Claims analyst jobs in Mount Vernon, New YorkCreate job alerts

Key Responsibilities Analyze processes and workflows to understand operations and end-user needs Develop, test, and maintain interface solutions to improve processes and enhance patient safety Troubleshoot integration issues and provide on-call support, ensuring effective system operation Requi

A company is looking for a Senior Allocation Analyst to support the forensics team in building claim-level allocation models and analytics.Key Responsibilities Perform quantitative analysis on potential policy exposure for complex insurance claims Build loss allocation models for mass torts and c

Job Description We have been widely recognized for our exceptional culture, world-class physicians, Magnet-designated nurses and passionate employees who make a real difference in our community. With tremendous growth opportunities, great benefits, and flexible work schedules, it is no wonder why we are consistently recognized as the best place to work in Westchester. Position Summary The Senior IT Applications Analyst is responsible for the advanced configuration, optimization, and support of healthcare information systems used across clinical, financial, and operational areas. This role provides subject matter expertise on application functionality, integration, and best practices, ensuring system reliability, regulatory compliance, and workflow efficiency. The Senior Analyst serves as a key liaison between clinical and business stakeholders, IT leadership, and software vendors. Often leading projects, mentoring junior analysts, and driving strategic initiatives that improve patient care and operational performance. Essential Functions and Responsibilities Includes the Following · Prior experience supporting clinical systems in hospitals or physician practices/clinics. · Possesses the necessary leadership and communication skills for a customer-driven service organization. · Demonstrates excellent oral and written communication skills. Can interact successfully with all levels of staff within the organization, physicians, vendors, and technicians. · Maintains confidentiality of patient records or other confidential information. · Demonstrates accountability and professional attitude regarding personal schedule and work commitments. · Foster’s positive interpersonal relationships and professional image by adhering to the behavioral standards with internal and external contacts. · Adheres to Human Resources Policies and Procedures. Application Support & Optimization · Provide expert-level support for healthcare clinical and business applications. · Diagnose and resolve complex application and integration issues; serve as an escalation point for Tier 1–2 analysts. · Lead efforts to optimize system functionality, improve performance, and enhance user satisfaction. · Ensure up-time, data integrity, and compliance with internal and external standards (HIPAA, Joint Commission, CMS). Implementation & Configuration · Lead the design, configuration, testing, and deployment of new applications, upgrades, and system enhancements. · Collaborate with stakeholders to analyze requirements and translate clinical/business needs into technical specifications. · Oversee system build activities and manages vendor relationships for application support and enhancements. Project Leadership · Manage or co-lead large-scale IT and clinical system projects through all lifecycle phases. · Develop and maintain project plans, timelines, and risk assessments. · Coordinate cross-functional teams, ensuring alignment between IT and clinical operations. Workflow Analysis & Training · Conduct advanced workflow analysis and recommend process improvements to increase efficiency and quality of care. · Develop and maintain a comprehensive system of documentation, policies, and procedures. · Mentor and train application analysts, superusers, and other stakeholders on system functionality and best practices. · Minimum 5–7 years of experience supporting healthcare information systems. · Advanced knowledge of several major healthcare applications is required. · Proven experience leading IT or application projects in a healthcare setting. · Experience mentoring junior staff or managing small teams preferred. · Demonstrated experience successfully supporting administrative, financial or clinical department managers and operating personnel with the ability to work well with a variety of personalities. · Understands and adheres to the Hospital Performance Standards, Policies and Behaviors. · Develops the project work plan, work breakdown structure, and schedule using a designated project management tool for project team usage. Project Plans include sufficient task level detail to capture known dependencies and major milestones. Management of all projects assigned to oversee. · Utilize effective project and time management skills to manage multiple projects simultaneously. · Ensure all projects are consistent with overall customer objectives and strategic plans. · Manage the day-to-day activities of cross-functional project teams and ensure adherence to the project plan. · Deploy best practices approach defined by Project Delivery Services team. · Work to control change, adjust the budget, timeline, and project scope to accommodate approved changes. · Produces timely, detailed summaries and high-level reports · Provide project schedule, actual vs. budget, and earned value information in project progress reports. · Identifies and mitigates project risk, keeping issues visible, to avoid impacting the project's success. · Confirm the alignment of customer expectations and project goals. · Ensure proper quality assurance and user acceptance of solutions prior to implementation. · Review and finalize deliverables and monitor quality control. · Develop customer Return on Investment metrics for project, based on customer objectives. · Develops and maintains all strong working relationships with all key stakeholders including, Client Executives, Product Managers, and Resource Allocation Manager. · Coordinate with Client Executives and Product Directors to align all projects with customer's strategic objectives · Collaborate with Resource Allocation Manager to ensure associates with required skills are available to support the implementation of new system solutions. Management of all resources assigned to projects. · Motivate, guide and lead implementation staff to achieve organizational goals and satisfy customers. · Proactively identify project and staff related issues. · Participate in performance appraisals and contribute to project team associate's performance appraisals. · Performs all other related duties as assigned. Education & Experience Requirements · Demonstrated experience managing IT projects in an enterprise environment · Experience working with tool to create and manage project plans using MS project Implementation management · Experience managing project budgets · Background in hospital/medical claims processes and knowledge of claims workflow is a requirement Core Competencies · Demonstrates ability to establish two-way communication by clearly defining expectations, communicating utilizing a variety of methods · Actively take note to ideas and concerns and respond in an appropriate manner. · Demonstrates ability to retain composure under stress For more information or to apply send resume to or call 914-940-

GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO is hiring a Senior Innovation Analyst to join their Claims Innovation team. Great Company: At GEICO, we help our customers through life's twists and turns.

Key Responsibilities Collaborate with the Epic analyst team to provide developer-level support Optimize system performance by applying knowledge of hospital billing and claims applications Troubleshoot and resolve issues within the HB and Claims modules Required Qualifications Epic HB Certifi

Key Responsibilities Serve as a subject matter expert for pharmacy COB processes and claims processing logic Analyze, monitor, and enhance processes and adjudication logic for pharmacy COB point-of-sale claims Lead projects related to process or logic changes across internal and external areas

A company is looking for a Business Systems Analyst. Key Responsibilities: Collaborate with business partners to implement and migrate to the DomaniRx platform Utilize knowledge of pharmacy claims to identify and resolve defects and issues Develop and validate test cases to ensure successful mig

Analyst, Claims Research serves as a senior-level subject matter expert in claims operations and research, leading the most complex and high-priority claims projects. The Senior Claims Research Analyst provides senior-level support for claims processing and claims research. Act as a senior claims su

Duration: 6 12 months +++ Hybrid 3 Days a Week: Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken, PA; Dallas, TX; Fargo, ND; Garden City, NY; Houston, TX; Jacksonville, IL; Lenexa, KS; Los Angeles, CA; Lubbock, TX; Morristown, NJ; Mt Juliet, TN; New York, NY; Purchase, NY; Topeka, KS

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