• Admission Registration Specialist 1

    Rush University Medical Center (Oak Park, IL)
    …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting, or ... customer service. * Knowledge of insurance and governmental programs, regulations, and billing processes eg, Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc., managed care contracts and coordination of… more
    Rush University Medical Center (01/05/26)
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  • Provider Relations Representative I (Hybrid)

    CareFirst (Baltimore, MD)
    …and procedures, including experience with providers, training, customer service, and claims processing . **Preferred Qualifications:** + Bachelor's Degree in ... business, healthcare administration or related industry. **Knowledge, Skills and Abilities (KSAs)** + Working knowledge of provider billing and coding mechanisms, including special pricing, medical terminology, CPT coding and CMS-1500 or CMS UB -04 claim… more
    CareFirst (01/05/26)
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  • Director, Accounting - Michigan - McLaren Careers

    McLaren Health Care (Flint, MI)
    …reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing , membership/eligibility, contracting and risk ... We are looking for a Director, Accounting to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and… more
    McLaren Health Care (01/04/26)
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  • Provider Relations Representative II (Hybrid)

    CareFirst (Baltimore, MD)
    …and procedures, including experience with providers, training, customer service, and claims processing . **Preferred Qualifications:** + Bachelor's Degree in ... business, healthcare administration or related industry. + 18 months of experience within CareFirsts Provider Relations Department. **Knowledge, Skills and Abilities (KSAs)** + Working knowledge of provider billing and coding mechanisms, including special… more
    CareFirst (01/03/26)
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  • Lead Systems Architect

    Tetrad Digital Integrity LLC (Washington, DC)
    …target start architecture + Architectural support of payer systems including: claims processing , enrollment and eligibility platforms, Pharmacy Benefit Manager ... (PBM) integrations, CRM and call center platforms and care/case management systems + Design secure integrations patterns (API's, middleware, EDI batch and event driven) + Ensure alignment with enterprise architecture standards, interoperability requirements,… more
    Tetrad Digital Integrity LLC (01/02/26)
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  • Engagement Director

    NTT DATA North America (Baton Rouge, LA)
    …Minimum of 2 years in implementation, operations, and maintenance of health care claims processing or eligibility system projects. + Experience with Medicaid, ... SNAP or TANF Terminology and Federal Requirements. + Bachelor's degree in IT, business, or a related field **Preferred Skills** : . Master's degree in IT, business, or a related field preferred Where required by law, NTT DATA provides a reasonable range of… more
    NTT DATA North America (12/31/25)
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  • Director, Revenue Accounting

    National Vision (Duluth, GA)
    …agreement reimbursement rates to determine payer reserve analysis + Monitoring billing, claims processing , and payment reconciliations performed by the RSC ... managed care team to determine accounting impacts. + Assessing revenue trends and projecting financial outcomes related to payer reimbursement rates through the use of Microsoft BI. + Ensuring alignment with healthcare regulations and payer policies. + Using… more
    National Vision (12/30/25)
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  • Coding Quality & Edu Spec 1 / HIM Coding

    Hartford HealthCare (Newington, CT)
    …Terminology(CPT) codes and resulting DRGs/APCs to ensure consistency and efficiency in claims processing , data collection, and quality reporting for HHC * ... Validates Home Health Coding/OASIS reviews. * Prepares written reports on the results of the audits, including recommendations for improvement and compliance with state and federal laws, regulations and policy. * Presents audit reports, results and action… more
    Hartford HealthCare (12/30/25)
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  • Mgr IT Applications

    Covenant Health Inc. (Knoxville, TN)
    …applications including scheduling, registration, financial clearance, charge capture, billing, claims processing , payment posting, and collections. + Collaborate ... with Revenue Cycle, Patient Access, HIM, Finance, Clinical Operations, and other IT professionals/leaders to identify technology needs and deliver solutions that enhance workflow and data integrity. + Oversee system upgrades, integrations, and enhancements in… more
    Covenant Health Inc. (12/30/25)
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  • Director, Revenue Division

    Sutter Health (Emeryville, CA)
    …and adjudication, state and federal billing and collections regulations, compliance, claims processing methods, Current Procedure Terminology (CPT) coding, and ... patient accounting management practices. + Proficiency in knowledge and use of the electronic health systems (specifically Epic). + Proficiency in various PC software programs such as spreadsheets and word processors, and other statistical tools. Able to… more
    Sutter Health (12/30/25)
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