• Certified Professional Coding Specialist

    Genesis Healthcare (PA)
    …will be key in assisting with the LTC ACO HCC program ensuring that claims are coded and documented accurately and completely, helping to identify remediation needs ... clinical documentation that supports and matches accurate and complete billing + Documentation and coding auditing of credentialed LTC...and Ethics Program, Standard code of Conduct, Federal False Claims Act and HIPAA. 2. Assist in the maintenance… more
    Genesis Healthcare (11/25/25)
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  • Medicare Specialist I

    Southeast Health (Dothan, AL)
    …Summary Performs daily activities involved in the reimbursement process, ie claims filing/follow-up, entry of payments/adjustments, and follow-up on non-payment or ... environment; + Maintains working knowledge of regulatory guidelines for billing ; + Ability to verify and load insurance coverages...edits and errors daily; + Provides follow up on claims which did not process correctly; + Provides follow… more
    Southeast Health (11/05/25)
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  • Appeals & Grievances Specialist (Complaints…

    Molina Healthcare (Tampa, FL)
    JOB DESCRIPTION Job Summary Provides support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to ... to ensure that internal and/or regulatory timelines are met. * Researches claims appeals and grievances using support systems to determine appropriate appeals and… more
    Molina Healthcare (12/14/25)
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  • Prior Authorization Specialist

    Polaris Pharmacy Services, LLC (Des Plaines, IL)
    …rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior ... + Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely ...claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their… more
    Polaris Pharmacy Services, LLC (12/23/25)
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  • Prior Authorization Supervisor

    Polaris Pharmacy Services, LLC (Covina, CA)
    …rejected pharmacy claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their customers. The Prior ... * Manage and identify a portfolio of rejected pharmacy claims to ensure maximum payer reimbursement and timely ...claims to ensure maximum payer reimbursement and timely billing to eliminate financial risks to Polaris and their… more
    Polaris Pharmacy Services, LLC (12/23/25)
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  • Prior Authorization Specialist

    Actalent (Sparta, NJ)
    …and update patient records, ensuring confidentiality and accuracy. + Process insurance claims , create invoices, and manage patient billing . + Assist with ... patient examinations, take vital signs, and prepare patients for procedures. + Update and maintain accurate patient medical histories and records. + Provide patients with information on treatments, medications, and post-procedure care. + Order and manage… more
    Actalent (12/23/25)
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  • Senior VP, Chief Population Health Officer

    Saint Francis Health System (Tulsa, OK)
    …Excel, Access, and other applicable software. Knowledge and understanding of healthcare billing operations and medical claims data. Strong understanding of Joint ... Commission, state, and federal guidelines, regulations and standards. Excellent communication skills, both written and verbal that present clear and concise information. Effective public speaking skills and problem-solving skills. Dynamic leadership skills and… more
    Saint Francis Health System (12/19/25)
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  • Associate Investigator

    Highmark Health (Pittsburgh, PA)
    …(AHFI) **SKILLS** + Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency + Must ... have understanding of technical and financial aspects of the health insurance industry + Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required + Must possess excellent communication skills and be detailed… more
    Highmark Health (12/18/25)
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  • Medical Admin

    Robert Half Office Team (Portland, OR)
    …communications between medical staff, patients, and insurance companies + Assist with billing , insurance verification, and claims processing + Perform general ... office tasks such as filing, faxing, and scanning documents + Ensure compliance with confidentiality and healthcare regulations Requirements Required Skills/Qualifications: + High school diploma or equivalent; additional certification is a plus + Prior… more
    Robert Half Office Team (12/15/25)
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  • Sr Admin Assistant

    Rochester Regional Health (Rochester, NY)
    …databases, paper files and records; may assist in budget preparation, patient billing , charging and insurance claims /programs; may coordinate activities such as: ... preparation and control of records, statistics and standard reports or documentation regarding quality, operations, personnel changes, performance appraisals, etc.; may perform various types of business analyses, including accumulating, calculating and… more
    Rochester Regional Health (12/13/25)
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