• Payment Integrity Clinician

    Highmark Health (Richmond, VA)
    …to accepted and established coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the delivery of ... claim review with the goal of proper and timely payment to provider and member satisfaction. The incumbent is...claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure… more
    Highmark Health (11/14/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Richmond, VA)
    …abuse prevention and control. + Review and conducts analysis of claims and medical records prior to payment . Researches new healthcare-related questions as ... **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days… more
    Elevance Health (11/04/25)
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  • Cash Post Review Specialist

    HCA Healthcare (Blacksburg, VA)
    …such as accounts receivable follow-up, insurance follow-up, insurance posting, professional medical /billing, medical payment posting, and/or cash ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
    HCA Healthcare (11/26/25)
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  • Patient Account Assoc II Credit Balance and Acct…

    Intermountain Health (Richmond, VA)
    …or workflow issues, and escalating in a timely manner + Advanced knowledge of Medical Terminology + Payment Handling + Effective written and verbal communication ... York, Rhode Island, Vermont, Washington** **Essential Functions** + Identifies appropriate payment details and saves back-up as appropriate. + Researches, validates… more
    Intermountain Health (11/27/25)
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  • Patient Account Assoc I Credit Balances

    Intermountain Health (Richmond, VA)
    …claim cycle + Understanding Coordination of Benefits + Understanding EOB + Understanding Medical Terminology + Payment Handling + Effective written and verbal ... York, Rhode Island, Vermont, Washington** **Essential Functions** + Identifies appropriate payment details and saves back-up as appropriate. + Researches, validates… more
    Intermountain Health (11/27/25)
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  • DRG Coding Auditor

    Elevance Health (Ashburn, VA)
    …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/ payment systems provider billing guidelines, payer reimbursement ... for employment, unless an accommodation is granted as required by law._ Carelon Payment Integrity is a proud member of the Elevance Health family of companies,… more
    Elevance Health (10/25/25)
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  • Senior Payment Integrity Professional

    Humana (Richmond, VA)
    …part of our caring community and help us put health first** The Senior Payment Integrity Professional uses technology and data mining, detects anomalies in data to ... the investigations of fraud waste and our financial recovery. The Senior Payment Integrity Professional work assignments involve moderately complex to complex issues… more
    Humana (11/15/25)
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  • Patient Admitting Representative

    University of Virginia (Charlottesville, VA)
    …issuing receipts. Answer patient questions regarding admission procedures, Screen patients' medical insurance and payment information validity and verify ... Compensation Range: $13.38 - $26.76 Hourly **Benefits** + Comprehensive Benefits Package: Medical , Dental, and Vision Insurance + Paid Time Off, Long-term and… more
    University of Virginia (11/19/25)
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  • Operations Analyst - Global Payment

    Bank of America (Richmond, VA)
    Operations Analyst - Global Payment Operations Wires Customer Service Richmond, Virginia **To proceed with your application, you must be at least 18 years of age.** ... be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Richmond/Operations-Analyst Global- Payment -Operations-Wires-Customer-Service\_25045446) **Job Description:** At Bank of America, we are… more
    Bank of America (11/26/25)
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  • Staff VP - Engineering, Medical Cost Mgmt…

    Elevance Health (Richmond, VA)
    …teams responsible for building, scaling, and maintaining platforms for: + Medical Cost Management (claims review, payment integrity, utilization management, ... **Staff VP Engineering** - Medical Cost Management & Cost of Care **Location:**...Strong knowledge of value-based care models, risk-based contracting, and payment integrity. + Executive presence with the ability to… more
    Elevance Health (11/26/25)
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