• Claims Representative - Remote

    The Cigna Group (Sacramento, CA)
    …setting preferred. . Knowledge of CPT/ICD-10 codes preferred. . Proven experience in health insurance claims processing or similar field preferred. If ... claims representative is responsible for manually reviewing and processing medical, supplemental, or dental claims . ...of benefits, with a focus on supporting your whole health . Starting on day one of your employment, you'll… more
    The Cigna Group (01/10/25)
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  • DMR Claims Service Specialist I

    UPMC (Pittsburgh, PA)
    …issues. + High school diploma or equivalent required + Minimum of 2 years' health insurance; claims processing and/or customer service experience preferred. ... Service Specialist I is responsible for the resolution of Health Plan Subscriber submitted claims . In this...there is no missing or incomplete information, manually enter claims into the claims processing more
    UPMC (01/10/25)
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  • Supervisor, Claims Services

    Medical Mutual of Ohio (Brooklyn, OH)
    …in a leadership capacity. **Technical Skills and Knowledge:** . Strong knowledge of health insurance claims processing policies and procedures, benefit ... Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace...quality of life. Supervises daily operations and staff of claims processing and/or claims support… more
    Medical Mutual of Ohio (01/09/25)
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  • Supervisor, Claims Processing

    Humana (San Juan, PR)
    **Become a part of our caring community and help us put health first** The Supervisor, Claims Processing reviews and adjudicates complex or specialty ... , submitted either via paper or electronically. The Supervisor, Claims Processing works within thorough, prescribed guidelines...Us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and… more
    Humana (01/11/25)
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  • Claims & Customer Service Auditor I

    University of Utah Health (Murray, UT)
    …to perform the essential functions of the job as outlined above. + Experience with claims processing in a health care delivery setting or insurance payer. ... the candidate's primary role will be auditing inbound customer service calls. + Claims processing knowledge in a health care delivery or insurance payer… more
    University of Utah Health (01/03/25)
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  • Cash Recovery Specialist

    Medical Mutual of Ohio (Brooklyn, OH)
    …applications. . Intermediate Microsoft Office, OnBase, database reporting skills. . Knowledge of health claims adjudication processing . . Strong math and ... to advanced Microsoft Office, OnBase, database reporting skills. . Knowledge of health claims adjudication processing . . Strong math and bookkeeping skills.… more
    Medical Mutual of Ohio (12/12/24)
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  • Specialist, Appeals & Grievances

    Molina Healthcare (Columbus, OH)
    …managed care experience (call center, appeals or claims environment). + Health claims processing background, including coordination of benefits, ... concisely and accurately, in accordance with regulatory requirements. + Research claims processing guidelines, provider contracts, fee schedules and system… more
    Molina Healthcare (01/08/25)
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  • Pharmacy Information Services Specialist II

    Medical Mutual of Ohio (OH)
    …or PBM, or equivalent experience in healthcare or financial services. . Strong health insurance claims processing and membership systems, database ... Access, and Power BI) skills. . Knowledge of interfacing health plan data, including membership and claims ,...(PBM) company. . Knowledge of PBM benefits set up, claims processing , and related regulatory requirements. .… more
    Medical Mutual of Ohio (10/19/24)
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  • Senior Medical Economics Analyst - Hybrid

    AdventHealth (Maitland, FL)
    claims analytics strongly preferred. + Managed Care, Patient Financial services, health insurance claims processing , contract management, or medical ... Repayment Program - Career Development - Whole Person Wellbeing Resources - Mental Health Resources and Support **Our promise to you:** Joining AdventHealth is about… more
    AdventHealth (12/12/24)
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  • Medical Review Manager

    Serco (VA)
    …in the health insurance industry, a utilization review firm, or another health care claims processing organization involving medical and coding reviews ... supervisory experience and subject matter expertise in the review of Medicare claims . This position is responsible for the businsess and operational processes to… more
    Serco (12/07/24)
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  • Compliance Auditor - Enterprise Risk - System Wide

