- Molina Healthcare (Kearney, NE)
- JOB DESCRIPTION Job Summary Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal ... to facilitate recovery of outstanding overpayments. Monitors and controls backlog and workflow of claims and ensures that claims are settled in a timely fashion… more
- Molina Healthcare (Nampa, ID)
- …Job Summary Respond to inbound calls to provides support for provider claims adjudication activities including responding to providers to address claim issues, and ... researching, investigating and ensuring appropriate resolution of claims . **Essential Job Duties** * Responds to incoming calls from providers regarding claims … more
- Martin's Point Health Care (Portland, ME)
- …years management and/or leadership experience, with a focus on Payment Integrity, claims operations, healthcare auditing, or related roles. + Experience managing ... claim payments. This role focuses on preventing overpayments, identifying incorrect claims , and leading recovery efforts while improving system controls and… more
- Molina Healthcare (Rio Rancho, NM)
- …or team leadership experience + 10 years' work experience preferable in claims processing environment and/or healthcare environment + Strong knowledge of ... strategic analysis. **KNOWLEDGE/SKILLS/ABILITIES** Manages and provides direct oversight of Healthcare Analytics Team activities and personnel. Provides technical expertise,… more
- Motion Recruitment Partners (Atlanta, GA)
- …Prefer those with Agile and SAFe development environment experience. + Experience with healthcare claims processing applications is a big plus! + Excellent ... an experience Java Software Engineer to join our team and develop leading healthcare applications. This role will be full stack Java development so looking for… more
- ManpowerGroup (Lake Forest, IL)
- …w2** **What's the Job?** + Validate, categorize, and analyze market, sales, and healthcare claims data to support strategic decision-making. + Prepare and ... Our client, a leading organization in the healthcare and medical device industry, is seeking a Market Analytics Specialist to join their dynamic team. As a Market… more
- Humana (Lansing, MI)
- …JD, MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + ... experience to include multiple practice areas + At least 2 years of healthcare fraud investigations and auditing experience + Knowledge of healthcare payment… more
- Waystar (Atlanta, GA)
- …and familiarity with ML frameworks (PyTorch, TensorFlow, XGBoost). + Experience working with healthcare , financial, or claims data is a plus. + Excellent ... data science solutions that support Waystar's AltitudeAI (TM) platform and healthcare revenue cycle management (RCM) products. This role requires strong hands-on… more
- Insight Global (Boca Raton, FL)
- …will have a solid foundation and proven track record in Commercial Healthcare Insurance including claims processing, products, and benefits management. The ... Skills and Requirements 5+ years of experience working within the Commercial Healthcare Insurance industry, including claims processing, products, and benefits… more
- Prime Healthcare (Victorville, CA)
- …Many more Voluntary Benefit Options! (https://www.primehealthcare.com/careers/benefits/) Responsibilities Claims Examiner processes routine and non-routine claims ... departmental policies and procedures. To accurately evaluate and adjudicate claims in a timely manner and according to set...Experience + 2-3 years relevant experience in health care claims and customer service. + Knowledge of Medical Terminology,… more