• Pharmacy Technician - NC Registration Needed

    Actalent (Cary, NC)
    …Locate and enter accurate prescription insurance information on patient profiles by processing eligibility checks and adjudicating pharmacy claims . + Adjudicate ... and financial support options. + Serve as a technical resource for adjudication while identifying areas for improvement. + Enter detailed, accurate, and… more
    Actalent (09/11/25)
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  • Provider Network Account Executive II

    AmeriHealth Caritas (Baton Rouge, LA)
    …+ Medicare and or Commercial experience is required. + Extensive knowledge of claims processing /billing is a plus. + Demonstrated experience with payment ... channels with internal stakeholders, including but not limited to Claims Operations, Medical Management, Credentialing, Legal, Analytics departments, Compliance,… more
    AmeriHealth Caritas (08/16/25)
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  • RCMI Senior Solution Technical Expert - Patient…

    Guidehouse (San Antonio, TX)
    …builds within Oracle Health (Cerner) EHR for insurance verification, claims submission, payment processing , account follow-up, records maintenance, and ... Cycle Management (RCM) professionals in support of our Military Health System client. These teammates will bring a vast...Federal or DoD "PUBLIC TRUST"; candidates must obtain approved adjudication of their PUBLIC TRUST prior to onboarding with… more
    Guidehouse (07/17/25)
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  • Human Service Assistant

    State of Massachusetts (Worcester, MA)
    …written and oral translation duties, in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational or ... rooms, and self-service stations. * Promote customer service delivery through document processing and management. * Convey information and explain actions to clients… more
    State of Massachusetts (09/13/25)
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  • Fraud and Waste Investigator

    Humana (Columbus, OH)
    …Certifications, CPC, CCS, CFE, AHFI). * Access * Understanding of healthcare industry, claims processing and investigative process development. * Experience in a ... **Become a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and… more
    Humana (09/16/25)
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  • Systems Analyst, EDI

    System One (Dayton, OH)
    …Enrollment, 837 Claims , 835 Remittance Advice, etc. Strong healthcare EDI Processing - Facets adjudication platform a plus. Essential Functions: + Leverage ... a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts,… more
    System One (09/13/25)
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  • Human Services Assistant

    State of Massachusetts (New Bedford, MA)
    …written and oral translation duties, in social work or social casework, claims adjudication , job placement, recruitment, employment counseling, vocational or ... rooms, and self-service stations. . Promote customer service delivery through document processing and management. . Convey information and explain actions to clients… more
    State of Massachusetts (09/17/25)
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  • Lead, US Field Access and Reimbursement - Retina…

    Astellas Pharma (South San Francisco, CA)
    …and private payers, their respective systems, processes, and key contacts involved in claims processing and adjudication . + Proven experience in working ... and conducting our business with ethics and integrity enables us to improve the health of people throughout the world. For more information on Astellas, please visit… more
    Astellas Pharma (09/13/25)
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  • Property/Casualty Insurance Program Manager

    State of Montana (Helena, MT)
    …(RMTD) provides comprehensive and cost-effective risk management programs, insurance coverage, claims adjudication services, and legal defense to state agencies ... techniques and problem determination; * Examine and interpret data prior to processing work assignments; * Communicate clearly and concisely both orally and in… more
    State of Montana (08/08/25)
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