NewClaims Specialist, Motor Vehicle Accident AspirionClaims Specialist, Motor Vehicle AccidentDenver, CO$21.63–$21.64 / hourSupport Compliance Program by adhering to policies and procedures pertaining to HIPAA, GLBA, FCRA, and other laws applicable to business practices; this includes becoming familiar with Code of Ethics, attending training as required, notifying management when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations. From 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.
NewReinsurance Analyst Senior USAAReinsurance Analyst SeniorColorado Springs, CO$93,770–$179,240 / yearLead and serve as a subject matter expert on special projects/audits related to reinsurance administration systems, legal contracts/treaties, new product launches and other initiatives. Collaborate and maintain strong relationships with business partners and may perform in an advisory capacity to operational business leaders on matters pertaining to business initiatives or strategies.
NewActuarial Analyst II (Intermediate) – Forecasting Analytics USAAActuarial Analyst II (Intermediate) – Forecasting AnalyticsColorado Springs, CO$77,120–$138,810 / yearIndependently applies actuarial methodologies to complete structured projects (e.g., Builds tools to test and implement new methodologies that improve accuracy of actuarial analysis; utilizes model results to select new variables and refresh existing variables in a rating algorithm; analyzes results from multiple methodologies to propose reserve selections and documenting rationale). Intermediate knowledge of data analysis tools, data visualization, developing analysis queries and procedures in Python, R, SQL, SAS, BI tools or other analysis software, and relevant industry data & methods and ability to connect technical insights to business problems.
EPIC Professional Billing Claims Analyst CommonSpirit HealthEPIC Professional Billing Claims AnalystEnglewood, COAs one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs.
Claims Audit Analyst - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) Denver Health and Hospital AuthorityClaims Audit Analyst - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)Denver, Colorado$60,500–$87,700 / yearInteract and collaborate with other corporate groups such as Provider Relations, Member Services, Information Systems, Compliance, Third Party Recovery, Finance, Patient Accounts, Enrollment, Utilization Management and Product Line Managers. Daily data analysis and research of claims processing to ensure benefit structures and operation processes are adhering to the rules, regulations and contractual requirements by CMS, DOI, contracted and non- contracted providers.
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 TimeCOEpic 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.
Data Exchange Analyst - Claims Operations Capital Rx, Inc.Data Exchange Analyst - Claims OperationsDenver, CO$96,800–$121,000 / yearThis role is responsible for executing and monitoring outbound eligibility, claims, formulary, and network reporting; supporting manual claims activities; assisting with custome data feed configurations; and participating in historical data loads and connectivity setups for JUDI Rx clients. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
NewCommercial Claims Insurance Analyst - Remote CSAA Insurance GroupCommercial Claims Insurance Analyst - RemoteCORemote$99,855–$110,950 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - 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 {+ 15 more}. Your Work: Performs complex data analysis for assigned client groups, evaluating findings in relation to broader business objectives Collaborates with cross-functional partners outside of IPM/IPO to gather insights, validate findings, and gain alignment on recommended actions.
Data Exchange Analyst - Claim Ops (Tpa) Capital Rx, Inc.Data Exchange Analyst - Claim Ops (Tpa)Denver, CO$96,800–$121,000 / yearKey Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Position Summary: The Data Exchange Analyst is a crucial member of our Data Operations team, responsible for ensuring the accurate, efficient, and secure exchange of healthcare data between Capital Rx - JUDI Health and its various partners, including employers, providers, and other TPAs.
Data Exchange Analyst - Claims Operations Capital Rx LLCData Exchange Analyst - Claims OperationsDenver, CO$96,800–$121,000 / yearJudi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and. This role is responsible for executing and monitoring outbound eligibility, claims, formulary, and network reporting; supporting manual claims activities; assisting with custome data feed configurations; and participating in historical data loads and connectivity setups for JUDI Rx clients.
Data Exchange Analyst - Claim Ops TPA Capital Rx LLCData Exchange Analyst - Claim Ops TPADenver, CO$96,800–$121,000 / yearKey Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and.
