Sr. Clinical AnalystSmartLight Analytics • Plano, TX, US
Sr. Clinical Analyst
SmartLight Analytics • Plano, TX, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
- serp_jobs.filters_job_card.quick_apply
job_description.job_card.job_descriptionPossess a clear understanding of the identification and investigation of issues and billing activities leading to improper payments is required as this work involves reviewing medical claims data (professionals, facilities, insured members, or the broker community). Utilize information from claims data analysis, plan representatives and other sources to accurately present the company’s findings to carriers in a way ensuring they will understand the issues and take recommended actions to remediate said inappropriate payments. Identify, analyze, and interpret trends or patterns in complex data sets Leverage available resources and systems (both internal and external) to analyze claim information and take appropriate action for payment resolution Perform review of claims resulting from overpayments related to benefits and policies Consider the financial impact of referrals with regard to identified savings and the potential of favorable resolution during the approval process Communicate and document findings, including trends and recommendations Ability to review and analyze medical records. Bachelor's degree in healthcare or related field, preferred At least one of : RN, CPC, CCS or other relevant clinical / coding certifications required, Multiple would be preferred A minimum of 5 years of experience in healthcare payment integrity, clinical auditing or claims management Experience in commercial payer environments Strong critical-thinking, communication and attention to detail skills Who is SmartLight Analytics SmartLight Analytics was formed by a group of industry insiders who wanted to make a meaningful impact on the rising cost of healthcare. With this end in mind, SmartLight works for self-funded employers to reduce wasteful spending in their healthcare plan through our proprietary data analysis. Our process works behind the scenes to save money without interrupting employee benefits or requiring employee behavior changes. Powered by JazzHR
Position Overview :
- The Senior Clinical Analyst role combines clinical data expertise with relationship management to ensure accurate claims processing, resolve billing discrepancies, and optimize carrier performance.
- The analyst plays a key role in identifying improper payments, communicating findings, and driving resolution through data-backed insights.
This is NOT a Data Analyst Position with SQL and data sets. Responsibilities :
Qualifications :
serp_jobs.job_alerts.create_a_job
Sr Analyst • Plano, TX, US
Job_description.internal_linking.related_jobs
Baylor Scott & White Medical Center - McKinney.Full Time Days, Monday, Wednesday, Friday, 6 : 30 AM-7 : 00 PM.Requires a min of 2 yrs CST experience .
Here at Baylor Scott & White Health we...serp_jobs.internal_linking.show_more
Slate Healthcare is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.Profession : CT Technologist, JobSpecialty : CT Tech, Shift : 4x10 Nights, Dura...serp_jobs.internal_linking.show_more
This job is member of the Citi Acquisitions team within the Commercial Organization.Responsible for leading the strategy and executing initiatives that drive innovation and growth for our AAdvantag...serp_jobs.internal_linking.show_more
Nightingale Nurses is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
You may not realize it, but as an RN with real world hospital experienc...serp_jobs.internal_linking.show_more
HonorVet Technologies is seeking a travel CVOR Technologist for a travel job in Plano, Texas.Job Description & Requirements.
Inpatient & Outpatient cases.CV and Vascular Cases - MUST have a ...serp_jobs.internal_linking.show_more
ADEX Healthcare Staffing LLC is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
Travel or Local Allied Healthcare Professional needed for ASA...serp_jobs.internal_linking.show_more
Host Healthcare is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.Pay package is based on 10 hour shifts and 40 hours per week (subject to c...serp_jobs.internal_linking.show_more
Lifeline Medical Staffing is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
Lifeline Medical Staffing Job ID #74389590.Pay package is based ...serp_jobs.internal_linking.show_more
Medical Solutions Allied is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
We’re seeking talented healthcare professionals whose adven...serp_jobs.internal_linking.show_more
Springboard Healthcare is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
Springboard Healthcare Job ID #806124.Pay package is based on 8 hou...serp_jobs.internal_linking.show_more
Invitation Homes (NYSE : INVH) is the leading owner and operator of single-family rental homes in the United States with a portfolio of over 100,000 owned and managed high-quality homes in over 16 m...serp_jobs.internal_linking.show_more
MedPro Healthcare Allied Staffing is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
Joint Commission-certified staffing agency, is seeking a...serp_jobs.internal_linking.show_more
We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...serp_jobs.internal_linking.show_more
CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.GetMed Staffing is searching for a strong CT Tech to assist our traveler-friendly client.A minimum of 1-2 year...serp_jobs.internal_linking.show_more
Malone Healthcare - Nursing is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
About Malone Healthcare - Nursing.With a commitment to pr...serp_jobs.internal_linking.show_more
CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend am...serp_jobs.internal_linking.show_more
CrossMed is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.At CrossMed Healthcare Staffing, we aim to create lasting impressions wherever we...serp_jobs.internal_linking.show_more
Skyline Med Staff Allied is seeking a travel CT Technologist for a travel job in McKinney, Texas.Job Description & Requirements.
Join the Top- Rated Travel Healthcare Team!.Skyline Med Staff was...serp_jobs.internal_linking.show_more
Certified Surgical Tech CST Days
Baylor Scott & White Health • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
Slate Healthcare • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Analyst / Sr Analyst, AAdvantage Co-Brand Partnerships
American Airlines • Dallas, TX, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Travel CT Technologist
Nightingale Nurses • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CVOR Technologist
HonorVet Technologies • Plano, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
ADEX Healthcare Staffing LLC • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
Host Healthcare • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
Lifeline Medical Staffing • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
Medical Solutions Allied • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
Springboard Healthcare • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Sr. Analyst
Invitation Homes • Dallas, TX, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Travel CT Technologist
MedPro Healthcare Allied Staffing • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Remote Investment Analyst – AI Trainer ($50-$60 / hour)
Data Annotation • McKinney, Texas
serp_jobs.filters.remote
serp_jobs.job_card.full_time +1
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
GetMed Staffing, Inc. • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
Malone Healthcare - Nursing • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Travel CT Technologist
Travel Nurses, Inc. • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
CrossMed • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel CT Technologist
Skyline Med Staff Allied • McKinney, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted