- Guidehouse (San Marcos, CA)
- …Diploma + One year relevant experience **What Would Be Nice To Have** **:** + Healthcare claims background + PC skills in a Windows environment are required. ... Knowledge and utilization of desktop applications to include Word and Excel is essential. + Ability to initiate and follow through on projects and work independently with minimal supervision required. \#IndeedSponsored The annual salary range for this position… more
- Hartford HealthCare (Hartford, CT)
- …Summary:* Manages a robust caseload, from inception to closure, of Hartford HealthCare 's claims and suits through HHC's Legal Department. Responsible to ... Listener who can exhibit empathy to claimants . Demonstrated history of proactive claims management . Demonstrated knowledge of the healthcare and insurance… more
- TEKsystems (Madison, WI)
- Job Summary: Responsible for processing medical claims and correspondence and handling customer service calls from members, providers, and clients. They work with ... on the hospitals and pharmacies and make determination on claims Essential Functions: * Process claims in a timely manner with acceptable accuracy * Handle… more
- BrightSpring Health Services (Oklahoma City, OK)
- …of patients nationwide through our growing network of branches and healthcare professionals. The Adjudication Specialistwill be responsible for all aspects of ... pharmacy and medical claims adjudication, accuracy of pharmacy and medical claims...Pharmacy + 1+ years pharmacy experience + Pharmacy or healthcare -related knowledge + Knowledge of pharmacy terminology including sig… more
- Robert Half Finance & Accounting (San Antonio, TX)
- …managerial experience, and a comprehensive understanding of Medicare guidelines and healthcare claims regulations. This role requires excellent leadership ... years in a managerial role. + In-depth knowledge of Medicare guidelines and healthcare claims regulations. + Experience with Delegated Medicare Advantage is… more
- HUB International (Summit, NJ)
- …- 3 - 5 years of experience in handling Specialty Lines and/or Healthcare claims including Professional Liability ( Healthcare and Miscellaneous E&O), ... and acquisitions. Hub International Northeast is seeking a Senior Claims Advocate for our Specialty Lines and Healthcare... Claims Advocate for our Specialty Lines and Healthcare Divisions. This person will perform a full range… more
- LA Care Health Plan (Los Angeles, CA)
- …Education Preferred Associate's Degree Experience Required: At least 1 year of healthcare claims processing experience in a managed care environment. Preferred: ... Claims Examiner II (Temporary) Job Category: Claims...Procedural Terminology (CPT), International Classification of Diseases (ICD-10), and Healthcare Common Procedure Coding System (HCPCS)), and complete product… more
- Universal Health Services (Reno, NV)
- …Supervisor will play a crucial role in ensuring the efficient and accurate processing of healthcare claims within our organization. You will lead a team of ... business or related field or equivalent experience + Minimum of 3 years in healthcare claims processing or a related role. + In-depth knowledge of healthcare … more
- Guidehouse (Lewisville, TX)
- …Representatives are responsible for taking in-coming and making out-going calls to patients and insurance companies to resolve account balances. All client policies ... and procedures are followed. Representatives will perform any and all job-related duties as assigned. **_This position will be on a hybrid schedule working two days in the office and three days from home._** **_Questions regarding this position, you may… more
- State of Indiana (Indianapolis, IN)
- …should have a Bachelor's degree with a minimum of five years of healthcare claims experience, extensive experience in data analysis, medical claim billing ... Medicare Claims Analyst Date Posted: May 8, 2024 Requisition...fully engaged with this mission. Role Overview: The Medicare Claims Analyst will serve as the primary subject matter… more
- Health Plans, Inc. (Dallas, TX)
- …Experience + Understanding of claims processing systems + 2+ years of healthcare claims processing (PPO and Medicare/RBP) + Detailed understanding of PPO ... Employers Health Network, LLC (EHN ) creates community-based healthcare networks and a unique governance model to form a true partnership between self-funded… more
- Conduent (Olympia, WA)
- …operations leadership + Account Management experience (3+ yrs) + Contract Management + Healthcare Claims processing exp (REQ'D) + Have experience organizing and ... is noticed and valued every day. **Senior Manager, Rx Claims Service Delivery-Olympia, WA** **Are you comfortable in a...agent project **Responsibilities** + Managing IT departments and Pharmacy Claims Processing & Rebates on a 24/7 basis +… more
- Conduent (Olympia, WA)
- …5-10 years general operations leadership + Account Management experience (3+ yrs) + Healthcare Claims processing exp (REQ'D) + Have experience organizing and ... is noticed and valued every day. **Job Description:** **Senior Manager, Rx Claims Delivery** **$ign-On Bonus available** **About the Role** Responsible for ensuring… more
- Hartford HealthCare (Hartford, CT)
- … Corporation ("HHC") manages and resolves all professional and general liability claims covered by HHC's subsidiary Hartford HealthCare Indemnity Services, Ltd. ... this is*your moment*. **Job:** **Legal / Compliance* **Organization:** **Hartford HealthCare Corp.* **Title:** * Claims Attorney* **Location:** *Connecticut-Hartford-100… more
- Molina Healthcare (New York, NY)
- …standard EST business hours **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
- TEKsystems (Wausau, WI)
- …and procedures. Assist with ad-hoc projects when assigned. Skills: Medical Claims , healthcare industry, Microsoft word, medical billing, insurance verification, ... Description: A Medical Billing & Claims Specialist is responsible for working and managing...requirements. Monitor insurance accounts receivable Follow up on unpaid claims . Process credit balances within a timely manner. Research… more
- Humana (Indianapolis, IN)
- …(PH), and Behavioral Health (BH) providers. + Advanced proficiency working with healthcare data, specifically medical claims . + Advanced proficiency with Excel ... Humana Healthy Horizons in Indiana is seeking a Senior Claims Research & Resolution Professional who is dedicated to...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- General Dynamics Information Technology (Fairfax, VA)
- …and experience. + 5+ years' business analyst/IT data quality analyst experience. + Healthcare claims processing knowledge. + Experience working as a member of ... the government, we own our opportunities to better enable healthcare organizations to identify theirs. You can make GDIT...data management team and provide partner feedback and deliver claims data in support of the TTP mission of… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …and present clinical observations and insights from the analysis of data from healthcare claims + Be responsible for standard and ad-hoc extracts/reports across ... business initiatives' success. With strong communication and organizational skills, the claims data analyst assists leadership and team in achieving goals,… more
- Providence (CA)
- …quality metrics for regulatory reporting requirements using SQL + Research and organize healthcare claims and clinical data from multiple sources + Maintain ... best people, we must empower them._** **Providence Health Plan is calling a Healthcare Data Analyst who will:** + Provide general support + Perform complex analyses… more
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