• Clinical Appeals Nurse (RN)

    Molina Healthcare (Omaha, NE)
    …of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of ... the specific programs supported by the plan such as Utilization Review, Medical Claims Review, Long Term Service and Support, or other specific program experience as… more
    Molina Healthcare (08/20/25)
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  • AVP, Encounters

    Molina Healthcare (Cincinnati, OH)
    …+ Responsible for encounters accuracy & completeness (ie, Encounter Production, Audit , Production Vendor Oversight) for assigned lines of business. Responsible for ... of encounters as well as provides leadership support at managing overall healthcare costs. + Ability to influence across multiple organizational functions - Payment… more
    Molina Healthcare (08/22/25)
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  • Biller 1

    Aveanna Healthcare (Atlanta, GA)
    …any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions ... correct and update EMR. Works with Collector to ensure claims are refiled and/or billed to the second insurance...school diploma or equivalent. Minimum six (6) month prior healthcare insurance experience. Computer literate and ability to type,… more
    Aveanna Healthcare (08/23/25)
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  • Accounts Receivable Collector 1

    Aveanna Healthcare (Atlanta, GA)
    …any and all guarantors for services provided. This is inclusive of claims to commercial, Medicare, Medicaid and private pay accounts. Essential Job Functions ... Requests Bridge Tickets to correct and update EMR. Works with Biller to ensure claims are refiled and/or billed to the second insurance in a timely manner.… more
    Aveanna Healthcare (08/08/25)
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  • Heath Plan Compliance Auditor Arizona Residency

    Banner Health (AZ)
    …(CCS) credentials, issued by either AAPC or AHIMA.** 4+ years of experience in claims processing, billing, or healthcare compliance. 4+ years of experience in ... care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal...Audit Plan within the health plan (such as claims , system analysts and referral coordinators). Prepares audit more
    Banner Health (09/20/25)
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  • Analyst, Quality Analytics & Performance…

    Molina Healthcare (Nampa, ID)
    …Analytics team. Designs and develops reporting solutions to assist HEDIS audit , rate tracking, and Identifying targeted Interventions and tracking outcomes on ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...department with HEDIS measure deep dive to support HEDIS audit and revenue at risk reporting. + Calculate and… more
    Molina Healthcare (09/18/25)
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  • University Associate, Disputes & Economics…

    Ankura (Chicago, IL)
    …practices focused on client delivery services across the Firm. Practice Overview: The Healthcare & Life Sciences practice focuses on assisting healthcare and ... understanding of the issues facing a broad range of clients in the healthcare industry including but not limited to provider, payer, and pharmacy clients. We… more
    Ankura (09/09/25)
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  • Senior Regional Production Specialist, Lexington…

    AIG (Chicago, IL)
    …to manage risk. Join us as a Senior Regional Production Specialist, Lexington Healthcare to play your part in that transformation. It's an opportunity to grow ... and service a profitable book of miscellaneous medical facilities and allied healthcare business. + Utilize underwriter authority in accordance with the published… more
    AIG (07/16/25)
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  • Clinical Denials Coding Review Specialist

    HCA Healthcare (Brentwood, TN)
    **Description** **Introduction** Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding ... on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny… more
    HCA Healthcare (09/05/25)
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  • Investment Tax Manager

    BJC HealthCare (St. Louis, MO)
    **City/State:** Saint Louis, Missouri **Categories:** Legal and Audit **Job Status:** Full-Time **Req ID** : 96236 **Pay Range:** $92,248.00 - $150,238.40 / year ... and relevant work experience) **Additional Information About the Role** BJC HealthCare has an opportunity for an Investment Tax Manager. Ideally looking… more
    BJC HealthCare (08/28/25)
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