- Elevance Health (East Syracuse, NY)
- …past five years._** **Preferred Skills, Capabilities and Experiences:** + Experience with healthcare insurance claims processing highly preferred. + Strong ... Medicaid Services to transform federal health programs. The **SCA Claims Processor I** is responsible for processing ...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- TEKsystems (Cary, NC)
- …to our patients, clinicians, and clients. Essential Duties and Responsibilities + Performs healthcare information & medical claims processing , healthcare ... outbound calls to primary providers and insurance to process claims and resolve any healthcare billing issues....should have 1+ years experience of the following): + Claims Processing (Pharmacy) + Reimbursement (Pharmacy) +… more
- CVS Health (Wellesley, MA)
- … healthcare fraud detection, investigation, or auditing + In-depth knowledge of healthcare systems, claims processing , and regulatory requirements related ... Manager to lead our new ASO investigations team. The Healthcare Fraud Senior Manager is responsible for overseeing and...prevention efforts to safeguard the organization's resources and reduce healthcare costs. This role involves leading a team of… more
- 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
- 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
- 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
- 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 (Cary, NC)
- …First work hours: 8 AM - 8 PM education: High School Responsibilities + Performs healthcare information & medical claims processing , healthcare billing & ... special drug program patients & their insurance companies. + Performs healthcare information & medical claims processing , healthcare billing & collection… more
- 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
- Randstad US (Franklin, TN)
- …and coding knowledge is a must. + Demonstrated knowledge of and experience in Healthcare medical billing, claims processing , follow-up and appeals a must. ... will play a vital role in managing our accounts receivable (AR), claims processing , and denials management. Your expertise will ensure our revenue cycle operates… more
- Guidehouse (Arlington, VA)
- …Information Systems, Engineering, Economics, Data Science or Data Analytics + Knowledge of healthcare claims processing systems and coding systems such as ... ICD, CPT, and DRG + Experience with EMR/EHR data and standards-based health terminology such as SNOMED, CDA, and FHIR + Experience with statistical analysis, predictive modelling, simulation, machine learning, or artificial intelligence + Experience selecting… more
- Access Dubuque (Dubuque, IA)
- Claims Processing Representative **Grand River Medical Group** 1 Positions ID: 1343279 Posted On 10/30/2024 **Job Overview** ** Claims Processing ... telecommuting options available **Grand River Medical Group, a leading healthcare provider in the Dubuque and tri-state area, is...report to the office once per week.** **Summary:** The Claims Processing Representative will provide a key… more
- 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
- Army National Guard Units (Columbus, OH)
- …MOS Medical Review Board (MMRB) Program, Medical Disqualification Program, Follow up HealthCare Program, Medical Claims Processing Program, Medical Travel ... Evaluation Board (MEB), Physical Evaluation Board (PEB), Soldier Readiness Processing (SRP),demobilization coordination with Post Deployment Health Re-Assessment (PDHRA).… more
- TEKsystems (Cary, NC)
- Job Description: + Performs healthcare information & medical claims processing , healthcare billing & collection services, & provides financial guidance ... 1+ years' experience of the following: Benefits Investigation Insurance Verification Claims Processing (Pharmacy) Reimbursement (Pharmacy) Customer Service Call… more
- Zelis (NJ)
- …experience in or the ability to quickly gain a deep understanding of the healthcare payer ecosystem, claims processing and provider networks landscape, and ... possess product marketing experience in B2B SaaS or services, prior healthcare experience and have experience working collaboratively on product commercialization… more
- 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
- CGI Technologies and Solutions, Inc. (Knoxville, TN)
- …(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
- Commonwealth Care Alliance (Boston, MA)
- …Revenue Integrity, Payment Integrity, and Analytics + 5+ years of Facets Claims Processing System **Required Knowledge, Skills & Abilities (must have):** ... Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will… more
- Providence (NM)
- …in any of the following areas of focus / specialty: + General Liability Claims Processing + General Liability Claims Management + General Liability ... empower them._** **Providence Health Plan is calling a General Liability Claims Manager, Healthcare who will:** + Be responsible for day-to-day oversight of… more