• Senior Fraud and Waste Investigator, Special…

    Humana (Dayton, OH)
    …best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Adequately staff and manage the program ... your skills to make an impact** **WORK STYLE:** Work at home /remote. While this is a remote...CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development +… more
    Humana (11/20/25)
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  • Encounter Data Management Professional

    Humana (Indianapolis, IN)
    …make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and ... creating pivot tables and consumable information within Excel **Additional Information** **Work- At - Home Requirements:** + WAH requirements: Must have the ability… more
    Humana (11/21/25)
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  • Revenue Cycle Specialist

    Gentiva (Mooresville, NC)
    …highly organized Revenue Cycle Specialist to support our billing operations through timely processing of Government and Commercial claims . This role plays a ... **Overview** **Streamline Claims . Ensure Accuracy. Support Quality Care.** We are...revenue cycle. The ideal candidate will have experience in home health or hospice billing, with a strong understanding… more
    Gentiva (11/08/25)
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  • Market Delivery Support Specialist

    Lowe's (Baltimore, MD)
    …inquiries. * Communicate with customers to capture feedback and enhance the in- home delivery experience. * Proactively manage and resolve customer issues, including ... * Coordinate with 3PL (third-party logistics) partners to resolve customer and cargo-related claims . * Input and manage claims (eg, property damage) into Lowe's… more
    Lowe's (11/08/25)
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  • Care Management Specialist II, D-SNP Team (12…

    LA Care Health Plan (Los Angeles, CA)
    …incentives or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member ... we make sure our members get the right care at the right place at the right...predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other… more
    LA Care Health Plan (10/21/25)
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  • Appeals Specialist II

    Health Care Service Corporation (Tulsa, OK)
    At HCSC, our employees are the cornerstone of our...Chip claims payment experience. * 2-year experience processing claims and utilizing a claims ... **Job Summary** Under Supervision, This Position Is Responsible For Processing And Adjudicating Complex Non-Utilization. Management Appeals According To The… more
    Health Care Service Corporation (11/22/25)
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  • Internal Provider Ntwk Rep I

    Health Care Service Corporation (Tulsa, OK)
    …+ Understanding of health care contracts, applications and products. + Working knowledge of claims processing systems. + 3 years experience utilizing a PC. + ... At HCSC, our employees are the cornerstone of...care contracts, applications and products. + Working knowledge of claims processing systems. **Are you being referred… more
    Health Care Service Corporation (11/19/25)
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  • Grievances & Appeals Representative

    Humana (San Juan, PR)
    …transitions outside of area prior to the end of the 18 months. **Additional Information** **Work at Home Guidance** To ensure Home or Hybrid Home /Office ... center or related customer service experience + Previous experience processing medical claims + Bilingual (English and...Home /Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and… more
    Humana (11/19/25)
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  • Inpatient Pharmacy Technician 1.0 (Certified…

    Billings Clinic (Billings, MT)
    …preparations, filling bottles/bingo cards with prescribed tablets/capsules, processing prescriptions and emergent prescriptions, adjudicating claims ... Recognition consecutively since 2006. And you'll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere,...family activities. Amazing outdoor recreation is just minutes from home . Four seasons of sunshine! You can make a… more
    Billings Clinic (11/21/25)
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  • Pharmacy Tech in Training, Non - Certified

    Billings Clinic (Bozeman, MT)
    …preparations, filling bottles/bingo cards with prescribed tablets/capsules, processing prescriptions and emergent prescriptions, adjudicating claims ... Recognition consecutively since 2006. And you'll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere,...family activities. Amazing outdoor recreation is just minutes from home . Four seasons of sunshine! You can make a… more
    Billings Clinic (10/25/25)
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