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219 fresh jobs found

Senior Specialist, Payment Integrity
Remote

Healthcare Claims Health care operations Payment Integrity Dispute resolution Business Insights Technology Platform Knowledge Management Lean Six Sigma Medical Coding +32

Senior Full Time

USD 59K+

Senior Specialist, Payment Policy
Remote

Payment policy Healthcare Claims Health care operations Payment Integrity Business Insights Technology Platform Knowledge Management Lean Six Sigma Medical Coding +32

Senior Full Time

USD 59K+

Senior Manager, Payment Integrity
Remote

Operational frameworks Healthcare Claims Payment Integrity Quality audits OKRs Technology Platform Lean Six Sigma Performance Indicators Medical Coding +29

Senior Full Time

USD 107K+

Customer Engagement Specialist
Remote

Accuserve Solutions

Sales-Centric Approach Agile Learning Restoration De-escalation Technology Proficiency Insurance Claims Detail oriented Claims Data Entry +10

Entry Mid Full Time

USD 36K+

Senior Pharmacy Resolution Specialist
Remote-MI, United States

Centene Corporation

Pharmacy retail Authorization requests Audit Preparation Pharmacy operations Pharmacy Technician Data gathering Guidelines Prior authorization Medical management +18

Senior Mid Full Time

USD 64K+

Accounts Receivable Field Support Reporting Specialist - REMOTE
USA - AL - Montgomery - 1230 Carmichael Way, United States

LCBS system Client collections Remittance Lcbs Cash Posting Healthcare Billing EOB Insurance Claims Internet +18

USD 40K+

Field Claims Specialist II, Property (Baltimore County, MD)-$2500 Sign on Bonus
Maryland-Work from Home-3, United States

Property claims handling Claims systems Property damage claims Claims adjusting Customer Value Mitigation Property and casualty Insurance Claims Property Damage +31

USD 55K+

FP&A Program Manager IV
Dayton WFH, United States

Budget Preparation Cost reduction Eligibility Data manipulation Enrollment Trend Analysis FP&A Data Mining Certification +31

USD 81K+

Claims Research & Resolution Lead
Remote US, United States

Long Term Services and Supports Trending Claims research Provider education Functional strategies Managed Care Contracts Claims resolution Driver safety program Microsoft Office Applications +66

Senior Mid Full Time

USD 94K+

Michigan Claim Support Assistant II
MI-HMI1 Empl Work From Home, United States

PC software applications Claims processing Claims Data processing Problem Resolution Administrative Auditing Investigation Mentoring +8

USD 36K+

Coding Auditor, Senior Associate
Any city, TX, US, 99999

Gainwell Technologies

AP-DRG ASC Internet Browsers APR-DRG Regulatory support Medical record documentation Coding certification CPC ICD-10-PCS +52

Senior Mid Full Time

USD 48K+

Medical Director - Florida
Remote US, United States

Clinical patient care Health claims Managed Care Knowledge Post-acute services Home health services Family practice Inpatient rehabilitation Hospitalist National Guidelines +73

Exec Senior Full Time

USD 223K+

Medical Director--Claims Management
Remote US, United States

Inpatient care Clinical patient care Computer-Based Review Outpatient services Home health services Grievance and appeals processes Clinical reference materials CMS policies Post-acute care +87

Exec Senior Full Time

USD 223K+

Care Specialist
Remote

Internal tech tools Escalations Provider experience Workflow improvement Tech Technology Platform Triage Quantitative Efficiency +12

Entry Mid Full Time

USD 44K+

Encounter Data Management Professional
Remote US, United States

Humana Image View Station CMS.gov Enterprise Portal EHub Encounter data management Edifecs Encounter data Claims research Microsoft SQL CAS +53

USD 59K+

Senior Business Analyst
Lakewood, CO, US, 80227

Gainwell Technologies

Business Rules Modeling Requirements Traceability Management Visualization Modeling Medical claims processing Relational Database Software Test Case Development Design Specifications Re-engineering ALM +54

Senior Full Time

USD 69K+

Senior Business Systems Analyst
Remote-PA, United States

Centene Corporation

Flow Charts Waterfall Methodology UAT Soft Health outcomes Waterfall IT services User Acceptance Testing Requirements Gathering +26

