Appeals Analyst – GP
NJM Insurance Group
Department Analyst I – Credentialing
Cleveland Clinic
full-time
Posted on:
Origin: • 🇺🇸 United States • Ohio
Visit company websiteJob Level
Junior
About the role
- Analyze and evaluate operational and financial functions of administrative and operational units.
- Analyze departmental resources, services, systems, budgets and programs.
- Prepare reports based on analysis.
- Conduct basic statistical analysis and evaluation of unit services and performance.
- Identify program or service strengths, weaknesses, and financial impact.
- Identify opportunities for service and program improvement.
- Develop special reports and recommendations.
- Assist with the development of operational plans, procedures and systems.
- Review and evaluate current procedures and systems and develop recommendations for improvement.
- Maintain awareness of and comply with various regulatory guidelines (JCAHO, FDA, HIPAA, OSHA, etc.).
Requirements
- Bachelor’s Degree in Business, Healthcare Administration or a related field and one year of statistical analysis experience
- High School Diploma/GED and five years of experience
- Associate’s Degree and three years of experience
- Master’s Degree
- Proficient with Microsoft products such as Outlook, Word and Excel
- Experience with design tracking tools
- Credentialing experience
- Must live in NE Ohio - occasional on site meetings in CC facilities in the NE Ohio area such as Independence
- Microsoft Office skills
