Claims Analyst jobs in Glendale, Arizona (AZ)

Manages a team of configuration analysts working remotely that develop and deploy configuration to QNXT and / or other Claims and Enrollment Applications.

The Reimbursement Services System Configuration Analyst is responsible for ensuring system setup accuracy translating to increased levels of auto-adjudication and accurate claims processing.

Elicit requirements using interviews, document analysis, requirements workshops, storyboards, business process analysis, use cases or user stories, scenarios, and workflow analysis.

Collaborate with business partners to generate metrics and research for development and evaluation of projects and programs.

Document and maintain related project sites including project server sites and Confluence repositories; serve as team expert on all components of IT Health: claims processing, reference administration, provider enrolment and management, finance, security, and other related functions as assigned.

Manage Customer Service Supervisors, performance to be measured against job descriptions and Roles and Responsibilities; apply development program for all direct reports.

Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting.

As the Data Scientist Senior Manager, you will be responsible for the development and implementation of proprietary machine learning algorithms and techniques to solve business problems and optimize our member experience.

Monitors and maintains current knowledge of industry trends in legal and compliance matters relating to the insurance industry and pursues ongoing professional development to maintain current knowledge on best practices.