• AI Product Engineer ( Remote Opportunity)

    VetsEZ (NC)
    …HL7, X12) and data governance in regulated environments; prior experience with claims adjudication , care coordination, or patient engagement systems is highly ... Intelligent Document Processing (IDP) pipelines to extract and validate data from claims , authorizations, and medical documentation. + Integrate LLMs and… more
    VetsEZ (10/03/25)
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  • Senior Quality Analyst

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …and ancillary claims . + Minimum 3 years in auditing of claims adjudication . + Working knowledge of medical terminologies and coding a plus + Excellent ... accurate claims processing and network compliance. This is a remote role. Primary Responsibilities + Audit system configuration against contract requirements. +… more
    Brighton Health Plan Solutions, LLC (10/04/25)
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  • Field Reimbursement Manager

    Amgen (Raleigh, NC)
    …insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution + Educate offices using approved materials + Review ... customer appointments, (geography specific) + General office demands - Remote , Work from Home + One to two home...in managed care, clinical support, and/or sales + Strong medical reimbursement experience and/or Specialty Pharmacy and Buy &… more
    Amgen (10/02/25)
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  • Senior Software Engineer- COBOL coding

    Humana (Raleigh, NC)
    …health first** **Requires a strong foundation in COBOL mainframe development ** The Claims Adjudication System (CAS) team at Humana is essential in delivering ... core services through effective claims processing and management solutions. This position involves coding...ongoing interruptions to protect member PHI / HIPAA information. \#LI- Remote ​ **Social Security Task** Humana values personal identity… more
    Humana (10/16/25)
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  • AI Innovation Lead - Data Science Lab

    Guardian Life (Raleigh, NC)
    …service logs. + Deliver solutions that enhance underwriting risk assessment, claims auto- adjudication , and customer servicing. Operational Excellence + Establish ... MA, Stamford, CT, Pittsfield, MA or Bethlehem, PA + Remote Candidates who can travel up to 20% of...individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue… more
    Guardian Life (09/12/25)
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