• Claims Specialist , Audit

    LogixHealth (Dania, FL)
    Location: On-Site in Dania, FL This Role: As a Claims Specialist , you will work with internal teams to provide cutting-edge solutions that will directly improve ... and carry out processes on all out of network claims . The ideal candidate will have strong technological skills,...and respond to carrier and/or arbitrator inquires + Submit claims through state arbitration portals Qualifications : To perform… more
    LogixHealth (07/11/25)
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  • Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …in claims systems (eg, Salesforce, Facets) in compliance with audit standards and MassHealth requirements. + Maintain awareness of MassHealth transmittals, ... 011250 CCA- Claims **_This position is available to remote employees...Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit , compliance, and provider engagement initiatives. This role also… more
    Commonwealth Care Alliance (08/31/25)
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  • Facilities Contract Specialist (Level I/II)…

    Navy Exchange Services (NEX) (Virginia Beach, VA)
    Title: Facilities Contract Specialist (Level I/II) Non-Competitive Progression Location: United States-Virginia-Virginia Beach Job Number: 250002P2 Are you ready to ... advance your career in facilities design and construction contracting ? NEXCOM is seeking driven professionals to join our team as Contract Specialist I and II… more
    Navy Exchange Services (NEX) (09/26/25)
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  • Senior Facilities Contract Specialist

    Navy Exchange Services (NEX) (Virginia Beach, VA)
    Title: SENIOR FACILITIES CONTRACT SPECIALIST Location: United States-Virginia-Virginia Beach Job Number: 2500008Y Navy Exchange Service Command (NEXCOM) offers ... Grade: NF05, Salary Code 5A. Acts as the Senior Facilities Contracts Specialist performing all duties related to the planning, development, advertisement, award,… more
    Navy Exchange Services (NEX) (09/19/25)
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  • Specialist , Config Oversight (healthcare…

    Molina Healthcare (NE)
    …various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure ... accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit… more
    Molina Healthcare (09/24/25)
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  • Provider Network Specialist

    OhioHealth (Columbus, OH)
    …our network, managing current contracts on the physicians and the management of claims complaints and quality of care complaints. The handling of recruitment in ... as having a business need, and negotiations of their fee schedules. Audit payer rosters, update credentialing software (Cactus) after committee approval and verify… more
    OhioHealth (09/24/25)
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  • Principal Project Controls Specialist

    Duke Energy (Charlotte, NC)
    …data integration across the organization. 5. Support for Procurement and Contracting Processes + Provide cost input for procurement strategies, contract ... regarding pricing and scope changes. 6. Change Management and Claims Support + Assess the cost impact of project...+ Identify and implement corrective actions in response to audit findings or process deficiencies. 8. Continuous Improvement and… more
    Duke Energy (09/26/25)
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