwriter III (Senior Underwriter) is responsible for independently evaluating, selecting, pricing, and managing complex commercial risks within assigned programs and authority levels. This role serves as a technical resource to underwriting staff, supports portfolio performance objectives, and contributes to program profitability through disciplined underwriting, broker...

We’re thrilled that you are interested in joining us here at the Amynta Group! Assistant Vice President Assist Managing Directors/VPs in underwriting R&W opportunities Review submission materials and draft NBI's to review with senior team members draft insurance excess and primary policies and binders Conduct due diligence review to analyze the risk to be insured, including (i) reviewing asset and merger agreements, disclosure schedules, data room materials and financial and operational records of prospective insureds, and (ii) preparing conference call agendas.   Engage in marketing efforts with brokers Assist Managing Directors/VPs in underwriting R&W opportunities Review submission materials and draft NBI's to review with senior team members Draft insurance excess and primary policies and binders Clear conflicts with vetting counsel Conduct due diligence review to analyze the risk to be insured, including (i) reviewing asset and merger...

ABOUT HUB: In a rapidly changing world, HUB advises businesses and individuals on how to prepare for the unexpected. As one of the worlds' largest insurance brokers, our focus is dedicated to providing our customers with the peace of mind that what matters most will be protected-through unrelenting advocacy and tailored insurance solutions that put our clients in control. Our growing team of professionals across North America represents a broad, deep and one-of -a kind aggregation of entrepreneurs and leaders recognized for their excellence throughout the insurance community. THE OPPORTUNITY: The Employee Benefits Account Representative works collaboratively with the Producer and Account Team managing a book of business. Coordinates and provides day-to-day service for employee benefits clients by maintaining client relationships, supporting client retention, maintaining strong carrier relationships and understanding client needs. Serves as day-to-day contact and...

Description Senior Data Engineer, Cloud & Core Data Warehouse About the Role At Liberty Mutual Investments Technology, we are building a modern, cloud-based data platform to power investment insights and decision-making across our portfolio. We are seeking a Senior Data Engineer to join our Core Data team, focused on designing and delivering scalable data warehouse solutions in Snowflake on AWS. In this role, you will develop high-quality data pipelines and solutions that enable trusted, accessible data for our investment teams. You’ll work in a collaborative, agile environment alongside engineers, analysts, and business partners, helping to shape the evolution of our data platform while contributing to a culture of continuous learning and engineering excellence. Responsibilities Design, build, and maintain scalable data pipelines and data solutions that support analytics and investment insights. Develop data provisioning workflows,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity The Go-To-Market Manager, Ecosystem Go‑to‑Market (eGTM) for the Auto and Home Ecosystems is a central orchestrator responsible for driving adoption, integration, and performance of interconnected products and services. As an evangelist for the ecosystem vision and strategy, this role influences business alignment, works with marketing for execution, and partners closely with advice, member value, product, experience owners, and other teams to deploy cohesive eGTM initiatives. Focused on the management, execution,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity The Director, Strategic Development is a key leader driving a core, association‑wide initiative to develop a home and auto ecosystem experience for our members. This role works horizontally across execution teams, user experience, and many stakeholders to ensure alignment and impact, while also leading a dedicated team responsible for delivering high‑value outcomes that enhance member experience and create new revenue opportunities.  As a dedicated Director, Digital / Technical Product Management, you will lead...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity The Opportunity Our Liquidity Strategy Analyst I develops, implements and monitors liquidity management strategies at the enterprise and line of business levels , specifically banking, utilizing proficient knowledge of the enterprise, financial services industry, regulatory requirements, rating agency requirements, risk management and financial planning. Provides analysis and support in the execution of complex liquidity and financial initiatives and implementation of business solutions that ensure USAA's...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a dedicated Decision Science Analyst Senior, you will provide decision support for business areas across the association. Staff in this area will be responsible for applying mathematical and statistical techniques and/or innovative /quantitative analytical approaches to draw conclusions and make 'insight to action' recommendations to answer business objectives and drive change. The essence of work performed by the Decision Science Analyst involves gathering, manipulating and synthesizing data (e.g., attributes,...