• Senior Software Product Engineer (Remote…

    VetsEZ (GA)
    …citizenship required). Preferred Experience: + Prior experience in care coordination, claims processing , or patient engagement systems. + Practical experience ... develop, test, and operationalize AI-driven product ideas-such as automated claims triage, intelligent document processing , and conversational assistants-into… more
    VetsEZ (12/31/25)
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  • Lead Networx Analyst, Contract Configuration Info…

    Molina Healthcare (Augusta, GA)
    …Networx. + Experience with QNXT is preferred. + Advanced experience using a claims processing system. + Advanced experienced verifying documentation related to ... updates/changes within a claims processing system. + Advanced experience validating and confirming information related to provider contracting, network… more
    Molina Healthcare (12/26/25)
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  • Senior Analyst, Configuration Information…

    Molina Healthcare (St. Petersburg, FL)
    …combination of relevant education and experience. * Advanced experience using a claims processing system. * Advanced experienced verifying documentation related ... to updates/changes within a claims processing system. * Advanced experience validating and confirming information related to provider contracting, network… more
    Molina Healthcare (12/25/25)
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  • QA Auditor II

    Healthfirst (NY)
    …to senior staff. + Complete subsequent auditing and handling of specific claims and appeal requests including processing where applicable, tracking, documenting, ... + Conduct moderately complex to complex quality audits of provider claims , pre-payments and post-payments including high-dollar and specialized claims more
    Healthfirst (12/05/25)
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  • Senior Provider Network Operations Analyst

    AmeriHealth Caritas (Manchester, NH)
    …New Hampshire (NH) location. **Responsibilities:** + Reviewing and auditing provider billing, claims processing and accuracy. + Develops the Pricing Agreement ... cause analysis skills are required. + Ability to focus on technical claims processing and Provider data maintenance knowledge. + Understanding of and experience… more
    AmeriHealth Caritas (12/12/25)
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  • Medical Biller

    Insight Global (Pawtucket, RI)
    …and Requirements -Medical Billing or Pro Fee billing Experience -Familiarity with claims processing or CPC certification -Onsite Requirement: Must work hybrid ... other departments to ensure accurate billing information. *Payment Processing : Processing and posting payments received. *Insurance Claims : Assisting in the… more
    Insight Global (12/11/25)
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  • Insurance Follow-Up Specialist

    Robert Half Accountemps (Tampa, FL)
    …extra follow-up tasks when required. Requirements * Previous experience in insurance, claims processing , or customer service is preferred. * Demonstrated ability ... with funeral homes and insurance representatives while ensuring timely document processing . As a contract position with potential for long-term collaboration, it… more
    Robert Half Accountemps (12/05/25)
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  • Clinical Business Consultant

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …Management, Case Management and operational procedures, Medical and Payment policies, claims processing , insurance and regulatory requirements, billing and ... a wide variety of stake holders to analyze high-cost claims and members, evaluate clinical trends, and formulate business...with various business units including teams across HMM, Sales, Claims Operations, Finance, and Legal. * This position is… more
    Blue Cross Blue Shield of Massachusetts (12/19/25)
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  • Government/Non-Government Specialist

    UNC Health Care (Goldsboro, NC)
    …and compliance guidelines. Assists the Manager and Director in all aspects of claims processing . Responsibilities: 1. Works insurance related billing errors in ... in maintaining accounts receivables at appropriate levels. Submits insurance claims to the appropriate payers on a daily basis...9. Responsible for the accurate and timely submission of claims , response to denials, and re-bills of insurance … more
    UNC Health Care (12/10/25)
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  • Sr Director, Insurance AI Innovation & GTM…

    NTT America, Inc. (Raleigh, NC)
    …carriers to deploy transformative AI solutions for core functions like underwriting, claims processing , and customer engagement. This dual-focus role demands a ... P&C and L&A sectors, identifying key use cases (eg, automated claims routing, risk assessment automation) and defining targeted value propositions.** **Collaborate… more
    NTT America, Inc. (12/10/25)
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