• Risk and Claims Specialist

    Billings Clinic (Billings, MT)
    …regional affiliate locations to support risk functions as indicated by Risk Management Director . The Risk and Claims Specialist assists in coordination of the ... claims at the direction of the Risk Management Director and/or the Risk and Claims Coordinator...Risk & Claims Coordinator and Risk and Claims Analyst on complex issues. * Works… more
    Billings Clinic (06/26/25)
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  • Medicare/Medicaid Claims Reimbursement…

    Commonwealth Care Alliance (Boston, MA)
    …billing-related certifications **Required Experience (must have):** + 3+ years in healthcare claims processing, provider reimbursement, or payment integrity. + ... 011250 CCA- Claims Job Description **Position Summary:** Reporting to the Director , Claims Operations and Quality Assurance, the Claims Sr. Analyst plays… more
    Commonwealth Care Alliance (05/31/25)
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  • EDI Claims Remittance and Enrollment…

    Beth Israel Lahey Health (Boston, MA)
    …+ Participate in ongoing professional development relative to latest EDI technologies healthcare regulatory changes, complex EDI architectures, to improve data ... a job, you're making a difference in people's lives.** Reporting to the Director of Revenue Cycle Operations, this position is responsible for planning, coordinating… more
    Beth Israel Lahey Health (06/06/25)
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  • Managed Care Claims Validator / Biller

    CommuniCare Health Services Corporate (Charleston, WV)
    …leader in post-acute care for those that are chronically ill or have complex conditions. Our more than 150 skilled nursing, assisted living, independent living, ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...team, CBO cash posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management, and others. The… more
    CommuniCare Health Services Corporate (06/29/25)
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  • Corporate Director , PFS Outsourcing…

    Prime Healthcare (Farmers Branch, TX)
    …trends and identify opportunities for process improvement and reimbursement optimization. + Complex Claims Management: identifies, trends, and owns portfolios of ... Outsourcing program across Revenue Cycle Management for all Prime Healthcare . The Corporate Director is responsible for... complex claims , including Third party claims , TDRG, Zero… more
    Prime Healthcare (06/20/25)
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  • CBO Trainer - Claims Trainer (on-site)

    Select Medical (Camp Hill, PA)
    …This position will also be involved in special projects as assigned by the Director of CBO or VP Patient Accounting. **Responsibilities** + Trains new IP CBO team ... Leadership and all IP team members. + Any additional projects as assigned by the Director of CBO or VP Patient Accounting + Training on various **OnBase, and old… more
    Select Medical (07/01/25)
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  • Occupational Health Medical Director

    Munson Healthcare (Traverse City, MI)
    HEALTHCARE 'S OCCUPATIONAL HEALTH TEAM! Full-Time | Monday-Friday | No Call Munson Healthcare is seeking a Medical Director for Occupational Medicine to lead ... injury/illness care, follow-up, and referral. Provide case management support for complex /long-term claims . + Provide leadership, direction and coordination of… more
    Munson Healthcare (07/14/25)
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  • Senior Director of Insurance & Risk…

    Hartford HealthCare (Hartford, CT)
    …And this is*your moment*. **Job:** **Management / Administration* **Organization:** **Hartford HealthCare Corp.* **Title:** *Senior Director of Insurance & Risk ... Work where*every moment*matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in...and Tallwood Urology & Kidney. Position Summary: The Senior Director of Insurance & Risk Financing will establish a… more
    Hartford HealthCare (07/10/25)
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  • Corporate Director of Clinical Utilization…

    Prime Healthcare (Ontario, CA)
    …including Claims and Customer Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals. + Integrates and coordinates services using ... Overview Prime Healthcare is an award-winning health system headquartered in...members to join our corporate team! Responsibilities The Corporate Director of Clinical Utilization Management (UM) provides comprehensive oversight… more
    Prime Healthcare (06/22/25)
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  • Director , Network Strategy (Marketplace)…

    Molina Healthcare (Cleveland, OH)
    …with federal and state laws. Negotiates and services larger and more complex market/national/group-based providers in accordance with company standards in order to ... expectations * Evaluates, negotiates and supports larger and more complex market/national/group-based providers in compliance with company standards while meeting… more
    Molina Healthcare (07/13/25)
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