- Solugenix (Los Angeles, CA)
- …Preferred Master's Degree Experience Required: A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal ... Financial Compliance Auditor III, Claims Los Angeles, CA ( Remote /Hybrid) 3-Month...capitated hospitals, and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates.… more
- EnableComp (Franklin, TN)
- …adoption across development teams Healthcare Domain Knowledge Understanding of healthcare claims processing , particularly complex claim types Experience ... of the platform that EnableComp RCM Analysts use to process complex healthcare claims . Key Responsibilities Direct oversight of all application development… more
- Tenet Health (Detroit, MI)
- …medical practice and/or billing company; specifically involved in the charge entry, claims processing , claim rejections and claims edit/correction processes ... (KPI) time frames. Works with the vendor on any claims that are not billed and escalates to RCM...terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly… more
- Cedars Sinai (Los Angeles, CA)
- … delivery systems with knowledge of CPT/HCPC, ICD-10 coding, clearinghouse, EDI claims and remittance advice processing , and Epic Revenue Cycle Applications ... (ie ADT/Prelude, Cadence, Resolute PB or HB) highly preferred. Why work here? Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b) Cedar-Sinai takes pride in hiring the best employees. Our accomplished staff… more
- Kaiser Permanente (Denver, CO)
- … processing , applicable insurance laws and regulations and procedures related to claims processing , including Medicare, Medicaid, work comp and no fault. ... inpatient/outpatient setting required. Minimum of six (6) months of experience researching and processing medical claims required. Minimum of six (6) months of… more
- Actalent (Houston, TX)
- … team. In this role, you will be responsible for handling insurance claims , processing prior authorizations, and making coverage determinations. You'll work ... Remote Pharmacy Technician - Insurance & Coverage Determination...medications. Key Responsibilities Process and follow up on insurance claims and prior authorizations Evaluate and make coverage determinations… more
- CoSourcing Partners (Chicago, IL)
- …implementation of Optum CES. Stong understanding of PPS reimbursement within the claims processing cycle. Experience with Epic Tapestry strongly preferred. ... Business Analyst, Optum CES Location: Remote Employment Type: 1 month contract with possibility...Proficiency in claims editing systems, claims adjudication logic, and healthcare EDI standards… more
- Alameda Alliance For Health (Alameda, CA)
- …: Full Time must live in one of 6 states: CA, AZ, NV, TX, WA, OR; remote and on site in Alameda County. Available for Full-Time Work Schedule 8:00am - 5pm Pacific ... contact for members, providers and others for questions related to claims , benefits, authorizations, pharmacy, member eligibility and other questions related to… more
- CERiS (Fort Worth, TX)
- …commercial payer policy in written and verbal format Strong understanding of claims processing , ICD-10 Coding, DRG Validation, Coordination of Benefits Strong ... policy, industry standards and/or CMS guidelines. This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Reviews, analyzes, and...understanding of healthcare revenue cycle and claims reimbursement Proficient… more
- Experity (Atlanta, GA)
- Experity is the leading software and services company for on-demand healthcare in the US We provide software solutions that remove complexities and simplify ... create, maintain, and support products to facilitate the complete on-demand healthcare experience: from patients finding clinics and making appointments, to checking… more
- Ampcus (Los Angeles, CA)
- …our talented Team. Job Title: General Accountant Location(s): Los Angeles, CA ( Remote ) SUMMARY STATEMENT: This position is responsible for providing technical and ... to the Assistant Director of Finance. Primary responsibilities include processing the general ledger month-end closing including coordination with internal… more
- Mass General Brigham (Newton, MA)
- …- Maintains ongoing communication with government agencies regarding the status of claims , following up with patients as necessary to obtain required documentation ... process. *Follows up and obtains all documentation required for application processing and accurately enters information into hospital and external systems as… more
- Blue Cross Blue Shield of Arizona (Phoenix, AZ)
- …and where employees work. Our positions are classified as hybrid, onsite or remote . While the majority of our employees are hybrid, the following classifications ... Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ,...requirement based on the essential functions of the job Remote : not held to onsite requirements, however, leadership can… more
- Allianz (Chicago, IL)
- …of policies and procedures Project Work Continuous improvement of payroll processing , eg LOA/RTW notifications, QA checks, off cycle payments, etc. Partner ... recognizes the value of striking a balance between in-person collaboration and remote working. Please feel free to discuss flexible working arrangements with us.… more
- NTT DATA North America (MO)
- …applicable methodology/ fee schedule **Required Skills/Experience** + 1+ years hands-on experience in Healthcare Claims Processing + 2+ years using a ... an overall sourcing strategy. NTT DATA currently seeks a ** Claims Processing Associate** to join our team...Processing Associate** to join our team for a remote position. **Role Responsibilities** - Processing of Professional… more
- NTT DATA North America (Orlando, FL)
- NTT DATA is seeking to hire a ** Remote Claims Processing Associate** to work for our end client and their team. **In this Role the candidate will be ... fee schedule **Requirements:** + 1-3 year(s) hands-on experience in Healthcare Claims Processing + 2+...be able to work 7am - 4 pm CST online/ remote (training is required on-camera). **Preferred Skills & Experiences:**… more
- NTT DATA North America (MO)
- NTT DATA is seeking to hire ** Remote Healthcare Claims Processing Associates** to work for our end client and their team. This is scheduled to be a 8+ ... fee schedule **Requirements:** + 1+ year(s) hands-on experience in Healthcare Claims Processing + 2+...be able to work 7am - 4 pm CST online/ remote (training is required on-camera). NTT DATA is an… more
- Molina Healthcare (Covington, KY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... knowledge of provider data/processes/requirements related to provider contracting, credentialing, claims processing and state/federal regulations + Ability to… more
- NTT DATA North America (St. Louis, MO)
- …methodology/ fee schedule **Required Skills/Experience** * Minimum of 1 year hands-on experience in healthcare claims processing * Minimum of 2 years using a ... who work here. NTT DATA is seeking to hire a ** Remote Claims Processor** to work ** remote (MO).** **Role Responsibilities:** * Processing of Professional… more
- Molina Healthcare (San Antonio, TX)
- …experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing /resolution, including ... Medicare standards and requirements related to non-contracted provider dispute/appeals processing . * Establishes member and non-contracted provider grievance/dispute and… more