- Healthfirst (NY)
- …of Medicare and Medicaid programs and reimbursement methodologies a plus. + Knowledge of healthcare claims processing practices in a managed care setting a plus. ... before sign-off and Production. + Assist in the on-going audit of configurations for new and existing claims...Qualifications:** + Managed care, commercial health plan (or other healthcare related) experience where you have performed claim or… more
- NextEra Energy (North Palm Beach, FL)
- …determine coverage and liability exposure to facilitate satisfactory settlement of claims under Miscellaneous Professional Liability (E&O), Allied Healthcare , ... **Professional Lines Claims Manager** **Date:** May 30, 2025 **Location(s):** North...post binding claim audits as needed and communicate the audit results to appropriate internal and external stakeholders. *… more
- CenterLight Health System (NY)
- …a pivotal role in enhancing the efficiency and effectiveness of the claims department by evaluating and refining processes, conducting comprehensive data analysis, ... guidelines. This position requires a working knowledge of Government Programs medical claims payment system and configuration with strong focus on data review and… more
- Henry Ford Health System (Detroit, MI)
- …and general liability, workers compensation and employers liability claims review, investigation, management and disposition, including financial mitigation ... and management of System reputation Will work under the guidance of Senior Claims Managers, Senior Claims Consultant, Director of Insurance, and Vice President,… more
- … claims processing certification required** **If you're passionate about healthcare administration and providing excellent support to patients and providers, we ... **Job Title:** Medical Claims Processor / Medical Claims Specialist...accurate financial records and assist with batch processing + Audit outgoing payments for accuracy and compliance + Manage… more
- DoorDash (Tempe, AZ)
- …company's bottom line. The team is divided into three separate subgroups: Actuarial, Claims Operations, and Risk Management & Mitigation. We are looking for forward ... cross-functional partners at DoorDash. About the Role We are seeking an experienced claims specialist who will be a member of DoorDash's Corporate Risk & Insurance… more
- Robert Half Accountemps (Minneapolis, MN)
- …in Minneapolis, Minnesota. In this role, you will analyze and process healthcare claims while ensuring strict compliance with industry standards, organizational ... adjustments in alignment with established procedures and guidelines. * Audit claims for accuracy and adherence to...* Knowledge of applicable regulations and industry standards in healthcare claims . Robert Half is the world's… more
- Centers Plan for Healthy Living (Staten Island, NY)
- Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and ... Responsible for the auditing functions of Centers Plan for Healthy Living (CPHL) claims . Collaborates with other Health plan departments and Management to ensure … more
- Robert Half Accountemps (Minneapolis, MN)
- …experience in quality assurance, auditing, or a related field, preferably within the healthcare industry. * Rx claims experience * Strong analytical skills with ... Description We are looking for a skilled Quality Audit Analyst to join our team in Minneapolis,...within the Enrollment Employer Installation division of a leading healthcare organization. Your expertise in quality assurance and process… more
- Otsuka America Pharmaceutical Inc. (Princeton, NJ)
- …Chief Compliance Officer in executing an effective compliance program. The Manager, Healthcare Law Auditing & Monitoring, executes the annual plan by conducting ... notes, speaker programs, and HCP spend to help to ensure compliance with healthcare laws, regulations and guidance (such as the Anti-Kickback Statute, False … more