• Denial Specialist Professional Billing

    Beth Israel Lahey Health (Burlington, MA)
    …and interpret third-party payments, adjustments, and denials. Initiates corrected claims , appeals, and analyzes unresolved third-party and self-pay accounts, ... to navigate the hospital billing system to identify paid claims or root causes of denial when assessing physician...meetings and serves on committees as requested. Maintains appropriate audit results or achieves exemplary audit results.… more
    Beth Israel Lahey Health (05/03/25)
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  • Pharmacy/Clinical Service Data Analyst

    Trinity Health (Columbus, OH)
    …of professional roles including information technology, financial analysis, audit , provider relations and more. **Position Purpose:** Pharmacy/Clinical Service ... Develop and run detailed ad hoc reports for pharmacy claims analysis and review. . Coordinate and work with...with PBM and internal departments related to the pharmacy audit requests. . Trend and identify inappropriate pharmacy utilization… more
    Trinity Health (06/03/25)
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  • Medicare Biller / Accounts Receivable

    CommuniCare Health Services Corporate (Indianapolis, IN)
    …Indiana, West Virginia, Virginia, and Maryland. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the ... development and management of adult living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in… more
    CommuniCare Health Services Corporate (05/19/25)
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  • Claim Governance and Control Lead

    AIG (Atlanta, GA)
    …Management (ERM), Internal Audit Group (IAG), Compliance, External Auditors and the Claims organization. How you will create an impact + Drive a strong control ... your specialist expertise and experience. Make your mark in Claims . Our Claims teams are the proven...ensure necessary changes to controls are made based upon audit feedback (self-audits, internal audits, PwC audits). + Drive… more
    AIG (05/19/25)
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  • Manager Benefit Administration - Sharp…

    Sharp HealthCare (San Diego, CA)
    …and responding to internal and external benefit inquiries, and supporting claims testing activities. Provides training to new and less experienced Benefit ... of the Director. **Required Qualifications** + 5 Years in HMO or Health Insurance Management. + 2 Years leadership experience working collaboratively across multiple… more
    Sharp HealthCare (05/11/25)
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  • Benefit Administration Analyst - Sharp…

    Sharp HealthCare (San Diego, CA)
    …investigating and responding to internal and external benefit inquiries, and supporting claims testing activities. **Required Qualifications** + 3 Years in HMO or ... Health Insurance Management. + Experience working collaboratively across multiple functional areas (eg, operations, configuration, clinical, IT, plan design) and… more
    Sharp HealthCare (05/11/25)
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  • Environmental Health and Safety Manager

    Leggett & Platt, Incorporated (Newnan, GA)
    Environmental Health and Safety Manager " Date:May 20, 2025 Location: Newnan, GA, US Company: Leggett & Platt We, at Elite Comfort Solutions LLC, are searching for ... an Environmental Health and Safety Manager within our health ...reduce or eliminate the frequency and severity of future claims to reduce the company's risk. The team you… more
    Leggett & Platt, Incorporated (05/24/25)
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  • Pharmacy 340B Program Analyst - York Hospital…

    WellSpan Health (York, PA)
    …qualified patients, drugs and locations. Monitors and audits state Medicaid claims to ensure compliance to prevent potential duplicate discount rebates. Evaluates ... and improve 340B Program compliance and performance and for compliance and audit purposes. Maintains up-to-date policies and procedures on 340B purchasing processes.… more
    WellSpan Health (05/31/25)
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  • Clin Supv-HC

    Covenant Health Inc. (Knoxville, TN)
    …reports every morning. + Follows up on identified deficiencies related to the billing claims audit within 24 hours following receipt of the Billing Claims ... reports every morning. + Follows up on identified deficiencies related to the billing claims audit within 24 hours following receipt of the Billing Claims… more
    Covenant Health Inc. (05/15/25)
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  • Coding Auditor Educator

    Highmark Health (Harrisburg, PA)
    **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding ... audit activities. Reviews medical records to determine data quality...of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines.… more
    Highmark Health (04/16/25)
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