• Payment Integrity Coding…

    Humana (Phoenix, AZ)
    **Become a part of our caring community and help us put health first** The Payment Integrity Coding Professional within Code Edit Vendor Management ... of situations or data requires an in-depth evaluation of variable factors. The Payment Integrity Coding Professional monitors and analyzes Code Edit… more
    Humana (12/18/25)
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  • Payment Integrity Clinician

    Highmark Health (Phoenix, AZ)
    …consistent with established industry and corporate standards and are within the Payment Integrity Clinician's professional discipline.Effectively function in ... The incumbent is responsible for the implementation of effective Payment Integrity strategies on a pre- payment...coding criteria, as well as other approved guidelines, payment and medical policies.Promote quality and efficiency in the… more
    Highmark Health (11/14/25)
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  • Medical Review Nurse (RN)

    Molina Healthcare (Phoenix, AZ)
    …level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to ... readmissions. + Validates member medical records and claims submitted/correct coding , to ensure appropriate reimbursement to providers. + Resolves escalated… more
    Molina Healthcare (12/26/25)
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  • Sr Financial Analyst

    CommonSpirit Health (Phoenix, AZ)
    …using Qlik, Looker, and Google BigQuery. + Leverage expertise in reimbursement/ payment policies, medical terminology, medical record coding , and claim ... reports and deliver compelling presentations to diverse audiences. + Consistently demonstrate integrity and ethical conduct in all professional interactions and… more
    CommonSpirit Health (12/17/25)
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  • IT Quality Assurance Analyst - Contract Role (AN)

    Nelnet (Phoenix, AZ)
    …a professional services company, consumer loan originator and servicer, payment processor, renewable energy innovator, and K-12 and higher education expert (and ... lives through the power of service as a student loan servicer, professional services company, consumer loan originator and servicer, payments processor, renewable… more
    Nelnet (12/03/25)
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  • Account Care Educator - Specialty Pharmacy

    AssistRx (Phoenix, AZ)
    …Completing Medicare and Commercial insurance claim submission. + Documenting and reporting payment information. + Professional level skills in computer use, ... product. You will support the healthcare providers addressing questions regarding coding and billing and navigating complex reimbursement issues. + Single point… more
    AssistRx (12/09/25)
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