Senior Mid Full Time

USD 85K+

Business Analyst - Medicaid Claims Processing
Any city, CT, US, 99999

Gainwell Technologies

Medicaid Claims Processing Business Solutions Software Programming concepts Computer Programming Business applications Technical Reviews Test planning Posting Edge +57

Entry Mid Full Time

USD 55K+

Application Analyst
USA IL Remote, United States

Canto Rover Clindoc Haiku EpicCare Orders Ambulatory Inpatient ASAP +64

Entry Mid Full Time

USD 74K+

Supervisor, Commercial Cargo Claims
TX Houston (Office), United States

Technical information application Commercial trucking operations Cargo liability laws Performance Appraisal Claims investigation Policy interpretation Investigations Claims Conflict Resolution +12

USD 73K+

RCIS Crop Claims Specialist (West or Central MN)
Virtual, MN, US

Zurich Insurance

Agricultural knowledge Crop claims Crop insurance Field Inspections Casualty insurance Claims management Claims Insurance Industry Technical knowledge +14

USD 48K+

Claims Specialist II - Commercial
TX Dallas (Office), United States

Commercial trucking operations Cargo liability laws Contractual disputes Multimodal transport Legal Collaboration Claims negotiation Claims analysis Policy interpretation Subrogation +10

USD 59K+

Senior Actuarial Analyst
Remote-IL, United States

Centene Corporation

Health care claims Pharmacy Claims Probability Data Sources Actuarial Financial SAS Data Security Claims +33

Senior Full Time

USD 68K+

SIU Investigator
Remote-NY, United States

Centene Corporation

Claims analysis Investigative Organizing Fraud Investigation Report Writing Fraud detection Data Mining Claims Audits +13

USD 55K+

Commercial Large Loss, National General Adjuster - Property
Virtual, TX, US

Zurich Insurance

Litigation claims management Commercial property claims Insurance Contracts Claims resolution Casualty insurance Claims handling Property Claims Claims management Litigation +14

USD 100K+

Clinical Systems Application Architect III
Dayton WFH, United States

Aerial 275 Jiva Zeomega Medecision Medhok Care management packages Healthedge Sdoh +75

Senior Full Time

USD 110K+

Claims Examiner -Remote WV
Any city, WV, US, 99999

Gainwell Technologies

Insurance Laws Regulatory Guidelines Accuracy Insurance policies Eligibility Effective Communication Claims processing Claims Medical +24

Entry Mid Full Time

USD 28K+

Medical Claims Clerk - Remote WV
Any city, WV, US, 99999

Gainwell Technologies

Insurance Laws Medical claims Regulatory Guidelines Accuracy Eligibility Insurance policies Effective Communication Claims processing Claims +25

Entry Mid Full Time

USD 28K+

Contract Implementation Analyst
Remote-LA, United States

Centene Corporation

Contract implementation Provider information system Provider contracts Amisys UAT Government programs Claims payment Claims analysis UAT testing +24

Entry Mid Full Time

USD 44K+

Market Facing Technology Underwriter, Middle Markets P&C
Virtual, TX, US

Zurich Insurance

Technology underwriting Exposure Evaluation Market Facing Technical Underwriting Risk Engineering Casualty insurance Claims Insurance Industry Pricing +16

Lead Senior Mid Full Time

USD 120K+

Compliance Analyst III
Dayton WFH, United States

Corrective action management Proper grammar usage Government programs Healthcare operations Gap Analysis Training and education Healthcare Compliance Analytic Certification +45

Senior Mid Full Time

USD 81K+

Reinsurance Underwriter
Any location, United States

Cyber risk Security Monitoring Insurance coverage Actuarial Reinsurance Coverage Claims Pricing Underwriting +12

USD 180K+

Senior Litigation & Product Counsel
Remote - USA

Clover Health Remote-first

Regulatory investigations Internal Investigations Healthcare Regulations Value-based care Legal research CMS Litigation Claims Risk mitigation +10

