- Molina Healthcare (Cleveland, OH)
- **Job Description** **Job Summary** The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims , coordinating, ... investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge… more
- Commonwealth Care Alliance (Boston, MA)
- …a related field preferred. Required Experience (must have): * 5+ years in healthcare compliance, regulatory affairs, or claims audit. * Experience working with ... 011250 CCA- Claims **_This position is available to remote employees...for ensuring CCA's operational compliance with state and federal healthcare regulations, particularly MassHealth (Massachusetts Medicaid) and CMS Medicare… more
- Synergy Healthcare Solutions (Dunwoody, GA)
- Full Time | Posted 09-Oct-2025 (EST) | Administration | Synergy Healthcare Services - Atlanta | 1040 Crown Pointe Pkwy, Dunwoody, GA, USA **Workers' Compensation ... Claims Assistant** Onsite @ Atlanta, GA | _Full-Time_ |...behind the scenes? We're looking for a **Workers' Compensation Claims Assistant** to join our team and provide essential… more
- The Joint Commission (Washington, DC)
- …and managing data from structured databases using SQL. + Experience working with real-world healthcare data such as EHRs, claims , or quality reporting metrics. + ... **Overview** Joint Commission seeks a highly skilled and motivated Healthcare Data Analyst to support a growing portfolio of research and analytics initiatives that… more
- Centene Corporation (Raleigh, NC)
- …workplace flexibility. Remote position. Must Reside in North Carolina **2+ years of healthcare grievance or appeals, claims , managed care experience, or relevant ... experience.** **Position Purpose:** Analyze and resolve verbal and written claims and authorization appeals from providers and pursue resolution of formal grievances… more
- CDPHP (Latham, NY)
- …SAS, SQL, Python, R, or other coding language preferred. + Knowledge of healthcare claims data elements, state, federal and regulatory requirements and/or ... including but not limited to statistical and/or financial analysis required. + Healthcare or managed care industry preferred. + Demonstrated analytic skill strength… more
- Evolent (Washington, DC)
- …You Will Be Doing:** + **Strategic Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... and identify key areas of sensitivity + 2 years of Account Management healthcare experience To ensure a secure hiring process we have implemented several identity… more
- Molina Healthcare (Cincinnati, OH)
- …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
- HCA Healthcare (Houston, TX)
- …and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, ... organization that invests in you as a Medical Insurance Claims Follow-up Specialist? At Parallon, you come first. HCA... Follow-up Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- Position Purpose: The Claims Examiner is responsible for providing expertise and/or claims support in reviewing, researching, investigating, processing and ... adjusting claims and other duties as necessary. Key Responsibilities: +...Key Responsibilities: + Review, research, analyze and process professional claims by navigating multiple applications and platforms accurately. +… more