- Prime Healthcare (Ontario, CA)
- …With Us! (https://careers-primehealthcare.icims.com/jobs/176331/vp-of-health-plan- operations -and- claims /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... to improve the quality and minimize process cost of Claims for all Prime Healthcare 's self-insured Employee...(7) to ten (10) years prior work experience in Claims Operations and Health Plan Strategy, in… more
- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional...an exciting time to join us - across our operations , we are thinking in new and innovative ways ... create an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability ("HPL") Claims Department of General… 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...on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into… 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 ... Overview: At Zelis, t he Business Analyst - Expert Claims Review (ECR) is ultimately responsible for enabling high...system/process updates and existing system functionality for reference by operations and alternate teams + Support training to … more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** The Claims Quality Review Auditor is HYBRID position accountable for auditing various claims to ensure quality and accuracy to related benefit ... help adherence to regulatory guidelines, internal policies and procedures related to claims processing and departmental accuracy standards related to claims … more
- Huron Consulting Group (Chicago, IL)
- …vendors, who process claims and manage IT + Experience managing large claims operations , including focused process and IT improvement efforts + Excellent ... our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations ,...working with QNXT Core Admin Platform (CAP) in the Claims and Enrollment setting. + Familiar and proficient using… more
- Trinity Health (Columbus, OH)
- …your own in Columbus. Learn more at www.experiencecolumbus.com ! **About the job:** The Manager Claims Operations manages the daily operations for claims ... to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a...as the main point of contact and as the Claims subject matter expert (SME) for internal and external… more
- Providence (Anaheim, CA)
- …of the Manager, this position is responsible for overseeing the day-to-day operations of the Support Services department with strong emphasis in Customer Service ... we must empower them. **Required qualifications:** + 3 years of experience as a Claims Examiner in an IPA, Medical Group, or Health Plan and knowledge of HIPAA… more
- Molina Healthcare (South Florida, FL)
- …with multiple types of business data. May be internal operations -focused or external client-focused. **KNOWLEDGE/SKILLS/ABILITIES** + Provides analytical, problem ... years formal training in Business Analysis and/or Systems Analysis + 1+ years claims background To all current Molina employees: If you are interested in applying… more
- Banner Health (Phoenix, AZ)
- …with healthcare risk management, quality management, in house liability claims management (including litigation and claims reserves) and litigation** ... claims management processes and procedures and other related healthcare regulatory and/or litigation experience preferred. Additional related education and/or… more
- AIG (Chicago, IL)
- …an impact + This position will ensure high quality claim handling in the Healthcare Professional Liability ("HPL") Claims Department of General Insurance (AIG, ... Senior Claims Analyst, Severity Join us as a Senior...The analyst will investigate losses, orchestrate defense strategies for healthcare provider insureds, conduct independent assessments as to exposures… more
- Zelis (Atlanta, GA)
- …responsibilities as assigned Education Bachelor's Degree preferred Skills 3-5 years of claims experience in a healthcare environment Zelis is modernizing the ... The Regulated Claims Settlement Coordinator supports the Claims ...the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers,… more
- Randstad US (Dallas, TX)
- …a leading name in healthcare , is seeking a skilled A/R Collections & Claims Specialist for a contract role. In this critical position, you will use your ... medical collections and claims specialist. + dallas , texas + posted...opportunity for a seasoned professional with 3-5 years of healthcare A/R or medical billing experience who thrives in… more
- Elevance Health (West Des Moines, IA)
- …contracts, pricing, processing, policies, procedures, government regs, coordination of benefits, healthcare terminology and/or adjust claims . + Good working ... ** Claims Representative II** **Location:** Ideal candidates will live...and/or re-consideration process. + Excellent knowledge of the various operations of the organization, products, and services. + Reviews,… more
- Molina Healthcare (Starkville, MS)
- …with multiple types of business data. May be internal operations -focused or external client-focused. **KNOWLEDGE/SKILLS/ABILITIES** + Elicit requirements using ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- LA Care Health Plan (Los Angeles, CA)
- … claims , Provider Disputes and Adjustments. This position works with the Claims Operations Supervisor to develop procedures ensuring the achievement of goals ... Claims Quality Auditor II Job Category: Claims...maintains up-to-date knowledge of current trends and issues in healthcare , national and statewide standards and regulations, policies and… more
- Randstad US (Duarte, CA)
- epic systems analyst - resolute pb/pb claims (remote). + duarte , california (remote) + posted 5 days ago **job details** summary + $65 - $85.02 per hour + contract ... Sr. Systems Analyst to support Resolute PB and PB Claims build for our large Health System client! If...Analyst opportunity! Minimum Qualifications and Experience: + 7+ years healthcare experience in a Revenue Cycle Systems Analyst role.… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …* 2 years clerical experience in health care revenue cycle operations : billing/ claims , patient accounting, collections, admissions, registration, etc. * ... *SUMMARY:* We are currently seeking an*RCM Representative Senior*to join our*Third-Party Claims - HB & PB *team. This full-time role will primarily work remotely… more
- UT Health (Houston, TX)
- Project Specialist - Texas All-Payor Claims Database - Hybrid **Location:** Texas Medical Center-Houston, Texas **Hot** **Category:** Engineering UTHealth Houston ... do here changes the world.** UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's… more
- Elevance Health (Atlanta, GA)
- …equivalent background. **Preferred Skills, Capabilities, and Experiences:** + Experience in healthcare industry with claims knowledge strongly preferred. + ... **Business Architect Executive - Claims ** **Location:** This position will work a hybrid...all constituents, including business executives, technologists, end users, and operations . **Minimum Requirements:** Requires an BA/BS degree in Information… more
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