• Adjudication Specialist

    Polaris Pharmacy Services, LLC (Covina, CA)
    …portfolio of rejected pharmacy claims, ensuring timely billing and maximum payer reimbursement. They prioritize customer needs, maintain courteous communication, and ... of disputed claims. + Monitor and resolve revenue risks associated with payer setup, billing, rebilling, and reversal processes. + Policy Interpretation and… more
    Polaris Pharmacy Services, LLC (12/23/25)
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  • Insurance Appeals Senior

    Covenant Health Inc. (Knoxville, TN)
    …support staff as it relates to front end and back end appeals hand-offs, payer correspondence, and claims processing. + Participates in the education and training of ... hand-offs. + Monitors for trends as it relates to payer denial activity and reports any payer ...to payer denial activity and reports any payer non-compliance with contracting terms, provider regulations, or grievance… more
    Covenant Health Inc. (12/23/25)
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  • Medical Coder/Coding Specialist

    Tidelands Health (WV)
    …clean claim including special billing procedures that may be defined by a payer or contract. + Review and resolve account checks, clearinghouse rejection errors, ... + Analyze clinical data and interpret information. + Have knowledge of payer guidelines related to MUE, Medical Necessity, LCD/NCD requirements and HIPAA/Compliance… more
    Tidelands Health (12/23/25)
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  • Compliance Coordinator

    Rochester Regional Health (Rochester, NY)
    …with management. . Coordinates and conducts audits to assess compliance with payer regulations and contract obligations. Audits include, but are not limited to ... system by agencies such as OIG, DOJ, OMIG, FBI, Medicare, and third-party payer fraud units. REQUIRED QUALIFICATIONS: . AAS or BS in Health Information Management,… more
    Rochester Regional Health (12/20/25)
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  • Research Specialist - Coverage Analyst

    UPMC (Pittsburgh, PA)
    …study documents. + Maintain up-to-date knowledge of healthcare billing regulations, payer policies, and clinical trial reimbursement guidelines. + Ensures compliance ... with Medicare's Clinical Trial Policy and other payer regulations related to clinical research billing. + Applies...should be covered by the study sponsor versus the payer . Communicate findings to clinical research coordinators, investigators, and… more
    UPMC (12/19/25)
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  • Pharmacy Infusion Billing Analyst

    Sanford Health (Fargo, ND)
    …claims, and denials for medications, supplies, and diagnosis within pharmacy. Maintains payer database, adding new payers when needed and assigning a pricing ... to assess outstanding accounts receivable. Stay current on changing payer rules by subscribing and reviewing payer ...changing payer rules by subscribing and reviewing payer updates and home infusion industry magazines and listservs.… more
    Sanford Health (12/19/25)
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  • Administrative Assistant | Patient Financial…

    CentraCare (St. Cloud, MN)
    …billing functions, customer service, collections, payment posting, credits, payer interactions, and facility credentialing. As the Administrative Assistant ... billing, collections, payment posting, and credits preferred. + Familiarity with payer processes and credentialing requirements preferred. + Experience working in a… more
    CentraCare (12/19/25)
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  • Physician Advisor

    Virginia Mason Franciscan Health (Burien, WA)
    …of patient care, medical necessity, compliance with regulatory guidelines, payer relationships; clinical documentation integrity, and identification of trends in ... with patients and families where appropriate * Liaise with Payer Strategy and Revenue Cycle regarding payer ...with Payer Strategy and Revenue Cycle regarding payer tactics and behaviors, as well as overall patterns… more
    Virginia Mason Franciscan Health (12/18/25)
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  • Patient Collection Representative

    BriteLife Recovery (Englewd Clfs, NJ)
    …Facility . Analyze and take appropriate action on unresolved accounts, including payer denials. . Evaluate patients' financial information to determine their ability ... with patients upon admission. . Update patient demographic, financial, and payer information in applicable systems. . Communicate with staff, patients, and… more
    BriteLife Recovery (12/18/25)
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  • Policy and Reimbursement Senior Director

    GRAIL (Washington, DC)
    …internal and external strategies related to broad access policy and specific public payer engagements / policy initiatives. Your role will directly contribute to the ... and meaningful reimbursement. + Manage/direct external consultants on GRAIL public payer reimbursement activities. + In partnership with VP, collaborate with… more
    GRAIL (12/17/25)
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