Education

Bachelor's Degree in Finance, Accounting, Healthcare Administration or related field of study required
Equivalent experience may be accepted in lieu of a degree
3+ years of experience required in revenue cycle analysis, billing, claims processing, or financial analysis in a healthcare setting

Skills for Success

Proficiency in revenue cycle management and data analysis tools.
Advanced Excel skills and familiarity with billing software and revenue management systems.
Strong problem-solving abilities and attention to detail.
Excellent communication and collaboration skills to work across departments.
Knowledge of billing regulations, reimbursement guidelines, and claims management practices.

Working Model Requirements

Remote working schedule requires a stable, secure, quiet, compliant workstation
M-F eastern business hours required

Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

","The Senior Revenue Analyst is responsible for analyzing, reporting, and optimizing revenue to support financial objectives. Ensures accurate billin...","Senior Revenue Analyst","Full Time",[90],["B","3326062212"],"Work at Mass General Brigham (Enterprise Services)","2 days ago","/jobs/3326062212-senior-revenue-analyst","Somerville, MA, United States","/jobs?keyword=Mass+General+Brigham+%28Enterprise+Services%29","/jobs?location=Somerville%2C+MA%2C+United+States","/jobs?keyword=Senior+Revenue+Analyst",{"_65":66,"_67":91,"_69":92,"_71":93,"_73":94},"Somerville","Somerville, MA, United States, 02145","MA","02145",["D",1776322800000],"Jobgether","We are currently looking for a Informaticist - REMOTE. The role involves coordinating with various analytics, IT, and business areas to ensure work is informed by insights from knowledgeable SMEs. As an Informaticist, you will leverage your expertise in data analysis, modeling, and optimization to drive decisions that enhance business outcomes. You will play a critical role in the Pharmacy Analytics division by working with claims data and evaluating clinical programs focused on improving member experiences. This position offers independence in decision-making, even in ambiguous situations, and requires minimal supervision.\nAccountabilities

Coordinate with analytics, IT, and business areas for project insights\nUse data to enhance decision-making and business strategies\nAnalyze pharmacy claims data and clinical programs\nPresent findings to business partners\nMake independent work method decisions\nFollow established guidelines and procedures\nRequirements

Bachelor's degree\n2-5 years of data analysis experience\nAt least 2 years of experience with Python/SQL\nAbility to drive business outcomes using data\nStrong presentation skills\nPassion for improving consumer experiences\nBenefits

Competitive salary range: $73,400 - $100,100 per year\nBonus incentive plan based on performance\nComprehensive medical, dental, and vision benefits\n401(k) retirement savings plan\nPaid time off and holidays\nShort-term and long-term disability coverage\nLife insurance\nOpportunities for personal development and wellness

#J-18808-Ljbffr\n","We are currently looking for a Informaticist - REMOTE. The role involves coordinating with various analytics, IT, and business areas to ensure work...","Remote Senior Informaticist",[109],["B","3316741927"],"Work at Jobgether","1 days ago","/jobs/3316741927-remote-senior-informaticist","New York, NY, United States","/jobs?keyword=Jobgether","/jobs?location=New+York%2C+NY%2C+United+States","/jobs?keyword=Remote+Senior+Informaticist",{"_65":66,"_67":110,"_69":105,"_71":111},"New York","NY",["D",1776016800000],"CVS Health Corporation","A leading healthcare company is seeking an experienced Google Cloud Platform - GCP and Power Platform Developer to drive analytics and insights across pharmacy claims and formularies. The ideal candidate will have over 5 years of experience in data analytics, especially in Pharmacy Benefit Management. Responsibilities include designing analytics solutions using GCP, developing SQL queries, and collaborating with clinical and operational teams. This full-time position is based in Scottsdale, Arizona, offering competitive pay and comprehensive benefits.\n#J-18808-Ljbffr\n","A leading healthcare company is seeking an experienced Google Cloud Platform - GCP and Power Platform Developer to drive analytics and insights acr...","Remote GCP & Power Platform Developer - PBM Analytics",[126],["B","3258580819"],"Work at CVS Health Corporation","Creative & Design","/jobs/3258580819-remote-gcp-power-platform-developer-pbm-analytics","Scottsdale, AZ, United States","/jobs?keyword=CVS+Health+Corporation","/jobs?location=Scottsdale%2C+AZ%2C+United+States","/jobs?keyword=Remote+GCP+%26+Power+Platform+Developer+-+PBM+Analytics",{"_65":66,"_67":127,"_69":128,"_71":129,"_73":130},"Scottsdale","Scottsdale, AZ, United States, 85261","AZ","85261",["D",1775854800000],"CVS Health","We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary\nThe Data Analyst for claims & reporting is responsible for overseeing Medicaid claims operations, inventory management, quality assurance, and compliance monitoring. This role ensures timely and accurate processing of Medicaid claims in accordance with state and federal regulations, contractual requirements, and organizational performance standards.

Key Responsibilities

Manage daily Maryland Medicaid claims pend buckets to ensure timely and accurate claims adjudication and payment.

