As a Claims Adjustment Specialist I, this individual will be responsible for analyzing standard to complex post paid healthcare claims that require in depth research to determine accuracy and mitigate payment errors. The Claims Adjustment Specialist I will also be responsible for adjusting medical claims that result in overpayment or underpayment due to claim processing s

The Data Analyst leads the technology process for the end to end Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) data flow and works within key regulator guidelines for acceptable data submission. Using SQL and SAS programs lead the gathering of data for submissions Risk Adjustment. As the senior analyst of data, will be responsible fo

of Job Ensure prompt, efficient, accurate and timely claims adjudication of high dollar claims in accordance with the current policy benefits, limitations or exclusions. Provide resolution of provider inquiries and collaborate with internal departments. Provide feedback or suggestions to enhance current processes and/or systems. Responsibilities Research and adjudicate hig

As a member of the Employee Relations & Legal Compliance Center of Excellence, the Compliance Specialist is responsible for ensuring the organization's employees adhere to legal standards and in house policies. The individual will perform regular audits of business procedures, processes and activities to ensure compliance as well as monitoring operations, reporting infrac

JOB DESCRIPTION Position Type Full time Type Of Hire Experienced (relevant combo of work and education) Education Desired Bachelor of Business Management Travel Percentage 10 15% Job Description Are you curious, motivated, and forward thinking? At FIS you'll have the opportunity to work on some of the most challenging and relevant issues in financial services and technolo

JOB DESCRIPTION Position Type Full time Type Of Hire Experienced (relevant combo of work and education) Travel Percentage 1 5% FIS is a leading provider of technology solutions for merchants, banks and capital markets firms globally. FIS stays ahead of how the world is evolving to power businesses in today's fast changing competitive landscape and help our clients run, gr

Job Description Serves as a liaison between internal/external stakeholders to facilitate the workers' compensation claim process throughout the continuum of care. Responsible for caseload within assigned region. Provides data and analytics to drive performance improvement. Participates in implementing loss control initiatives and education. Job Responsibility 1.Advocates