- Solugenix (Los Angeles, CA)
- … is responsible for various tasks within the Financial Compliance Unit, including the audit of claims processed by medical groups and health plans contracted ... regulatory and contractual requirements. Communicate issues and findings that would affect the audit results. Perform claims audits for all medical groups and… more
- Aquent (Los Angeles, CA)
- …a vital role in ensuring the financial integrity and regulatory compliance of healthcare claims , directly contributing to the organization's mission of providing ... up to $66.00/hr Start Date: 07.21.2025 Make a real impact on healthcare accessibility and affordability as a Financial Compliance Auditor with a mission-driven… more
- Monarch Healthcare Management (St. Paul, MN)
- …monthly billing (including Medical Assistance), and handles collections, refunds, insurance claims , and reporting. Financial and Audit Preparation: Balances ... Monarch Healthcare Management Benefits Include: UKG Wallet - get...accounts receivable monthly, prepares aged trial balances, compiles audit documentation, and processes Certificates of Rent Paid (CRPs)… more
- Fallon Health (Buffalo, NY)
- …implementation of processes and workflows, network development, contract management, claims , billing, and authorization assistance. This position may require ... processes: Working with the Clinical Leadership team to develop, implement, monitor, audit and report on effectiveness of clinical and operational processes and… more
- EnableComp (Franklin, TN)
- …of the platform that EnableComp RCM Analysts use to process complex healthcare claims . Key Responsibilities Direct oversight of all application development ... adoption across development teams Healthcare Domain Knowledge Understanding of healthcare claims processing, particularly complex claim types Experience with… more
- Walgreens (Fairmont, NC)
- …when using the pharmacy. Enhances customer experience by increasing focus on healthcare services. Operations Responsible for assisting pharmacist in the delivery of ... allowed by law). Under the supervision of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health… more
- CERiS (Fort Worth, TX)
- …ICD-10 Coding, DRG Validation, Coordination of Benefits Strong understanding of healthcare revenue cycle and claims reimbursement Proficient in Microsoft ... or L&D, Geriatrics and Orthopedics Knowledge of worker's compensation claims process Prospective, concurrent and retrospective utilization review Bachelor's degree… more
- Main Line Health (Broomall, PA)
- …Payment System/Outpatient Perspective Payment System (IPPS/OPPS) reviews inpatient hospital claims for proper reimbursement and handles provider disputes in a ... provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters,… more
- Covenant Health (Knoxville, TN)
- …Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant ... division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than… more
- PayerFusion (Miami, FL)
- …maintaining financial records, preparing reports, and supporting compliance within a healthcare /TPA environment. The ideal candidate will have prior experience in ... insurance or healthcare finance and will ensure the accuracy and integrity...quarterly, and year-end financial close processes. Reconcile bank accounts, claims accounts, and premium receipts. Monitor accounts payable/receivable and… more
- Walgreens (Canton, MI)
- …into the data processing system for new patient/new referrals. Participates in the review/ audit of test claims for new patient/new referral. Handles processing ... school or equivalent GED. At least 1 year of work experience in healthcare , specialty pharmacy, PBM and/or call center settings. PTCB or ExCPT certification… more
- Bluebird Health (Meridian, ID)
- …operations and effective accounts receivable management. Provides oversight and approval of claims audits and processing. Conducts final billing audit and issues ... Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living… more
- Providence Health & Services (Anaheim, CA)
- …medical claims processing. Preferred qualifications: Bachelor's Degree in Business, Healthcare Administration or related field. 3 years of Work experience in as ... Job Description The Pharmacy Billing Specialist is responsible to proactively audit , monitor, and analyze complex dispensing and charging information, processes and… more
- Trinity Health (Athens, GA)
- …a culture committed to patient safety and the elimination of patient Hospital/ Healthcare Acquired Infections. Ensures safe conditions and procedures are followed at ... all times to minimize/eliminate workman's compensation claims and create a safe working environment for all Environmental Services colleagues. Maintains accurate and… more
- Walgreens (Chicago, IL)
- …usage of medications, awareness with drug interactions and offering preventive healthcare services such as immunizations. Responsible for ensuring the proper ... Supports efforts on enhancing customer experience by increasing focus on healthcare services (eg patient consultation, medication management, drug therapy reviews,… more
- Blue Cross Blue Shield of Arizona (Phoenix, AZ)
- …Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited ... experience with compliance, privacy, government programs or legal issues in a healthcare industry Preferred Education Master's degree in business or healthcare … more
- Allianz (Chicago, IL)
- …procedures and workflow processes within the payroll area Archive records to satisfy audit and statutory requirements Draft standards to improve quality as well as ... From our support for flexible working, health and wellbeing (including private healthcare and generous parental leave benefits), to helping people return from career… more
- Luster National (New York, NY)
- …briefs. Conduct forensic schedule analyses to evaluate contractor delay claims -quantifying excusable versus non-excusable and concurrent delays-and advise leadership ... and contingency recommendations before executive boards, external funders, and audit bodies. Experience with advanced analytics and visualizations, including Power… more
- Veterans Health Administration (Davenport, IA)
- …System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and ... to the examination of claimants filing compensation and pension claims . Clinical The PA practices general medicine with a...clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical… more
- Lyric (Newtown Square, PA)
- …infrastructure. **REQUIRED QUALIFICATIONS** + Minimum of ten (10) years of experience in healthcare claims , coding, or audit operations, with an emphasis ... Lyric, formerly ClaimsXten, is a leading healthcare technology company, committed to simplifying the business...the adoption of Lyric's Replay platform to payer's pre-pay audit teams, helping convert opportunities into measurable adoption. The… more
