• Claims Examiner

    Veterans Affairs, Veterans Health Administration (Denver, CO)
    …transactions to analyze and resolve issues involving claim submission utilizing automated healthcare claims processing systems, methods, procedures, and ... involving payment and denials of claims utilizing automated healthcare claims processing systems, methods, procedures, and techniques. Complete data… more
    Veterans Affairs, Veterans Health Administration (11/26/24)
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  • Business Systems Specialist

    Medical Mutual of Ohio (OH)
    …or equivalent combination of training and experience. . Significant experience utilizing healthcare claims processing systems, which includes basic exposure ... business requirements. Drives change by creating viable solutions to Claims and Customer Care end to end processing... Claims and Customer Care end to end processing . . Works independently with Information System Development (ISD)… more
    Medical Mutual of Ohio (11/07/24)
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  • Mgr, Configuration - Medicare/QNXT/NetworX…

    Molina Healthcare (NM)
    …solutions + Advanced knowledge of health care benefits. + Advanced knowledge of healthcare claims and claim processing from receipt through encounter ... including accurate and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases and ensure… more
    Molina Healthcare (11/21/24)
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  • Account Specialist - RemitConnect

    Commerce Bank (Kansas City, MO)
    …other duties as assigned Knowledge, Skills & Abilities Required + Basic knowledge of healthcare insurance claims processing , healthcare revenue cycle, ... or equivalent combination of education and experience required + 1+ year healthcare insurance claims processing or payment posting experience required + 1+… more
    Commerce Bank (09/27/24)
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  • Senior Fraud and Waste Investigator, Special…

    Humana (Indianapolis, IN)
    …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. ... closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and...+ Bachelor's degree + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of… more
    Humana (11/22/24)
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  • Director of Revenue

    Robert Half Finance & Accounting (Oklahoma City, OK)
    …of healthcare billing procedures and standards. * In-depth understanding of healthcare claims processing . * Proven experience in hospital billing ... Description A dynamic and private equity backed healthcare company, with operations spanning across Oklahoma, Texas,...its operational excellence. Ideal Experience includes: - MUST have healthcare experience - 5+ years of coding, collections, and… more
    Robert Half Finance & Accounting (11/19/24)
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  • Reimbursement Specialist

    Randstad US (Cary, NC)
    …financial operations occupations + referenceAB_4646614 job details The Reimbursement Specialist Performs healthcare information & medical claims processing , ... AM - 7 PM education: High School Responsibilities + Performs healthcare information & medical claims processing , healthcare billing & collection… more
    Randstad US (11/01/24)
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  • Billing Subject Matter Expert II

    Abbott (Livermore, CA)
    …compliance and insurance reimbursement processes is essential. + Previous experience in healthcare billing, coding, claims processing , particularly in ... Abbott is a global healthcare leader that helps people live more fully...software (such as XiFin, Telcor, Carevoyant, or Quad X), claims processing systems, Salesforce or other CRM… more
    Abbott (10/29/24)
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  • Workforce Systems & Reporting Analyst

    Healthfirst (NV)
    …+ Knowledge of Medicare and Medicaid programs and reimbursement methodologies + Knowledge of healthcare claims processing practices in a managed care setting ... WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic… more
    Healthfirst (11/20/24)
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  • Claims Processing Representative

    Access Dubuque (Dubuque, IA)
    Claims Processing Representative **Grand River Medical Group** 1 Positions ID: 1343279 Posted On 10/30/2024 **Job Overview** ** Claims Processing ... available Grand River Medical Group is seeking an experienced Claims Processing Representative to join our Revenue...in Dubuque, IA. We provide a wide range of healthcare services from primary care to subspecialty care for… more
    Access Dubuque (10/31/24)
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  • Assistant of Claims Processing

    Ascension Health (Jacksonville, FL)
    **Details** + **Department:** Billing/ Claims Processing + **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM + **Hospital:** Ascension St. Vincent + **Location:** ... party payers in an out-patient or medical office environment. + Prepare insurance claims for submission to third party payers and/or responsible parties. + Review … more
    Ascension Health (10/31/24)
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  • HealthCare Claims Intelligence…

    CGI Technologies and Solutions, Inc. (Atlanta, GA)
    …(ML), data analysis, Business Intelligence and Data Visualizations to streamline the claims processing , Payment Integrity and healthcare analytics systems. ... ** HealthCare Claims Intelligence Engineer** **Category:** Analytics...with data scientists to extract insights that help optimize claims processing and reduce time to settlement.… more
    CGI Technologies and Solutions, Inc. (10/08/24)
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  • Analyst, Claims Research

    Molina Healthcare (MI)
    claims projects + Assists with reducing re-work by identifying and remediating claims processing issues + Locate and interpret regulatory and contractual ... using standard principles and applicable state specific policies and regulations to identify claims processing errors + Applies claims processing and… more
    Molina Healthcare (11/15/24)
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  • Copay Lead - Support/ Claims

    AssistRx (Orlando, FL)
    …uptake, visibility and outcomes. Our talented team members provide therapy and healthcare system expertise to help patients achieve better results from care. As ... to support all operational and financial processes related to claim processing activities ensuring effective day-to-day operations and provide ongoing Copay program… more
    AssistRx (11/13/24)
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  • Senior Claims Examiner

    HCA Healthcare (Campbell, CA)
    …when necessary. Requirements: + High school diploma + Three to Five years of experience processing regular and complex claims + Ability to act as a resource and ... Do you have the career opportunities as a Senior Claims Examiner you want with your current employer? We...which is part of the nation's leading provider of healthcare services, HCA Healthcare . **Benefits** HCA … more
    HCA Healthcare (11/07/24)
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  • Claims Examiner

    HCA Healthcare (Nashville, TN)
    …accounts. Requirements + High school diploma or equivalent + Two (2) years of experience processing claims , with at least one year of claims adjudication ... join an organization that invests in you as a Claims Examiner? At Work from Home, you come first. HCA Healthcare has committed up to $300 million in programs to… more
    HCA Healthcare (11/07/24)
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  • Healthcare Medical Claims Coding Sr.…

    Commonwealth Care Alliance (Boston, MA)
    …Healhcare Revenue Integrity, Payment Integrity, and Analytics * 5+ years of Facets Claims Processing System Desired Experience (nice to have): * Required ... (CPT, HCPCS, Modifiers) along with the application of Medicare/Massachusetts Medicaid claims ' processing policies, coding principals and payment methodologies *… more
    Commonwealth Care Alliance (11/26/24)
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  • Claims Auditor

    HCA Healthcare (Nashville, TN)
    …The Claims Auditor will serve as a Subject Matter Expert (SME) in medical claims processing at health plan payor, MSO, HMO, and IPA organizations with the ... ? At Work from Home, you come first. HCA Healthcare has committed up to $300 million in programs...primary function to ensure examiner payment accuracy of all claims processing including analysis of support services… more
    HCA Healthcare (10/24/24)
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  • Mgr, Healthcare Analytics

    Molina Healthcare (KY)
    …management or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
    Molina Healthcare (11/21/24)
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  • Specialist, Config Oversight - Remote (Must…

    Molina Healthcare (NY)
    …communicate written and verbal + Knowledge of verifying documentation related to updates/changes within claims processing system . + Experience using claims ... order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims . ( _Use for claims specific… more
    Molina Healthcare (11/09/24)
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