• Medicaid Claims Processing…

    MVP Health Care (Rochester, NY)
    …requires innovative thinking and continuous improvement. To achieve this, we're looking for a Claims Examiner to join #TeamMVP. If you have a passion for medical ... claims and attention to detail this is the opportunity...York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred… more
    MVP Health Care (11/19/25)
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  • Medicare/ Medicaid Claims…

    Commonwealth Care Alliance (Boston, MA)
    …certifications **Required Experience (must have):** + 3+ years in healthcare claims processing , provider reimbursement, or payment integrity. + Experience ... have):** + N/A **Desired Education (nice to have):** + Associate 's or Bachelor's degree in Health Administration, Finance, or...+ Certified Professional Coder (CPC) - AAPC + Certified Claims Professional (CCP) + Other AHIMA or Medicaid… more
    Commonwealth Care Alliance (08/31/25)
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  • Claims Processing Representative 2

    Humana (San Juan, PR)
    …a part of our caring community and help us put health first** The Claims Processing Representative 2 reviews and adjudicates complex or specialty claims ... either via paper or electronically. The Claims Processing Representative 2 performs varied activities and moderately complex...to start on January 26th, 2026 + **Any Humana associate who speaks with a member in a language… more
    Humana (11/20/25)
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  • Medicaid State Technology Lead

    Humana (Honolulu, HI)
    …and processes + Solid understanding of healthcare operations, particularly around claims processing , enrollment, provider data management and clinical ... all delivery for their assigned state, supporting the business goals of the Medicaid IT program. + Identifies and implements best practice changes within their… more
    Humana (11/20/25)
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  • Specialist, Claims Recovery (Remote)

    Molina Healthcare (Detroit, MI)
    **JOB DESCRIPTION** **Job Summary** Responsible for reviewing Medicaid , Medicare, and Marketplace claims for overpayments; researching claim payment guidelines, ... tools such as DSHS and Medicare billing guidelines, Molina claims ' processing policies and procedures, and other...of 1 year experience in healthcare insurance environment with Medicaid , or Managed Care + Strong verbal and written… more
    Molina Healthcare (11/03/25)
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  • Claims Examiner

    NTT DATA North America (Plano, TX)
    "NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. In this Role the candidate will be responsible ... MS-Excel. Preferred Skills & Experiences: * Amisys or Xcelys * Medicaid and Medicare Claims processing experience * Ability to communicate (oral/written)… more
    NTT DATA North America (11/19/25)
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  • Billing and Follow-up Representative-II (Hospital…

    Trinity Health (Farmington Hills, MI)
    …organization or other health care financial service setting, performing medical claims processing , financial counseling, financial clearance, accounting or ... of the revenue cycle process for an assigned PBS location. Documents claims billed, paid, settled, and follow-up in appropriate system(s). Identifies and escalates… more
    Trinity Health (11/12/25)
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  • Claims Examiner III

    Dignity Health (Bakersfield, CA)
    …of complex healthcare claims . This position requires expert knowledge of claims processing , coding, and regulatory compliance. The Claims Examiner ... **Minimum Qualifications:** + 3-5 years of experience in healthcare claims processing , with at least 2 years...of CPT, ICD-10, HCPCS coding, and medical terminology. + Associate 's Degree - Associate 's Degree in healthcare… more
    Dignity Health (09/25/25)
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  • Senior Fraud and Waste Investigator, Special…

    Humana (Tallahassee, FL)
    …Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a ... (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart… more
    Humana (11/13/25)
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  • Claims Examiner

    ManpowerGroup (Marquette, MI)
    …Marquette, MI Pay: $16.32 per Hour What's the Job? - Accurately process Medicaid claims in compliance with policies and regulatory guidelines. - Maintain ... - Meet or exceed production and quality goals for claims processing . - Assist with training new...unpaid lunch. - Required: High school diploma or GED ( Associate degree preferred). - Required: 1 year experience in… more
    ManpowerGroup (11/07/25)
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