Oversee inventory levels, turnaround times (TAT), backlog reduction, reduction of claims interest, suspended claims work queues, and provider dispute resolution.

Drive improvements in auto-adjudication rates, accuracy, and first-pass resolution.

Ensure all claims processes comply with:

State Medicaid regulations and billing guidelines

CMS requirements and Federal managed care rules

Timely filing laws and encounter data reporting requirements

Support readiness reviews, audits, Corrective Action Plans (CAPs), and state submissions.

Implement QA programs to monitor claim accuracy, provider payment integrity, and policy adherence.

Review and analyze claims performance dashboards, error trends, and key metrics (TAT, payment accuracy, denial rates, encounters, etc.).

Partner with Finance on claims reserves, cost-of-care reporting, and reconciliation issues.

Work closely with Configuration, Cotiviti and Claim Xten to resolve system issues, benefit configuration errors, and pricing or editing defects.

Partner with Provider Relations to address contractual interpretation questions and recurring provider submission issues.

Collaborate with Utilization Management/Medical Management on authorization-related claims issues.

Coordinate with Compliance and Legal on regulatory changes and required process updates.

Lead initiatives to streamline workflows, automate processes, reduce manual interventions, and improve accuracy.

Drive root-cause analysis and implement sustainable corrective actions.

Participate in the development of policy and procedure updates for Medicaid claims operations.

Required Qualifications

Bachelor’s degree in Business, Healthcare Administration, or related field.

3+ years of claims experience in Medicaid.

Strong understanding of Medicaid billing rules, HSCRC, provider types, benefit structures, and encounter reporting.

Experience with major claims systems (e.g., QNXT).

Problem solving mindset; adaptable, ability to analyze processes.

Analytical skills with proficiency in Excel and claims data analysis.

Job responsibilities are not limited to the description above.

Preferred Qualifications

Experience with Medicaid managed care organizations (MCOs) or state Medicaid agencies.

Knowledge of fee schedules, and Medicaid pricing methodologies.

Background in payment integrity, claims audits, configuration testing, or encounter operations.

Education\nBachelor’s degree in Business, Healthcare Administration, or related field.

Anticipated Weekly Hours\n40

Time Type\nFull time

Pay Range\nThe typical pay range for this role is:

$46,988.00 - $112,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Benefits\nWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland).

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.

#J-18808-Ljbffr\n","We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®...","Business Analytics, Senior Analyst",[145],["B","3233886024"],"Work at CVS Health","7 days ago","/jobs/3233886024-business-analytics-senior-analyst","Annapolis, MD, United States","/jobs?keyword=CVS+Health","/jobs?location=Annapolis%2C+MD%2C+United+States","/jobs?keyword=Business+Analytics%2C+Senior+Analyst",{"_65":66,"_67":146,"_69":147,"_71":148,"_73":149},"Annapolis","Annapolis, MD, United States, 21403","MD","21403",8752,"name","Newsday Media Group","agency","logo","https://production-rails-default.s3.us-east-2.amazonaws.com/public/legacy-logos/351727.GIF","slug","newsday-media-group","

Newsday Media Group is a locally owned, independent media company grounded in journalistic excellence, integrity, and commitment to the communities it serves. With 19 Pulitzer Prizes and dozens of Emmy Awards, it's one of the most decorated news organizations in the country.

The company is in the middle of a significant transformation, expanding from its newspaper roots into a multimedia operation spanning digital, video, podcasts, live events, and data-driven civic engagement. NMG properties include the flagship Newsday and Newsday.com, NewsdayTV, the Newsday Live events series, and nextLI, a civic research and community forum platform funded by The Rauch Foundation.

A new 130,000-square-foot headquarters in Melville features a broadcast-quality TV studio and multimedia production space. Newsday Live produces a growing calendar of food and wine tastings, author talks, sports Q&As, concerts, and community events. Feed Me, the company's food and dining vertical, includes a web series, quarterly print magazine, and restaurant coverage. Brand 360, the in-house content studio, partners with advertisers across healthcare, education, energy, tourism, and retail.

Newsday's investigative unit has driven real-world change, from prompting schools to replace unsafe football helmets to contributing reporting that led to federal corruption convictions. Community programs include the Newsday Marching Band Festival, CheerFest, Scholar-Artist honors, and partnerships with local nonprofits focused on hunger, housing, youth education, and child welfare.

For people who care about local journalism, multimedia storytelling, and community impact, Newsday is doing the work at scale.

