• Claims Quality Specialist

    Dignity Health (Bakersfield, CA)
    …role within a managed care or healthcare environment. Strong knowledge of healthcare claims processing , coding (ICD-10, CPT, HCPCS), and billing ... Quality Specialist is responsible for ensuring the accuracy and quality of claims processing within a managed care service organization. This role involves… more
    Dignity Health (01/05/25)
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  • Claims Examiner I

    LA Care Health Plan (Los Angeles, CA)
    …School Equivalency Certificate Education Preferred Experience Required: At least 6 months of healthcare claims processing experience in a managed care ... delegated claims per regulatory and contractual guidelines, which includes: * Processing claims for all lines of business, including complex claims *… more
    LA Care Health Plan (12/10/24)
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  • Claims Examiner III

    Dignity Health (Bakersfield, CA)
    …policies and procedures. **Qualifications** **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing , with at least 2 years in ... related field preference. + CPC **Preferred Qualifications:** + 5-7 years of experience in healthcare claims processing , with at least 4 years in a senior or… more
    Dignity Health (12/26/24)
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  • Claims Overpayment Specialist

    Robert Half Accountemps (Villa Park, IL)
    …adjustments, documenting all communication in our database. * Use your knowledge of healthcare billing claims processing and insurance procedures to identify ... decision makers at healthcare providers offices and initiate refund requests from claim... Claims data is required * Experience in Claims Processing is mandatory * Knowledge of… more
    Robert Half Accountemps (12/09/24)
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  • Director, Configuration (EDI - Claims )

    Molina Healthcare (KY)
    …+ Advanced knowledge of Excel + SQL knowledge preferred + 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 (01/05/25)
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  • Manager, Configuration (EDI - Claims )

    Molina Healthcare (Columbus, OH)
    …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 (01/05/25)
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  • Healthcare Services Analyst 60k+ DOE Weekly…

    TEKsystems (Honolulu, HI)
    …related work experience. Preferred - * Experience in a position related to healthcare , claims processing , or medical coding Professional skills/knowledge ... Description Serves as the entry level position for the Healthcare Service Analyst job family. Employees in this position...strategic planning. * Learns to conduct cost/benefit analysis of claims processing . Extract and analyze data using… more
    TEKsystems (01/03/25)
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  • Care Navigator, Bi-Lingual *Remote

    Providence (Portland, OR)
    …Services + 2 Years: Healthcare : Medical Billing / Insurance Verification + 2 Years: Healthcare : Claims Processing + 2 Years: Healthcare : Benefits + 2 ... use of health plan and clinic services, research and respond to claims and authorization inquiries, and resolve customer issues and concerns. The position… more
    Providence (12/21/24)
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  • Reimbursement Specialist

    Adecco US, Inc. (Cary, NC)
    …NC. In this role, you will play a crucial part in ensuring seamless healthcare claims processing , financial guidance, and patient support. **Top reasons ... or insurance industry (preferred, but not required). + Knowledge of healthcare claims processing , billing, and collections. + Proficiency in Microsoft… more
    Adecco US, Inc. (01/03/25)
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  • Project Delivery Sr Analyst

    Deloitte (Austin, TX)
    healthcare systems, and X12 testing. This role requires a deep understanding of healthcare claims processing and the ability to update companion guides. ... weekly governance meetings. + Oversee the integration and functionality of enterprise healthcare systems involving Fee-For-Service (FFS) claims and Encounters. +… more
    Deloitte (12/20/24)
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  • Senior Stop Loss Benefit Specialist (Hybrid)

    CVS Health (Plymouth, MN)
    …by the stop loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with ... This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider… more
    CVS Health (12/26/24)
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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 (12/19/24)
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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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  • QA Analyst - ETL / Agile

    Molina Healthcare (Columbus, OH)
    …- both verbally and written. + You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You pay attention to ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare more
    Molina Healthcare (12/28/24)
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  • Senior Full Stack (Java, Angular) Software…

    Motion Recruitment Partners (Atlanta, GA)
    …or Kubernetes. + Agile and SAFe development environment experience. + Any experience with healthcare claims processing applications is a big plus! + ... - Atlanta, GA Atlanta, Georgia **Hybrid** Contract $70/hr - $85/hr Giant healthcare organization seeking a full stack Java/Angular SW Engineer for their growing… more
    Motion Recruitment Partners (12/12/24)
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  • Medical 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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  • Special Investigation Unit Manager Clinical…

    CVS Health (Columbus, OH)
    healthcare fraud detection, investigation, or auditing In-depth knowledge of healthcare systems, claims processing , and regulatory requirements related ... investigation, and prevention efforts to safeguard the organization's resources and reduce healthcare costs. This role involves leading a team of CPC's, working… more
    CVS Health (12/25/24)
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  • Fraud and Waste Investigator

    Humana (Madison, WI)
    …Certifications, CPC, CCS, CFE, AHFI). + Bachelor's degree + Understanding of healthcare industry, claims processing and investigative process development. ... experience to include multiple practice areas + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment… more
    Humana (12/19/24)
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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 ... 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 (12/25/24)
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  • Claims Processing - Representative…

    CVS Health (Scottsdale, AZ)
    …-Working within turnaround times to meet client performance guarantees for claims processing . -Meeting productivity and accuracy standards **Required ... include: -Outbound calls to Members and/or Providers for verification of information - Processing and adjudicating paper claims . -Maintaining integrity of … more
    CVS Health (11/27/24)
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