- CenterWell (Phoenix, AZ)
- …our caring community and help us put health first** The Manager of Pre -Bill Audit provides strategic leadership and operational oversight for the organization's ... pre -billing function. This role is responsible for ensuring all claims are audit-ready prior to release, driving standardization across branches, and delivering… more
- AssistRx (Phoenix, AZ)
- The Copay Support/ Claims Processing Specialist is a critical role within the organization and is responsible for servicing inbound calls, EOB faxes, and mail ... Sites of Care and Health Care Providers. The Copay Support/ Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim reversals,… more
- Humana (Phoenix, AZ)
- …+ Previous encounter submissions experience + Prior internship or experience in healthcare data management, claims processing, or actuarial services + Working ... knowledge of Microsoft SQL or SAS + Understanding of healthcare encounter data and basic knowledge of claims submission and reconciliation processes. + Strong… more
- Humana (Phoenix, AZ)
- …Excel (pivot tables, VLOOKUP, formulas) + Familiarity with Medicaid systems, claims platforms, and reconciliation tools **Work-At- Home Requirements** + At ... existing Medicaid business processes, with a focus on eligibility, enrollment, claims , and compliance workflows. This role develops sustainable, repeatable, and… more
- Humana (Phoenix, AZ)
- …escalations. **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home . While this is a remote position, occasional travel to Humana's offices for ... certification experience utilizing coding guidelines by reading and interpreting claims + Exceptional understanding of Centers for Medicare &...hours are 8AM - 5PM Eastern time. **Work at Home Requirements** * At minimum, a download speed of… more
- Oracle (Phoenix, AZ)
- …MS Excel, MS Word + Highly desirable to have: + Experience using EHR and/or healthcare claims data + Familiarity with Python or other programming language At ... **Evidence Generation Lead/Snr Research Consultant, RWE, Health Outcomes** **Remote/Work from home ** Oracle Life Sciences is seeking a qualified health outcomes… more
- Walgreens (Phoenix, AZ)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Evolent (Phoenix, AZ)
- …seamlessly with diverse teams and stakeholders. + Deep understanding of healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including ... preferred. + 10+ years of analytics & reporting experience in healthcare , including medical economics, cost/utilization analysis, and membership trend reporting. +… more
- AssistRx (Phoenix, AZ)
- This role works directly with healthcare providers & insurance plans/payers to gather information about a patient's insurance and the coverage provided for a ... specific pharmaceutical product. You will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement… more
- Evolent (Phoenix, AZ)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication to key ... of Actuaries credentials with Group Health track **(Preferred)** + Familiarity with healthcare claim processing **(Preferred)** + 5+ years experience at payer or… more