Lead, Medical Network Claims Pricer Capital Rx, Inc.Lead, Medical Network Claims PricerDenver, CO$128,000–$160,000 / yearApply Medicare-based pricing, Reference-Based Pricing (RBP), fee schedules, resource-based relative value methodologies, diagnosis-related groups, ambulatory payment classifications, per-diem rates, case rates, percent-of-charge arrangements, stop-loss provisions, and other approved reimbursement approaches. Advanced knowledge of procedure, revenue, diagnosis, and modifier logic; physician fee schedules; resource-based relative value methodologies; diagnosis-related groups; ambulatory payment classifications; per-diem, case-rate, percent-of-charge, and other medical reimbursement arrangements.
Telephone Claims Adjuster Allstate Insurance CompanyTelephone Claims AdjusterCOAs a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment. Through 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.
Non-Attorney Represented Bodily Injury Claims Adjuster - PST/MST (Remote) Allstate Insurance CompanyNon-Attorney Represented Bodily Injury Claims Adjuster - PST/MST (Remote)CORemote$47,500–$61,600 / yearCase Management, Claims Administration, Claims Resolution, Claims Review, Customer Centricity, Customer Service, Digital Literacy, Inclusive Leadership, Insurance Claims Investigations, Learning Agility, Personal Injury Claims, Problem Solving, Results-Oriented, Time Management, Written Communication. As a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment.
Attorney-Represented Bodily Injury Claims Adjuster - PST/MST (Remote) Allstate Insurance CompanyAttorney-Represented Bodily Injury Claims Adjuster - PST/MST (Remote)CORemoteAs a requirement of employment, individuals who currently hold an active insurance license must terminate all existing appointments prior to onboarding and must not hold any outside appointments at any point during employment. Through 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.
Civil Engineer (Highway) (Claims) U.S. Department of TransportationCivil Engineer (Highway) (Claims)Lakewood, CO$118,675–$154,280 / yearSpecified academic courses -- Successful completion of at least 60 semester hours of courses in the physical, mathematical, and engineering sciences and that included the courses specified in the basic requirements under paragraph A. The courses must be fully acceptable toward meeting the requirements of an engineering program as described in paragraph A. Related curriculum -- Successful completion of a curriculum leading to a bachelors degree in an appropriate scientific field, e.g., engineering technology, physics, chemistry, architecture, computer science, mathematics, hydrology, or geology, may be accepted in lieu of a bachelor's degree in engineering, provided the applicant has had at least 1 year of professional engineering experience acquired under professional engineering supervision and guidance. The ideal candidate should also possess a strong technical background in the field of highway engineering and construction, including a broad understanding of roadway design, geotechnical engineering, structural engineering, hydraulics, material quality requirements and heavy highway construction practices for the design and construction of highways and bridges.
NewStop Loss Aggregate Analyst CVS Health CorpStop Loss Aggregate AnalystCO$18.50–$35.29 / hourThis role involves preparing, tracking, reconciling, and helping generate and marshal stop loss filings to completion while serving as a key liaison across internal business partners, external stakeholders, and stop loss carriers. The position offers exposure to many areas of healthcare claims administration, including stop loss and reinsurance policy, data analytics, underwriting, eligibility, finance, client management, and provider and broker relations.
Analyst, Data Exchange Medical, Dental & Vision Capital Rx LLCAnalyst, Data Exchange Medical, Dental & VisionDenver, CO$96,800–$121,000 / yearPosition Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Position Summary: The Data Exchange Analyst is a crucial member of our Data Operations team, responsible for ensuring the accurate, efficient, and secure exchange of healthcare data between Capital Rx - JUDI Health and its various partners, including employers, providers, and other TPAs.
Analyst, Data Exchange (Medical, Dental & Vision) Capital Rx, Inc.Analyst, Data Exchange (Medical, Dental & Vision)Denver, CO$96,800–$121,000 / yearPosition Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Position Summary: The Data Exchange Analyst is a crucial member of our Data Operations team, responsible for ensuring the accurate, efficient, and secure exchange of healthcare data between Capital Rx - JUDI Health and its various partners, including employers, providers, and other TPAs.
Staff Analyst, Analytics - Jumbo Insights Capital Rx LLCStaff Analyst, Analytics - Jumbo InsightsDenver, CO$150,800–$188,500 / yearThis role requires strong PBM industry knowledge, advanced data analysis skills, and the ability to translate complex pharmacy benefit, claims, and performance data into clear, actionable insights for clients and internal stakeholders. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.