    Bon Secours Mercy Health (Cincinnati, OH)
    Health . **Essential Job Functions** + Assists in the review of Bon Secours Mercy Health coding, billing and claims processing policies and procedures for ... . + Coordinates periodic review and analysis of Bon Secours Mercy Health hospital claims denial reports, operational assessment reports, internal quality… more
    Bon Secours Mercy Health (11/25/24)
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  • Fraud Waste and Abuse (FWA) Audit Manager

    Fallon Health (Worcester, MA)
    …least 1 - 2 years of managing direct reports + Experience working in health insurance specifically with claims processing , billing, reimbursement, coding, or ... investigations, mitigate risk, and capture results. + 5-8 years of related health care claims auditing experience in a complex healthcare environment, with at… more
    Fallon Health (11/09/24)
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  • Business Claims Processing

    CGI Technologies and Solutions, Inc. (Albany, NY)
    **Business Claims Processing Specialist** **Category:** Administration **Main location:** United States, New York, Albany **Position ID:** J1024-0536 ... of affordable housing has an opening for a Business Claims Processing Specialist in Albany, NY. This...You'll be supported by leaders who care about your health and well-being and provide you with opportunities to… more
    CGI Technologies and Solutions, Inc. (01/05/25)
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  • Dir, Process Improvement & Health Plan Ops…

    Molina Healthcare (WA)
    …* 4 years of management level experience * Understanding of all areas of health plan operations: claims processing , customer service/call center, provider ... Coordinates and collaborates with Molina enterprise Operational Excellence team and health plan Operational Excellence teams * Ensures appropriate alignment within… more
    Molina Healthcare (11/20/24)
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  • Claims Processing Representative

    Access Dubuque (Dubuque, IA)
    Claims Processing Representative **Grand River Medical Group** 1 Positions ID: 1384666 Posted On 12/23/2024 **Job Overview** ** Claims Processing ... IA; telecommuting options available Grand River Medical Group is seeking an experienced Claims Processing Representative to join our Revenue Cycle Team. You will… more
    Access Dubuque (12/25/24)
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  • Supervisor Claims - Claims

    Providence (Mission Hills, CA)
    …the supervision of staff and for overseeing the day-to-day operations of the Claims Processing and UM Denial Letter Units. Additional responsibilities include ... experience. + 2 years experience in a medical/institutional claims customer services unit within a health ...time **Job Shift:** Day **Career Track:** Leadership **Department:** 7520 CLAIMS PROCESSING CA HERITAGE SERVICES **Address:** CA… more
    Providence (12/25/24)
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  • Experienced Patient Support Medical/Biller…

    IQVIA (Phoenix, AZ)
    **Experienced Patient Support Medical Claims Processing ​ Representative** _Contract Remote Role - Location (Open to Remote US)_ As the only global provider of ... are looking for a 100% remote (work from home-WFH) contact **Patient Support Medical Claims Processing Representative** to join our team. In this position, you… more
    IQVIA (12/21/24)
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  • Data Engineer- Veterans Affairs (Remote)

    Liberty IT Solutions, LLC (Boston, MA)
    …Knowledge of EDI file types: X12, XML, JSON, NCPDP, and flat files Knowledge of health claims processing Vetting: Applicants selected will be subject to a ... government investigation and may need to meet eligibility requirements of the US government client. ThunderYard Solutions is proud to be an Equal Opportunity Employer. We don't just accept difference - we celebrate it, we support it, and we thrive on it for… more
    Liberty IT Solutions, LLC (11/08/24)
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  • Health System Specialist

    Army National Guard Units (Carson City, NV)
    …Program, MOS Medical Review Board (MMRB) Program, Medical Disqualification Program, Follow up Health Care Program, Medical Claims Processing Program, Medical ... Summary This position is for a HEALTH SYSTEM SPECIALIST, PD# D1119000, part of the...provide transcripts or other documentation to support your Training/Educational claims . To receive credit for Training/Education, you must provide… more
    Army National Guard Units (12/22/24)
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  • Sr Rep, Claims Processing

    CVS Health (Tualatin, OR)
    Bring your heart to CVS Health . Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health . This purpose ... guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in...this purpose. We want everyone who works at CVS Health to feel empowered by the role they play… more
    CVS Health (12/21/24)
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