• Claims Quality Review (remote)

    Cognizant (Lansing, MI)
    …+ Minimum of one (3) years QA Experience + Minimum of one (5) years Healthcare claims processing experience + Good Spoken & Written English Good Communication ... established claims adjudication team. We are seeking highly motivated healthcare professionals with auditing experience in professional claims adjudication… more
    Cognizant (10/09/25)
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  • Medicare/Medicaid Claims Editing Specialist

    Commonwealth Care Alliance (Boston, MA)
    …Summary:** Working under the direction of the Sr. Director, TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will ... 011250 CCA- Claims Hiring for One Year Term **_This position...Degree **Required Experience (must have):** + 7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+… more
    Commonwealth Care Alliance (08/26/25)
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  • Claims Examiner- Fully Remote!

    TEKsystems (Harrisburg, PA)
    …high-risk cases for further investigation or legal review. Skills customer service, healthcare industry, claims processing, medical billing, claims analysis ... TekSystems is currently hiring for a FULLY REMOTE Claims examiner contract position! THIS POSITION CAN START ASAP! MUST HAVE: 1-3 years of recent medical claims more
    TEKsystems (10/08/25)
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  • Analyst, Healthcare Reporting & Analytics…

    Molina Healthcare (Lexington, KY)
    …DESCRIPTION** **Job Summary** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
    Molina Healthcare (10/09/25)
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  • Lead Analyst, Healthcare Analytics- Managed…

    Molina Healthcare (Albany, NY)
    …and work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
    Molina Healthcare (09/11/25)
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  • Senior Analyst, Healthcare Analytics…

    Molina Healthcare (Yonkers, NY)
    **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
    Molina Healthcare (10/04/25)
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  • Analyst, Healthcare Ops - Remote GA

    Molina Healthcare (Kenosha, WI)
    …must reside in Georgia **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network ... utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on… more
    Molina Healthcare (09/21/25)
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  • Specialist, Config Oversight ( healthcare

    Molina Healthcare (NE)
    …combination of education and experience **PREFERRED EXPERIENCE:** 3+ years healthcare Medical claims auditing **PHYSICAL DEMANDS:** Working environment ... hours will be 7am-3:30pm PST M-F** **Job Summary** Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor,… more
    Molina Healthcare (09/24/25)
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  • Claims Representative (Remote)

    Adecco US, Inc. (Minneapolis, MN)
    …your foot in the door with a company that is driving innovation in healthcare administration. If the Claims Representative position sounds like something you ... School Diploma or GED (required). + 1+ year of experience in claims processing, healthcare administration, or a related field. + Proficiency in Microsoft Office… more
    Adecco US, Inc. (10/09/25)
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  • Medical Claims Specialist - Remote

    Rising Medical Solutions (Tampa, FL)
    …medical coding certification preferred Experience + 2-4 years of insurance or healthcare experience, preferably in claims or medical billing-related position(s) ... The Claims Specialist will assist in reviewing, processing, and...knowledge of medical terminology, CPT and ICD coding, and healthcare billing practices + Well-developed time-management, organization, and prioritization… more
    Rising Medical Solutions (09/27/25)
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