• Self-Pay Collection Rep II

    University of Rochester (Rochester, NY)
    …party payer issues. **ESSENTIAL FUNCTIONS** + Reviews reports of unbilled cash claims , self-pay plans not final billed, hold bill worklists, statement edits, credit ... lists as needed to decrease the amount of unbilled self-pay visits and ensure timely billing to patients. Ensures all hold bills are resolved within 30 days of hold.… more
    University of Rochester (10/01/25)
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  • Sr. Project Manager

    RK Mechanical (Aurora, CO)
    …and safety requirements are met. You'll also oversee change orders, billing , subcontractor coordination, and labor productivity, making a direct impact on ... and oversee required project administration and documentation to avoid claims and protect the best interest of RK Mechanical,...and maintained. + Develop, submit and obtain approval of billing schedule of values. + Maintain an over billed… more
    RK Mechanical (09/27/25)
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  • Senior Payer Process Assessment & BPM Lead

    CGI Technologies and Solutions, Inc. (Canton, MA)
    …and analyzing current-state workflows across key functions such as claims , provider operations, member services, utilization management, care management, and ... this role:** . Deep, practical experience in payer operations such as: o Claims processing o Provider data management o Auth/UM/CM workflows o Appeals & grievances… more
    CGI Technologies and Solutions, Inc. (12/25/25)
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  • Fraud and Waste Investigator

    Humana (Santa Fe, NM)
    …appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares investigative and audit reports. Begins to influence ... and auditing experience * Knowledge of healthcare payment methodologies, claims , submissions, and payments * Strong organizational, interpersonal, and communication… more
    Humana (12/24/25)
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  • Manager, Fraud and Waste, Special Investigation…

    Humana (Pierre, SD)
    …Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions are ... Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of...CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience… more
    Humana (12/24/25)
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  • Commercial Hospital Collections Representative

    UCLA Health (Los Angeles, CA)
    …you will manage a designated portfolio of inpatient and outpatient claims , ensuring effective and efficient collection efforts. Your primary responsibilities ... payers to resolve reimbursement discrepancies. + Diligently following up on claims to ensure timely resolution. + Communicate with insurance providers, patients,… more
    UCLA Health (12/24/25)
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  • Exception Specialist III

    Modivcare (Charleston, WV)
    …the provider liquidated damage process, including documentation and resolution of claims related to service disruptions or contract breaches. + Ensures trip ... phone activity for quality and operational efficiency. + Investigates utilization and billing patterns to detect and report abusive practices. + May generate and… more
    Modivcare (12/24/25)
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  • Benefit Coordinator I

    Koniag Government Services (Wolf Point, MT)
    …eligibility, assists with enrollment processes, and follows up on pending claims to ensure timely resolution. **Essential Functions, Responsibilities & Duties may ... for alternate resource programs. + Monitor and follow up on all pending claims to secure updated status, resolve discrepancies, and ensure timely processing. +… more
    Koniag Government Services (12/24/25)
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  • Professional Fee Coder II (Remote)

    Stanford Health Care (Palo Alto, CA)
    …to individual patient health information for data retrieval, analysis and claims processing. Works closely with departments to optimize reimbursement, ensure charge ... coding guidelines. + Code all documented professional services and submit for billing . + Ensure coded services, provider charges and medical record documentation… more
    Stanford Health Care (12/24/25)
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  • Med Staff/Credentialing Spec

    University of Michigan (Ann Arbor, MI)
    …our patients and safeguard Michigan Medicine against loss of accreditation, malpractice claims , and claims of negligent credentialing. + Completes evaluation of ... systems, such as the electronic health record, online provider directory, and billing system. Ensures database accuracy so that Provider Enrollment can complete… more
    University of Michigan (12/24/25)
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