• Payment Integrity DRG Coding & Clinical Validation…

    Excellus BlueCross BlueShield (Rochester, NY)
    …. Ensures accurate payment by independently utilizing DRG grouper, encoder, and claims processing platform. . Manages case volumes and review/audit schedules, ... business analysis. . Intermediate knowledge of PC, software, auditing tools and claims processing systems. Level II (in addition to Level I Qualifications) .… more
    Excellus BlueCross BlueShield (10/23/25)
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  • Financial Operations Recovery Specialist II

    Elevance Health (Norfolk, VA)
    …+ Requires a HS diploma or equivalent and a minimum of 2 years of claims processing and/or customer service experience; or any combination of education and ... Specialist II is** responsible for the discovery, validation, recovery, and adjustments of claims overpayments. May do all or some of the following in relation to… more
    Elevance Health (01/09/26)
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  • Medical Biller

    Robert Half Accountemps (Los Angeles, CA)
    …and manually, as needed, and uses all technology available to produce clean claims . * Interprets claims processing reports and applies information ... information as necessary in order to produce a clean claim . * Meets or exceeds productivity standards in the...ability to analyze coding to assure proper billing of claim . * Participates in a variety of hospital educational… more
    Robert Half Accountemps (01/01/26)
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  • Accts Receivable Team Lead / PA Non Medicare…

    Hartford HealthCare (Farmington, CT)
    …as they pertain to billing processes and procedures . Knowledge of insurance claim processing and third party reimbursement . Knowledge and detailed ... efforts to review and resolve issues related to insurance claim denials, no response claims and payment...related to insurance claim denials, no response claims and payment variances including underpayments and overpayments. Provides… more
    Hartford HealthCare (12/23/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (York, ME)
    …rewarding position in the medical billing field. Responsibilities: * Manage the daily processing of medical claims , ensuring accuracy and compliance with billing ... basis. This role involves working with healthcare billing processes, reviewing insurance claims , and ensuring accurate coding practices. Based in York, Maine, this… more
    Robert Half Accountemps (12/15/25)
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  • Project Commercial Director

    AECOM (New York, NY)
    …of additional work and potential claims . + Help to prepare and submit claims and claim responses as required. + Management of project tasks, DBE compliance, ... activities. + Identify conditions that could lead to a change orders or claims . + Review contract documents and advise regarding procedures and policy within. When… more
    AECOM (12/11/25)
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  • VP, Data Science

    Waystar (Atlanta, GA)
    …We process billions of transactions annually, leveraging a massive dataset of claims , remittances, and patient data to drive outcomes. With Waystar AltitudeAI (TM) ... using LLMs for policy document interpretation, predictive modeling for claim denial rates, intelligent task prioritization) to create differentiated, proprietary… more
    Waystar (10/30/25)
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  • Specialist, Revenue Cycle - Managed Care

    Cardinal Health (Indianapolis, IN)
    … + Preparing, reviewing and billing claims via electronic software and paper claim processing + Insurance claims follow up regarding discrepancies in ... administration, customer and vendor pricing, rebates, billing (including drop-ships), processing charge backs and vendor invoices, developing and negotiating… more
    Cardinal Health (01/13/26)
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  • Accountant IV-Health Insurance Billing - 1

    MyFlorida (Largo, FL)
    …portals and websites. The Accountant IV incumbent is responsible for performing claims processing , posting payments and collection activities of the State ... year of experience in medical billing (billing third-party health insurance) and processing electronic claims . + Experience in accounts receivables and… more
    MyFlorida (01/06/26)
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  • Configuration Auditor/Analyst

    AmeriHealth Caritas (Philadelphia, PA)
    …must possess a comprehensive knowledge of technical and workflow process components of claims processing .All auditors must attend ongoing training as needed and ... will be expected to build/run complex queries to identify claims affected by the configuration change and analyze all...of 3 years of system configuration experience + Facets claim processing knowledge required + Microsoft Access… more
    AmeriHealth Caritas (12/24/25)
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