• Fraud Customer Support Sr Specialist

    Citizens (Medford, MA)
    …gain the customer's consent on a resolution. + Provide accurate complete claims processing , and records management using established procedures in moving/placing ... documents appropriately through software (eg, claims management system) or manual methods, to maintain claim records. + Experience leadership that's invested in… more
    Citizens (01/02/26)
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  • Senior Analyst, Actuarial (ADP)

    CVS Health (Springfield, IL)
    …identifies opportunities for cost containment, fraud detection, and quality improvement in claims processing and reimbursement. + Assesses impacts of new ... and projection analysis to estimate future healthcare costs, revenue, and profitability. + Analyzes claims data to assess patterns, trends, and cost drivers and… more
    CVS Health (01/02/26)
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  • Insurance Collections Coordinator, Revenue Cycle

    CVS Health (Monroeville, PA)
    …offices as well as insurance companies as needed in order to expedite claims processing . **Required Qualifications** + 1+ years of Healthcare Insurance related ... Internet, and in writing. + Follow-up on unpaid, recouped payments, and underpaid claims + Resolve issues with nonpayment of invoices due to insurance problems that… more
    CVS Health (01/02/26)
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  • Accounting Specialist *Remote

    Providence (OR)
    …accounts payable or other equivalent accounting experience. + Experience in medical claims billing or insurance claims processing . **Preferred ... Qualifications:** + Coursework/Training: College or professional business course in computer/ten keying, accounting, or math. + 6 or more months experience in HME and infusion cash posting + 1 year recent experience with a computerized spreadsheet application… more
    Providence (12/31/25)
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  • Senior Medical Coding Analyst

    Aston Carter (Salem, OR)
    …data manipulation and use of data analysis tools. + In-depth understanding of claims processing , clinical edits, fee schedules, and payer contracts. + Proficient ... improvement projects within a medical coding environment. + Understanding of EHR, Claims Adjudication Systems, Revenue Cycle concepts, and data mining tools. Work… more
    Aston Carter (12/30/25)
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  • Medical Benefit Credit & Refund Coordinator…

    CVS Health (Monroeville, PA)
    …offices as well as insurance companies as needed in order to validate claims processing and payments. **Required Qualifications** + 1+ years of Healthcare ... cycle department managing healthcare accounts receivable. + Initiate refunds, reverse claims , request payer offsets, and post adjustment transactions. + Maintain… more
    CVS Health (12/25/25)
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  • Fraud and Waste Investigator

    Humana (Hartford, CT)
    …CFE, AHFI) * Experience testifying in court * Understanding of healthcare industry, claims processing , and investigative process development * Experience in a ... 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)
    …Certifications, CPC, CCS, CFE, AHFI) + Understanding of healthcare industry, claims processing and internal investigative process development + Experience ... it takes to Succeed** + Bachelor's Degree + Minimum of 3 yrs health insurance claims or Medicare experience + Minimum 3 years of experience with Fraud, Waste, and… more
    Humana (12/24/25)
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  • Program Manager (Remote)

    CareFirst (Baltimore, MD)
    …program management experience in Healthcare Operations including an emphasis on Claims Processing , Business Systems, and/or Operations Technical Support ... digital record storage related to member and provider submitted paper claims , correspondence, appeals, finance checks, enrollment forms and provider credentialing… more
    CareFirst (12/24/25)
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  • Medical Billing Specialist

    Robert Half Accountemps (Greenville, SC)
    …experience in medical billing and a strong understanding of healthcare systems and claims processing . Responsibilities: * Establish and manage payment plans with ... bad-debt cost reports by tracking billings and monitoring collections. * Handle claims against estates by coordinating with legal teams and probate courts. *… more
    Robert Half Accountemps (12/24/25)
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