• Care Management Specialist II

    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 ... stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data… more
    LA Care Health Plan (12/20/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Loveland, CO)
    …will be responsible for managing essential billing operations, ensuring accuracy in claims processing , and contributing to the efficiency of healthcare ... in a collaborative and fast-paced environment. Responsibilities: * Submit accurate claims to insurance providers, adhering to regulatory standards and guidelines. *… more
    Robert Half Accountemps (12/17/25)
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  • Director, Provider Relations

    Commonwealth Care Alliance (Boston, MA)
    …Required Knowledge, Skills & Abilities (must have): * Strong understanding of claims processing , reimbursement methodologies, and payment policies, with the ... team. Cross-Functional Collaboration * Work closely with network contracting, credentialing, claims , IT, customer service, compliance, and quality teams to address… more
    Commonwealth Care Alliance (10/18/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Hampton, VA)
    …in Hampton, Virginia. This role requires expertise in medical billing, coding, and claims processing to ensure accurate and timely management of healthcare ... * Proven experience or eagerness to learn medical billing, coding, and claims processing . * Familiarity with medical terminology and coding systems. * Ability to… more
    Robert Half Accountemps (12/30/25)
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  • Lead Product Consultant

    Cognizant (Owings Mills, MD)
    …types, service tiers, and penalty configurations to support healthcare products and claims processing . . Gather and analyze business requirements for benefit ... tiers, penalties). . Strong understanding of healthcare administration, benefit design, and claims processing workflows. . Proficiency in Facets modules such as… more
    Cognizant (12/20/25)
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  • Document Management Technician

    Amentum (Washington, DC)
    …Expected duties may include the following: + Scan and copy incoming materials related to claims processing . + Data entry from paper document into the database. + ... Technicians to assist with the the Radiation Exposure Compensation Act (RECA/Downwinders) claims team. The Document Management Technician role is crucial in ensuring… more
    Amentum (12/17/25)
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  • PFS Contract Variance Analyst Sr, Denials Analysis

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …in healthcare contract variance analysis, including an in-depth knowledge of healthcare claims processing -OR- * An approved equivalent combination of education ... Skills/ Abilities:*/ * Excellent problem solving skills * Knowledge of EPIC claims processing systems and electronic health records * Must have skills in data… more
    Minnesota Visiting Nurse Agency (12/10/25)
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  • Senior Fraud & Waste Investigator

    Humana (Oklahoma City, OK)
    …best outcomes; work closely with internal and external auditors, financial investigators, and claims processing areas + Assist in developing FWA education to ... (Clinical Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and investigative process development + Experience in a… more
    Humana (12/07/25)
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  • Account Billing Specialist - Hospital Billing_QHS…

    Queen's Health System (Honolulu, HI)
    …highly desirable. B. EXPERIENCE: * One (1) year experience in medical insurance claims processing or billing. An Associate's or Bachelor's degree in business ... field may be substituted for one (1) year experience in medical insurance claims processing or billing. * Prior recent billing experience in an acute care… more
    Queen's Health System (11/27/25)
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  • Document Management Technician

    Amentum (Washington, DC)
    …Expected duties may include the following: + Scan and copy incoming materials related to claims processing . + Data entry from paper document into the database. + ... Technicians to assist with the the Radiation Exposure Compensation Act (RECA/Downwinders) claims team. The Document Management Technician role is crucial in ensuring… more
    Amentum (11/26/25)
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