- Dignity Health (Bakersfield, CA)
- …within a managed care or healthcare environment. + Strong knowledge of healthcare claims processing , coding (ICD-10, CPT, HCPCS), and billing practices ... is responsible for ensuring the accuracy and quality of claims processing within a managed care service...as SQL, SAS + Previous experience working directly with healthcare providers or within a provider network setting +… more
- ManpowerGroup (Linthicum Heights, MD)
- …to work in a dynamic and supportive environment. + Gain valuable experience in the healthcare claims processing field. + Collaborate with a team of dedicated ... will be part of the medical claims processing department supporting the efficient management of healthcare claims . The ideal candidate will have strong… more
- Healthfirst (NY)
- …of Medicare and Medicaid programs and reimbursement methodologies a plus. + Knowledge of healthcare claims processing practices in a managed care setting a ... fee schedules and accurately document file changes into the claims processing system + Research and identify...Qualifications:** + Managed care, commercial health plan (or other healthcare related) experience where you have performed claim or… more
- NTT DATA North America (Plano, TX)
- …role include:** + **1 year experience with HRP system** + **1-3 year(s) of hands-on Healthcare Claims Processing experience** + 2+ year(s) using a computer ... Claims Processor to join our team in Plano, TX. **HRP Claims Processing Specialist** **Monday-Friday 9am-5pm CST** **In this Role the candidate will be… more
- …claims processing experience with HRP system** + **2+ years of full cycle, Healthcare Claims Processing (Pay, Pend, Deny)** + 2+ year(s) using a ... an inclusive, adaptable, and forward-thinking organization, apply now. **HRP Claims Processing Specialists (temp)** **Location: Remote** **Monday-Friday 9am-5pm… more
- NTT DATA North America (Plano, TX)
- …have 1 year experience with HRP system** + **1-3 year(s) of hands on experience in Healthcare Claims Processing ** + 2+ year(s) using a computer with Windows ... Claims Processor to join our team in Plano, TX. **HRP Claims Processing Specialist** **Monday-Friday 9am-5pm CST** **In this Role the candidate will be… more
- Commonwealth Care Alliance (Boston, MA)
- …Medicaid billing-related certifications **Required Experience (must have):** + 3+ years in healthcare claims processing , provider reimbursement, or payment ... 011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a… more
- Central Maine Medical Center (Lewiston, ME)
- …care and experiences for our community and for each other every day. Central Maine Healthcare is seeking a Claims Processing Rep to join our Team. ... At Central Maine Healthcare our team members are committed to providing...The rate of pay is $20.00 per hour. The Claims Processing Billing Representative's responsibility is to… more
- NTT DATA North America (Plano, TX)
- …+ **Must have experience with HRP system** + **1-3 year(s) of hands-on experience in Healthcare Claims Processing ** + 2+ year(s) using a computer with ... overall sourcing strategy. NTT DATA currently seeks a **HRP Claims Processor** to join our team for a remote...join our team for a remote position. **Role Responsibilities** - Processing of Professional claim forms files by provider -Reviewing… more
- Molina Healthcare (IA)
- …the solution or configuration during warranty period. **KNOWLEDGE/SKILLS/ABILITIES** + Knowledge of healthcare claims and claim processing from receipt ... functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …process improvements for Core back-Office systems including but not limited to: Core Healthcare Claims Processing Platform including Eligibility & Enrollment ... growth, with a strong emphasis on quality control and improvements to enhance claims processing stability, flexibility, and innovation. The Director will be… more
- Cognizant (Lincoln, NE)
- …to understand and use Optum PPS configuration. + Demonstrate strong understanding of healthcare claims processing , provider contracts, fee schedules, and ... Healthcare Product Consulting - NetworX Consultant (Remote) Job...knowledge of NetworX data structures. + 10 years of healthcare experience, with 5 years of recent and relevant… more
- St. Luke's Health System (Boise, ID)
- …ability to obtain certification within a defined timeframe). + Strong understanding of healthcare claims processing , CMS requirements, HIPAA, and managed ... Claims functionality. This role ensures the integrity and efficiency of claims processing , vendor payments, adjudication logic, and integration with financial… more
- Cognizant (Sacramento, CA)
- …Facets - Benefit Configuration Domain Skills- Claims , Billing . Knowledge of healthcare claims processing and regulations. . Familiar with the Core ... analysis, troubleshooting, and reporting, and conduct testing to ensure accurate claims processing , collaborating with QA teams. Maintaining documentation is… more
- Actalent (Bronx, NY)
- …in Microsoft Office, including Excel, Word, and PowerPoint. + Experience in medical claims processing and healthcare customer service. + Knowledge of ... No-Fault, and Subrogation conditions. Essential Skills + Experience in claims processing , data entry, and insurance. +...+ Certified Professional Coder (a plus). + Experience within healthcare or managed care setting preferred. + Knowledge of… more
- Molina Healthcare (NM)
- …solutions + Advanced knowledge of health care benefits. + Advanced knowledge of healthcare claims and claim processing from receipt through encounter ... Molina Healthcare is in search of a Manager, Configuration....and timely implementation and maintenance of critical information on claims databases. Validate data to be housed on databases… more
- WelbeHealth (Los Angeles, CA)
- …professional experience may be substituted + Minimum of five (5) years of experience in healthcare claims electronic processing system + Minimum of two (2) ... **Plan Operation Audit Specialist** WelbeHealth is a value-based healthcare organization that's transforming the future of senior...updates and provider terminations to ensure timely updates to claims processing system + Review performance of… more
- Integra Partners (Troy, MI)
- …or Revenue Cycle Management organization. This includes depth of knowledge of healthcare claims processing , billing, adjudication, EDI, clinical information ... passion for Integra's vision to reimagine access to in-home healthcare to improve the quality of life for the...to adapt to a fast-moving company and rapidly changing healthcare landscape. Accountability for the Company Platforms As a… more
- Humana (Oklahoma City, OK)
- …applicable certifications (Clinical Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process ... closely with internal and external auditors, financial investigators, and claims processing areas + Assist in developing...**Must be an Oklahoma resident** + 2+ years of healthcare fraud investigations and auditing experience + Knowledge of… more
- CVS Health (Plymouth, MN)
- …by the stop loss carrier. **Required Qualifications** *Minimum of 1 year of experience in healthcare claims processing *Minimum of 2 years of experience with ... This challenging role provides exposure to virtually all aspects of healthcare claims administration, from reinsurance/stop loss, data analytics, provider… more