• Senior Analyst, Encounters

    Molina Healthcare (Miami, FL)
    …statuses and risks, and facilitating calls with cross-functional teams + Claims processing , provider contacting, health data analysis and reporting, ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… more
    Molina Healthcare (10/18/25)
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  • Endoscopy ASC Billing Spec II/Medical Records…

    Community Health Systems (Birmingham, AL)
    …II is responsible for managing complex billing functions, ensuring timely and accurate claims processing , and resolving issues related to insurance payments and ... **Qualifications** + 2-4 years of experience in medical billing, insurance claims processing , or revenue cycle management required + 1-3 years in collections,… more
    Community Health Systems (10/04/25)
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  • Medical Billing & Denials Specialist

    Rochester Regional Health (Rochester, NY)
    …actions. RESPONSIBILITIES: + Medical Billing Expertise: Proficient in billing, claims processing (Inpatient, Outpatient, Critical Access, Rural Health), ... terminology, physician fee schedules, DRGs, and reimbursement procedures. + Claims and Appeals Processing : Submits and follows up on insurance claims ;… more
    Rochester Regional Health (09/20/25)
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  • Billing Specialist - Pharmacy Technician

    Independent Health (Buffalo, NY)
    …Reliance Rx Operations & Compliance department. + Experience working with online claims processing system preferred. + Effective oral and written communication ... primarily responsible for completing the billing of both pharmacy and medical claims and adjudicating rejections. **Signing Bonus:** This position will be granted a… more
    Independent Health (09/10/25)
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  • Medicare Billing Specialist- Onsite

    Community Health Systems (La Follette, TN)
    …experience in understanding the minimum requirements needed for Medicare billing, medical claims processing , or hospital revenue cycle operations required + ... for performing timely and accurate Medicare billing activities, including claims preparation, eligibility verification, census validation, and documentation review.… more
    Community Health Systems (09/09/25)
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  • Medical Claim Review Nurse (RN)

    Molina Healthcare (Buffalo, NY)
    …appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims processing . + Identifies and reports quality of care issues. + ... work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
    Molina Healthcare (10/18/25)
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  • Utilization Management Specialist

    TEKsystems (Los Angeles, CA)
    …a Medical Assistant (required). + Experience in quality improvement, patient care, claims processing , and prior authorization. + Proficiency with EMR/EHR systems ... within the Quality Management department, serving as the last line of defense for claims that have been denied. This position is responsible for researching denied … more
    TEKsystems (10/18/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (Sterling Heights, MI)
    …and tests assumptions through data, but leads with contextual knowledge of claims processing , provider contracts, and operational realities. + Creates succinct ... operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to...a business lens to ensure accurate interpretation of provider claims trends, payment integrity issues, and process gaps. +… more
    Molina Healthcare (10/18/25)
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  • On-Site Procedural Billing Specialist I…

    Mount Sinai Health System (New York, NY)
    …Accounts Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and ... problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the...+ 5 years experience in medical billing or health claims , with experience in IDX billing systems in a… more
    Mount Sinai Health System (10/10/25)
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  • Medicare Billing Specialist

    Insight Global (Pleasanton, CA)
    …with Medicare regulations and supports the clinic's financial health through timely claims processing , payment posting, denial management, and collaboration with ... is responsible for the accurate preparation, submission, and reconciliation of Medicare claims for outpatient mental health services. This role ensures compliance… more
    Insight Global (10/03/25)
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