• Clinical Nurse, Case and Disease Management - High…

    Blue KC (Workman, MN)
    …intervals for monitoring plan of care. Utilizes internal, community and other healthcare resources to maximize outcomes. + Acts as liaison between member, employer, ... BlueCross BlueShield of Kansas City. Works with multiple members of the healthcare team to foster continuity and coordination of care. + Prioritizes interventions… more
    Blue KC (09/17/25)
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  • Mechanical Claims Adjuster (Remote)

    DriveTime (Mesa, AZ)
    …which provides quality warranty and ancillary products, and a customer-friendly claims process. SilverRock offers a variety of ancillary products and administrative ... with over 1 million service contracts, products, and warranties, and over $300 million in claims . **That's Nice, But What's the Job?** In short, as a Claims more
    DriveTime (09/30/25)
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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 (10/14/25)
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  • Data and Reporting Analyst Assoc- REMOTE

    Prime Therapeutics (Jefferson City, MO)
    …data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... in the implementation of quality process improvement efforts + Experience documenting requirements, creating training materials and working directly with end users Every employee must understand, comply with and attest to the security responsibilities and… more
    Prime Therapeutics (10/08/25)
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  • Legal Counsel, Americas

    Danaher Corporation (Waltham, MA)
    …laws, industry codes (eg, AdvaMed), and internal policies-particularly in relation to healthcare advertising, product claims , and interactions with healthcare ... supply, licensing, marketing, sponsorship, group purchasing organization (GPO), and healthcare professional (HCP) agreements. . Provide legal support for Leica's… more
    Danaher Corporation (10/02/25)
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  • Lead Managed Care Contract Manager

    Baystate Health (Springfield, MA)
    …requirements. Data Analysis: Experience in data analysis and the ability to interpret healthcare utilization data, claims data, and financial reports is often ... care contracting. This includes negotiating, analyzing, and managing contracts with healthcare providers, insurance companies, or other healthcare organizations.… more
    Baystate Health (08/30/25)
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  • Patient Claims Specialist

    Modernizing Medicine (Tampa, FL)
    We are united in our mission to make a positive impact on healthcare . Join Us! + South Florida Business Journal, Best Places to Work 2024 + Inc. 5000 Fastest-Growing ... door to an exhilarating career path for individuals driven by a passion for healthcare and exceptional customer service within a fast-paced Healthcare IT company… more
    Modernizing Medicine (08/08/25)
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  • Call Center Claims Representative…

    Mass Markets (Killeen, TX)
    …technology solutions across a wide range of industries, including healthcare , retail, government, education, telecom, technology e-commerce, and financial services. ... globally expanding, industry-leading organization. We are looking forCall Center Claims Representativesto support inbound customer service, help desk, and… more
    Mass Markets (10/13/25)
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  • Fully Remote Senior Medical Claims Analyst

    TEKsystems (San Antonio, TX)
    TEKsystems is looking to hire several FULLY REMOTE Seasoned Medical Claims Analyst for a large healthcare client. **If you have 5+ years of completing a deep ... level of research within PBM claims , and have 3+ years of experience running queries...project team to support their coupon process in their claims system. They are currently in process of building… more
    TEKsystems (10/11/25)
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  • Claims & Disputes Specialist

    US Bank (Tempe, AZ)
    …you excel at-all from Day One. **Job Description** Responsible for claims and disputes intake, review, and/or disposition of potentially suspicious transactions, ... specialized areas of focus, including but not limited to case/ claims processing, claims , disputes and risk-based actions,...may vary based on role, location or hours): + Healthcare (medical, dental, vision) + Basic term and optional… more
    US Bank (10/10/25)
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