• Director II Digital Claims Operations

    Elevance Health (Chicago, IL)
    …leading Claims Operations teams and strategy within a large healthcare payor environment strongly preferred. + Proven track record leading Digital Transformation ... **Director II Digital Claims Operations (Dir II Digital Ops)** Location: This...Benefits Administration, Provider Engagement and Contracting, Sales and Internal Audit . + Hires, trains coaches, counsels, and evaluates performance… more
    Elevance Health (09/23/25)
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  • Claims Auditor

    Marshfield Clinic (Marshfield, WI)
    …together to support the most exciting missions in the world!** **Job Title:** Claims Auditor **Cost Center:** 682891379 SHP- Claims **Scheduled Weekly Hours:** 40 ... shifts (United States of America) **Job Description:** **JOB SUMMARY** The Claims Auditor is responsible for performing payment, procedural accuracy, turnaround… more
    Marshfield Clinic (09/23/25)
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  • Claims Reporting/Data Analyst

    Commonwealth Care Alliance (Boston, MA)
    011250 CCA- Claims **_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this ... Position Summary: Working under the direction of the SVP Claims , the Senior Data Analyst - Payment Integrity &...claim retraction valuation and viability, support payment policies, support audit requests, assist in the development of a claim… more
    Commonwealth Care Alliance (09/16/25)
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  • Business Analyst - Claims Systems

    Levi, Ray & Shoup, Inc. (Chicago, IL)
    …for you! The Business Analyst will: + Lead efforts to analyze and optimize healthcare claims processes to improve accuracy and first-pass resolution rates. + ... at least 6 years relevant IT experience overall. + Experience in the Healthcare industry domain, including and especially Claims systems experience. + Experience… more
    Levi, Ray & Shoup, Inc. (07/22/25)
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  • Claims Auditor

    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
    Centers Plan for Healthy Living (07/15/25)
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  • Medical Billing/ Claims /Collections

    Robert Half Accountemps (Canton, OH)
    Description Contract Medical Billing/ Claims /Collections Specialist Location: Remote, Northeast Ohio (Canton, OH-Based) We are seeking a detail-oriented and ... experienced Medical Billing/ Claims /Collections Specialist to join our talented team on a...guidelines while adhering to relevant industry standards. + Educate healthcare providers on coding specificity and quality indicators to… more
    Robert Half Accountemps (09/18/25)
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  • Claims and Litigation Specialist

    Ascension Health (Austin, TX)
    …requirements established by Health and Human Services Commission. Perform routine and/or targeted audit of claims to ensure payment accuracy and adherence to ... agencies to ensure that internal and/or regulatory timelines are met. + Research claims appeals using support systems to determine appeal outcomes. + Composes all… more
    Ascension Health (08/29/25)
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  • Senior Trainer - Special Investigations…

    CVS Health (Lansing, MI)
    …skills for development purposes. + Provides Coordinators the training and support and reviewing claims for potential acts of healthcare fraud and abuse by both ... subsequent training sessions to company-designated audiences of learners in the Claims area. **Key Responsibilities** + Independently oversees and leads the virtual… more
    CVS Health (09/20/25)
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  • HRIS Senior Supervisor of Benefits & Unemployment…

    University of Michigan (Ann Arbor, MI)
    HRIS Senior Supervisor of Benefits & Unemployment Claims Apply Now **How to Apply** A cover letter is required for consideration for this position and should be ... Operations, you will lead teams responsible for benefit data transactions, unemployment claims , and the systems used to perform these responsibilities. As a member… more
    University of Michigan (09/15/25)
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  • Claims Configuration - QNXT Quality…

    TEKsystems (Honolulu, HI)
    …and configuration processes is required. + Experience in auditing, quality assurance, or healthcare claims systems. + Strong attention to detail and analytical ... to ensure accuracy and compliance with established processes. Key Responsibilities: + Audit QNXT configuration work against build sheets and documentation. + Verify… more
    TEKsystems (09/17/25)
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