- The Cigna Group (Bloomfield, CT)
- …to succeed:** + High School Diploma or GED required + 5+ years of healthcare claims lifecycle; ** Claims systems configuration** design, editing, claims ... a division of the Cigna Group is hiring a Claims Systems Configuration Senior Analyst. For this crucial senior...401(k) with company match, company paid life insurance, tuition reimbursement , a minimum of 18 days of paid time… 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
- Medical Mutual of Ohio (Brooklyn, OH)
- …knowledge and skills obtained through on the job training to process routine healthcare claims and respond to inquiries from third party administration and/or ... /Customer Care Specialist I - TPA** . Processes routine healthcare claims while providing customer service via...keyboard, mouse and headset. + Whether you are working remote or in the office, employees have access to… more
- Medical Mutual of Ohio (Centerville, OH)
- **_The SDC - Claims /Customer Care Specialist - TPA position allows you the flexibility to work at home as long as you reside within a 50-mile radius of an Ohio ... of life. In this blended role, processes routine to moderately complex claims , while handling inbound calls and written inquiries (multiple channels) from members,… more
- CGI Technologies and Solutions, Inc. (Baltimore, MD)
- …both quantitative and qualitative pricing/contracting analyses to support the drug claims /rebate ecosystem. * Understand the US healthcare market, Medicare ... **Drug Claims Processing SME** **Category:** Business Consulting, Strategy and Digital Transformation **Main location:** United States, Remote **Alternate… more
- AmeriHealth Caritas (Philadelphia, PA)
- ** Claims Enrollment Specialist** Location: Philadelphia, PA Primary Job Function: Operations ID**: 34210 Your career starts now. We are looking for the next ... generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about...at www.amerihealthcaritas.com. **Responsibilities:** Under the direct supervision of the Claims Supervisor, reviews claims received via the… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Department:** Claims Processing Pulmonology + **Schedule:** Days Monday- Friday, hybrid remote , 2 days onsite, 3 days remote . 7:30a-4:00p + ... disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community _*Please note, benefits… more
- BrightSpring Health Services (Longmont, CO)
- …top-quality care come join our team and apply today! We are seeking Claims Supervisors with 3rdparty claims experience. Pharmacy Technicians, with supervisory ... career move from the retail environment are desired This is a remote position. Applicants can live anywhere within the continental USA. Schedule: Monday-Friday,… more
- Modernizing Medicine (Boca Raton, FL)
- We are united in our mission to make a positive impact on healthcare . Join Us! + South Florida Business Journal, Best Places to Work 2024 + Inc. 5000 Fastest-Growing ... Santiago, Chile, Berlin, Germany, Hyderabad, India, and a robust remote workforce with team members across the US. ModMed...career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced … more
- Centene Corporation (Jefferson City, MO)
- …preferred. + 7+ years of professional management level experience in healthcare operations, compliance, finance, or program management required. + Knowledge and ... of compliance regulations and practices, specifically as they relate to healthcare products required. + 3+ years of supervisory/management experience required. +… more
- Trinity Health (Dubuque, IA)
- …**Description:** **POSITION PURPOSE:** The HIM (Resource Utilization/Classification Tech/ Reimbursement ) Specialist coordinates with physicians' offices and as ... to determine medical necessity of all outpatient procedures/tests to assure reimbursement . Is responsible for assuring all departments that schedule tests/procedures… more
- The Cigna Group (Bloomfield, CT)
- …and solutions that align to Cigna's overall value proposition of lowering total healthcare costs. + Act as Pharmacy Sales support for renewals involving consultants. ... sales teams. + Support detailed ad-hoc analysis of pharmacy claims utilization in order to provide clients with proactive...401(k) with company match, company paid life insurance, tuition reimbursement , a minimum of 18 days of paid time… more
- Conduent (Los Angeles, CA)
- …Specialist is responsible for analyzing medical claims data, seeking reimbursement , and recovering overpayments from healthcare providers, third parties, ... Part A, Part B and Part D + Health Insurance, and Medical. + Healthcare reimbursement in different settings (ie, Inpatient, Outpatient, home health, long term… more
- Bozeman Health (Bozeman, MT)
- Approved Remote States 1. Arizona 2. Florida 3. Georgia 4. Idaho 5. Indiana 6. Iowa 7. Maine 8. Michigan 9. South Dakota 10. Texas 11. South Carolina 12. North ... Insurance Billing Specialist's main focus is to obtain maximum and appropriate reimbursement for Bozeman Health and all related entities, hospital (HB) and/or… more
- St. Luke's University Health Network (Allentown, PA)
- …payment discrepancies with optimal goal of receiving accurate payments and maximum reimbursement . + Statuses claims resolution, appeals and corrected claims ... Receivable Specialist I is responsible for accurate and timely submission of claims to third-party payers, intermediaries and guarantors in accordance with network… more
- KPH Healthcare Services, Inc. (Gouverneur, NY)
- …maintains various files and information for the department ensuring proper reimbursement **.** Works collaboratively within the department to ensure licensing, ... gross margin according to plan. THIS IS NOT A REMOTE POSITION. OFFICE WILL BE IN SYRACUSE OR GOUVERNEUR,...+ Responsible for PBM related billing communications regarding better reimbursement strategies and issues faced to all locations. +… more
- Trinity Health (Farmington Hills, MI)
- …overpayment and underpayment accounts with the objective of appropriately optimizing reimbursement for services rendered. Ensures that claims are paid/settled ... **Employment Type:** Full time **Shift:** **Description:** **POSITION PURPOSE** Work Remote Position (Pay Range: $18.4663-$27.6994) Performs day-to- day payment… more
- Trinity Health (Farmington Hills, MI)
- …overpayment and underpayment accounts with the objective of appropriately optimizing reimbursement for services rendered. Ensures that claims are paid/settled ... Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position (Pay Range: $20.6822-$31.0233) Performs day-to- day payment resolution… more
- Bozeman Health (Bozeman, MT)
- …and timely claims development and submission to payers to maximize reimbursement for the system. Conducts training and education for all billing functions to ... This position is remote possible if you live in one of...to include insurance follow-up related to no response, returned claims , denied claims , or claim edits preventing… more
- University of Michigan (Ann Arbor, MI)
- …strong clinical knowledge, analytical skills, and a deep understanding of healthcare reimbursement processes. **Mission Statement** Michigan Medicine improves ... Inpatient Coding and Appeals Coordinator - Remote Apply Now **How to Apply** A cover...Responsible for completing retrospective medical record audits of denied claims related to DRG reimbursement . Evaluate and… more