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This role ensures timely and accurate processing of Medicaid claims in accordance wi Senior Analyst, Business Analytics, Business, Analyst, Senior, Analytics, Technology, Retail","The Data Analyst for claims & reporting is responsible for overseeing Medicaid claims operations, inventory management, quality assurance, and comp...",[202],"CVS Pharmacy","salaryMin","salaryMax","salaryDescription","url","https://us.thebigjobsite.com/redirectfeedjob?jobid=6F1AD174AE63B014EC7FE92157D517B1&source=mediabistroxmlus&utm_source=mediabistroxmlus&jobSiteKey=388EFC42367487CA6D54FA53129E60C8","companyDescription","companyWebsite","Work at CVS Pharmacy","isManualPosted","costPerClick",0.15,"/jobs/3287892890-business-analytics-senior-analyst","fullUrl","https://www.mediabistro.com/jobs/3287892890-business-analytics-senior-analyst","strippedDescription","parsedLocation",{"_69":141,"_200":39,"_201":39,"_67":146,"_71":148,"_65":66,"_73":149},"3 days ago","level","/jobs?keyword=CVS+Pharmacy","street1","street2",{"_69":147,"_67":146,"_71":148,"_65":66,"_73":149},"honeypotInputProps",{"_636":637,"_638":639,"_640":641},"board",{"_151":234,"_235":234,"_236":223,"_237":238,"_239":240,"_241":242,"_243":244,"_245":246,"_247":248,"_249":250,"_251":252,"_253":254,"_255":256,"_257":258,"_259":260,"_261":262,"_263":264,"_265":266,"_267":268,"_269":270,"_271":272},"requestInfo",{"_224":225,"_226":223,"_227":191,"_228":229},"env",{"_214":215,"_216":217,"_218":219,"_220":221,"_222":223},"user","toast","confettiId","MODE","production","SENTRY_ENV","mediabistro","NEW_JOB_BOARD_SENTRY_DSN","https://235251e3654b447a82e934b7c2ce7c93@o4504103609303040.ingest.sentry.io/4504806528253952","SENTRY_RELEASE","e0320c8f25a431ad115c221a013d9029ffe6d050","WEBSITE_URL","https://www.mediabistro.com","hints",{"_230":231,"_232":233},"origin","path","userPrefs",{"_230":231},"theme","light","timeZone","UTC","Mediabistro","fullName","siteUrl","pages",{"_633":634,"_635":471},"mainCss",":root{--background:white;--foreground:black;--card:oklch(100% 0 0);--card-foreground:oklch(25% .001 0);--popover:white;--popover-foreground:black;--primary:oklch(59% .23 31.14);--primary-foreground:oklch(100% 0 0);--secondary:oklch(98% .001 0);--secondary-foreground:oklch(25% .001 0);--muted:oklch(97% 0 0);--muted-foreground:oklch(55.6% 0 0);--accent:oklch(96% 0 0);--accent-foreground:oklch(25% .001 0);--destructive:oklch(65% .15 15);--border:oklch(90% .001 0);--input:oklch(90% .001 0);--ring:oklch(70% .15 25);--chart-1:oklch(70% .15 25);--chart-2:oklch(70% .12 140);--chart-3:oklch(75% .12 60);--chart-4:oklch(50% .07 250);--chart-5:oklch(34% .03 240);--sidebar:oklch(98% .001 0);--sidebar-foreground:oklch(25% .001 0);--sidebar-primary:oklch(70% .15 25);--sidebar-primary-foreground:oklch(100% 0 0);--sidebar-accent:oklch(98% .001 0);--sidebar-accent-foreground:oklch(25% .001 0);--sidebar-border:oklch(90% .001 0);--sidebar-ring:oklch(70% .15 25);--footer-background:oklch(14% .07 288.16);--footer-foreground:oklch(100% 0 0);--footer-border:oklch(70% .15 25);--primary-surface:oklch(59% .23 31.14)}.dark{--background:oklch(20% .02 235);--foreground:oklch(100% 0 0);--card:oklch(25% .03 232);--card-foreground:oklch(100% 0 0);--muted:oklch(31% .02 232);--muted-foreground:oklch(78% .01 220);--popover:oklch(25% .03 232);--popover-foreground:oklch(100% 0 0);--border:oklch(35% .03 220);--primary-surface:oklch(100% 0 0)}","analytics",{"_631":632},"meta",{"_598":599},"favicon",{"_592":593,"_594":595,"_596":597},"metaTags",{"_590":591},"social",{"_577":578,"_579":580,"_581":582,"_583":584,"_585":586},"helpEmail","help@mediabistro.com","transactionalEmail",{"_571":572,"_573":574,"_575":576},"header",{"_154":478,"_479":480},"footer",{"_154":427,"_428":429,"_389":39,"_430":431,"_432":433,"_385":434,"_435":436,"_437":438},"styleGuide",{"_398":399,"_400":401},"jobsSearch",{"_392":393},"hero",{"_36":387,"_339":388,"_389":390,"_374":391},"flags",{"_384":15,"_385":15,"_386":371},"postJobs",{"_243":282,"_263":283,"_284":285,"_286":287,"_265":288,"_289":290,"_291":292,"_293":294,"_295":296,"_297":298,"_299":300},"createAlertMeta",[278,279],"jobsPortalSignupMeta",[273,274],{"_36":277},{"_151":31,"_275":276},"content","Create your free profile to apply for jobs, upload your resume, and set job alerts. 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