- CenterWell (Atlanta, GA)
- …caring community and help us put health first** As an **Accounts Receivable Specialist/ Healthcare Claims Denials Specialist** , you will: + Ensure the ... High School Diploma or the equivalent + Minimum of two years medical claims processing experience + Knowledge of healthcare collection procedures and… more
- System One (Reston, VA)
- AUTOMATED SOFTWARE TESTING ENGINEER - HEALTHCARE CLAIMS PROCESSING ALTA IT Services is staffing a 100% remote, 3-month contract opening for an Automated Software ... Engineer to support a respected health insurance customer. Candidates must have healthcare claims processing and core framework development experience. REQUIRED… more
- Commonwealth Care Alliance (Boston, MA)
- …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and...Degree Required Experience (must have): + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+… more
- Zelis (St. Petersburg, FL)
- …or advanced understanding of payment integrity, claim processing and/or revenue cycle for healthcare claims + Understanding of medical coding and medical ... Position Overview: At Zelis, t he Business Analyst - Expert Claims Review (ECR) is ultimately responsible for enabling high quality user stories under our ECR… more
- AIG (San Francisco, CA)
- Claims Complex Director - Healthcare Professional Liability (HPL) Join us as a Claims Complex Director to take on key responsibilities within a world-class ... create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims Department of General… more
- Hartford HealthCare (Hartford, CT)
- …Summary:* Manages a robust caseload, from inception to closure, of Hartford HealthCare 's claims and suits through HHC's Legal Department. Responsible to ... Listener who can exhibit empathy to claimants . Demonstrated history of proactive claims management . Demonstrated knowledge of the healthcare and insurance… more
- Guidehouse (Lewisville, TX)
- …billing, secondary billing, and payer audit follow-up for government and non-government claims . Must work with other departments to facilitate the meeting of both ... Billing Emphasis + Correcting and billing electronic and hardcopy claims + Submits Adjusted claims + Provides...GED. + 0-2+ years working within the following sectors: healthcare , insurance, business, finance or customer service. + Working… more
- Molina Healthcare (Nicholasville, KY)
- …solution or configuration during warranty period. **KNOWLEDGE/SKILLS/ABILITIES** + Knowledge of healthcare claims and claim processing from receipt through ... + Strong SQL knowledge preferred + Edifecs knowledge preferred + Understanding of Healthcare EDI Claims transactions preferred + Understanding of complex claim… more
- BrightSpring Health Services (Oklahoma City, OK)
- …of patients nationwide through our growing network of branches and healthcare professionals. The Adjudication Specialistwill be responsible for all aspects of ... pharmacy and medical claims adjudication, accuracy of pharmacy and medical claims...Pharmacy + 1+ years pharmacy experience + Pharmacy or healthcare -related knowledge + Knowledge of pharmacy terminology including sig… more
- CVS Health (Franklin, TN)
- …resolve any issues **Preferred Qualifications** + 1-2 years Experience in a healthcare claims processing environment **Education** HS Diploma **Pay Range** The ... communication skills. **What you will do** + Handles and processes Benefits claims submitted by healthcare providers, ensuring accuracy, efficiency, and strict… more
- The Cigna Group (Bloomfield, CT)
- …with all MS office products including PowerPoint - REQUIRED + 5+ years of healthcare claims life cycle experience, emphasis in claims system requirements ... a division of the Cigna Group is hiring a Claims System Configuration Lead Analyst. This highly technical systems...acts as the Subject Matter Expert (SME) for the Claims Configuration of the eviCore Claims Systems… more
- The Cigna Group (Bloomfield, CT)
- …work independently and as a team + Strongcommunicationskills + 5+ years of healthcare claims lifecycle; configuration design, editing, claims system ... a division of the Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst. For this...Analyst. For this highly technical role, you'll review our claims system to ensure all configurations were input correctly… more
- Brighton Health Plan Solutions, LLC (Westbury, NY)
- About The Role Brighton Health Plan Solutions (BHPS) is seeking an experienced Healthcare Claims Examiner skilled in the interpretation of Hospital and Ancillary ... Payment procedures as well as capable of manually processing claims according to all outlined Policies and Procedures. This...our people are committed to the improvement of how healthcare is accessed and delivered. When you join our… more
- The Cigna Group (Bloomfield, CT)
- …School Diploma or GED required, bachelor's degree preferred + **5+ years of healthcare claims lifecycle; configuration design, editing, claims system ... a division of the Cigna Group is hiring a Claims System Configuration Senior Analyst. This highly technical systems...highly technical systems role requires the review of our claims processing system to ensure all configurations were input… more
- System One (Fairfax, VA)
- ALTA IT Services is staffing a contract to hire opportunity for a Healthcare Claims Processor to support a leading health insurance customer. The individual will ... review and adjudicate paper/electronic claims , also use automated system..., also use automated system processes to send pending claims to ensure accurate completion according to medical policy,… more
- Commonwealth Care Alliance (Boston, MA)
- …including the MHK Market Prominence platform. **Knowledge, Skills & Abilities Required:** ** Healthcare Claims ** Strong knowledge of healthcare claims ... a related field **Education Desired:** Master's degree in computer science, Healthcare , Data Science, Business Administration **Experience Required:** + 5+ years'… more
- J&J Family of Companies (Skillman, NJ)
- …review and approve product labels and advertising copy for consumers and healthcare professionals. * Prepare claims support documentation for product launch, ... Senior Scientist, Claims & Clin Strat - 2407025259W **Description** Kenvue,...2407025259W **Description** Kenvue, is currently recruiting for: **Senior Scientist, Claims & Clinical Strategy, Essential Health** This position reports… more
- TEKsystems (St. Louis, MO)
- … claims processing and/or medical billing. * Working knowledge of the healthcare industry, insurance claims , and the associated medical terminology. * Strong ... Medical Claims Processor Full-Time Opportunity Available TEKsystems is looking...families. Assist with their inquiries and advocate for their healthcare needs. Ensure members receive all available benefits to… more
- Guidehouse (Lewisville, TX)
- …Representatives are responsible for taking in-coming and making out-going calls to patients and insurance companies to resolve account balances. All client policies ... and procedures are followed. Representatives will perform any and all job-related duties as assigned. **_This position will be on a hybrid schedule working two days in the office and three days from home._** **_Questions regarding this position, you may… more
- TEKsystems (St. Louis, MO)
- …in claims processing and/or medical billing. *Working knowledge of healthcare industry, insurance claims , and the associated medical terminology. *Strong ... looking for someone to join a team of medical claims processors who advocate for the Fund's members while...families. Assist with their inquiries and advocate for their healthcare needs. Ensure members receive all available benefits to… more