Senior Full Time

USD 189K+

Network Operations Coordinator
Remote US, United States

Provider audits Data integrity management Contract Interpretation Processes Provider Relations Consumer Experiences Oversight Credentialing Interviewing +47

USD 53K+

Contract Negotiator II
Remote-NC, United States

Centene Corporation

Provider experience Contract Analysis Contract Compliance Guidelines Claims Adjudication Adjudication Provider Relations Health Plan Healthcare administration +22

USD 55K+

Escalation Response Specialist III
Remote-FL, United States

Centene Corporation

Provider experience Claims payment Escalation management Claims Adjudication Adjudication Contact center Customer Care Issue Resolution Claims processing +18

Senior Mid Full Time

USD 68K+

Senior Director, Continuous Improvement Provider Engagement
Remote-MO, United States

Centene Corporation

Data-driven recommendations Provider experience Provider engagement Healthcare operations Healthcare administration Methodologies Performance Improvement Health Services Cross-functional Teams +34

Senior Full Time

USD 145K+

AVP Life Sciences Underwriter, Middle Markets
Virtual, KS, US

Zurich Insurance

Life sciences underwriting Exposure Evaluation Technical Underwriting Market Facing Risk Engineering Casualty insurance Claims Insurance Industry Pricing +15

Exec Senior Full Time

USD 115K+

Principal Solution Strategist - Remote
Home, United States

Prime Therapeutics

Pharmaceutical claims data Medical claims data Queries Operational readiness Software implementation Healthcare administration Software design Business Processes Claims +23

Senior Full Time

USD 108K+

Claims Analyst
Remote-CA, United States

Centene Corporation

Revenue Codes Basic math Medical claims ICD-9 HCPCS ICD-10 Training Programs Quality Standards CPT +18

Entry Full Time

USD 30K+

Sr Solution Strategist - Remote
Home, United States

Prime Therapeutics

Medical claims data Pharmaceutical claims data Queries Consensus Building Meeting Facilitation Healthcare administration Conflict Management Claims Reports +27

Senior Full Time

USD 94K+

Public Programs Specialist
Remote-CA, United States

Centene Corporation

Member access Provider network management Clinical Management Grievances Healthcare Collaboration Health care services Service coordination Pharmacy Technician Medical Review +25

Entry Mid Full Time

USD 77K+

Property Engineer, Risk Management
California-Work from Home-3, United States

Sprinkler Analysis Thermal Imaging Property Engineering Fire Protection Systems NFPA Standards Food manufacturing Agribusiness Loss control Customer Value +29

USD 104K+

Claims Escalation Response Specialist IV
Remote-FL, United States

Centene Corporation

Contact center Customer Care Issue Resolution Claims management CMS Claims Medicaid Medicare Health Insurance +15

USD 76K+

Outbound Customer Service Advocate II
Remote-TN, United States

Centene Corporation

CRM applications Contact Center Operations Contact center Performance Tracking Tracking Customer Care Quality Standards Claims Audits +16

Entry Mid Full Time

USD 55K+

Patient Care Advocate
Remote-AR, United States

Centene Corporation

Member advocacy Quality Initiatives Provider experience Health coaching Health administration Telephonic Outreach NCQA HEDIS Provider Relations +35

USD 52K+

Medical Coding Auditor, SIU
Remote

Insurance Billing Provider Contracting Technology Platform Medical Coding HCPCS Report Writing Medical Records ICD-10 Fraud detection +24

Entry Mid Full Time

USD 56K+

Provider Account Manager
Remote-TX, United States

Centene Corporation

Claims billing practices Claims billing Billing practices Provider Relations Commercial Insurance Health Plan Tracking Client Services Claims +24

USD 55K+

Associate Counsel - Chicago, IL (REMOTE)
IL Chicago - JPS, United States

Personal injury Insurance defense Civil Litigation Legal research Litigation Claims Conflict Resolution Multi-tasking Insurance +5

USD 112K+

NC/ SC Auto Liability Claim Representative II
NC-HMNC Empl Work From Home, United States

Claims Management System Claim settlements PC Software Human Anatomy Subrogation Claims Liability determination Coverage Analysis Insurance Knowledge Subrogation +18

USD 50K+

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