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212 fresh jobs found

ADML Senior Associate
Chicago, IL, United States

Vendor procurement Disability Management FMLA Revenue Generation Claims Microsoft PowerPoint Underwriting Procurement Team Collaboration +15

Senior Mid Full Time

USD 90K+

Data Analyst IV
Remote-MO, United States

Centene Corporation

Data quality audits Data design Analytical support Data Aggregation Quality audits Data verification Report development MS Access Project Implementation +36

Senior Full Time

USD 86K+

Provider Engagement Account Manager
Remote-OK, United States

Centene Corporation

Cost and utilization Network performance Quality measures Utilization Provider education Provider engagement HEDIS Provider Relations Health Plan +28

USD 55K+

Patient Care Advocate
Remote-AR, United States

Centene Corporation

Member advocacy Provider experience Quality Initiatives Health administration HEDIS NCQA CPT coding Health coaching Risk Adjustment +34

USD 52K+

Remote Medical Director - South Carolina
Remote-SC, United States

Centene Corporation

Utilization Medical management programs Clinical quality improvement Health care quality Government programs Provider network development Health financing Personnel management Accreditation Standards +39

Exec Mid Full Time

USD 221K+

Field Claims Specialist II, Property Content (Maryland)
Maryland-Work from Home-2, United States

Content inventory Property claims handling Property damage claims Claims systems Customer Value Mitigation Property and casualty Insurance Claims Property Damage +29

USD 55K+

Claims Specialist III, Commercial Casualty (Construction Defect)
Colorado-Work from Home-3, United States

Catastrophic loss management Fraud identification Insurance liability Property Damage Evaluation Commercial casualty Construction Defect Commercial Claims Claims systems Property damage claims +34

Senior Mid Full Time

USD 77K+

Provider Engagement Administrator II
Remote-NJ, United States

Centene Corporation

Claims reimbursement Claims billing Cost and utilization Network performance Utilization Provider education Provider engagement HEDIS Provider Relations +27

USD 55K+

Data Scientist II - Shiny
Remote-CA, United States

Centene Corporation

R-Shiny SAP HANA Health management Teradata MS SQL Server DB2 Statistical modeling Predictive Modeling Data Mining +29

USD 86K+

Pharmacy Claims Representative
Remote US, United States

Drug knowledge Dispensing systems Pbm systems Electronic claims submissions Pharmacy Claims PBM Prescription Pharmacy Technician Claims Adjudication +37

Entry Mid Full Time

USD 40K+

Provider Account Manager II
Remote-TX, United States

Centene Corporation

Health Plan Operations Provider Contracting Data Systems Long Term Care Commercial Insurance Provider Relations Health Plan Performance Improvement Issue Resolution +27

USD 55K+

Accounts Receivable Specialist- Work from Home
USA - NC - Burlington - 458 S Main Street, United States

Remittance Cash Posting EOB Macros Revenue Cycle Management Healthcare industry Claims Accounts Receivable Data Entry +12

Entry Mid Full Time

USD 30K+

Medical Provider Claims Fraud Investigator
Virtual, CA, US

Zurich Insurance

Billing data interpretation Insurance special investigations Claims investigations Medical records analysis Law Enforcement CPT coding Casualty insurance Investigations Insurance Industry +12

USD 71K+

Complex Liability Claims Specialist
United States, RW, US

Zurich Insurance

Caseload management Coverage evaluation Insurance Regulations Litigation management Casualty insurance Collaborative Insurance Industry Litigation Claims management +14

Senior Mid Full Time

USD 75K+

Investigations Manager, SIU
Remote

Provider Contracting Education and Training Technology Platform Fraud detection Investigations Process improvements Claims processing Data Security Policy Development +19

USD 88K+

Complaints and Issues Specialist II
Remote-MO, United States

Centene Corporation

Complaint Resolution Medicare Knowledge Grievances Customer Care Contact center Appeals Quality Standards Procedures Claims +21

Entry Mid Full Time

USD 55K+

Experienced QNXT Developer
Any city, TX, US, 99999

Gainwell Technologies

Web Forms Platform Configurations Payer Systems Qnxt .NET framework Posting Claims Adjudication ASP.NET Healthcare IT +31

Senior Full Time

USD 77K+

Business Analyst II
Remote-MO, United States

Centene Corporation

Claims Payment Analysis Managed Care Information Systems Provider reimbursement methodologies Structured Testing Managed Care Information Claims payment Reimbursement methodologies Business Process Analysis Business solutions +26

Entry Mid Full Time

USD 55K+

Contract Implementation Analyst
Remote-LA, United States

Centene Corporation

Provider information system Provider contracts Contract implementation Amisys Claims payment Government programs UAT testing Claims analysis Contract Analysis +21

Entry Mid Full Time

USD 44K+

Remote Child / Adolescent Medical Director - Florida
Remote-FL, United States

Centene Corporation

Utilization Claims review Clinical quality improvement Medical management programs Health care quality Provider network development Health financing Personnel management Accreditation Standards +39

Exec Senior Full Time

USD 231K+

Manager, Encounter Data Management
Remote US, United States

Hero applications X-12 data Business process development Encounter data Edifecs Tactical Operations Large data sets Microsoft SQL Microsoft Office Applications +59

USD 86K+

EDI Gateway & Integrated Solutions Manager
Any city, ID, US, 99999

Gainwell Technologies

Applications Development Methodology Applications Outsourcing Qnxt Applications development Edifecs X12 Posting Supervisory experience Healthcare Management +41

Senior Mid Full Time

USD 81K+

EDI Gateway & Integration Solutions Lead/Manager
Any city, ID, US, 99999

Gainwell Technologies

Qnxt Edifecs Applications development X12 Integration solutions Posting Supervisory experience Healthcare Management Pharmacy benefit management +42

Senior Full Time

USD 101K+

Provider Engagement Account Executive
Remote-OK, United States

Centene Corporation

Value-based performance Utilization Cost and utilization Interpersonal relationships Quality measures HEDIS Health administration Provider engagement Network management +37

Exec Mid Full Time

USD 86K+

Sr. Claim Specialist, Workman's Compensation
Virtual, PA, US

Zurich Insurance

Insurance Regulations Litigation management Casualty insurance Workers Compensation Collaborative Insurance Industry Litigation Claims management Claims +17

Senior Full Time

USD 74K+

Medical Director - Gulf South
Remote US, United States

Post-acute services Grievance and appeals processes Community Groups Outpatient services Clinical group practice management Commercial health insurance Inpatient rehabilitation Post-acute care Humana policies +88

Exec Senior Full Time

USD 223K+

Health Data Analyst - Remote
Home, United States

Prime Therapeutics

Health data analysis Queries Pharmacy benefits management Data Research Client Consultation Pharmacy benefit management Data manipulation SAS Claims +19

Entry Mid Full Time

USD 66K+

Grievance & Appeals Coordinator I
Burr Ridge - 1333 Burr Ridge Pkwy, Ste 125 (10938), United States

Centene Corporation

Claims research Utilization Grievance Grievances Managed care experience HEDIS Appeals Medical management Health Services +14

Entry Mid Full Time

USD 64K+

Business Analyst II
Remote-NY, United States

Centene Corporation

SQL scripting HIPAA Transactions Managed Care Systems Managed Care Information Business Process Analysis Business solutions User Acceptance Testing Information systems Claims processing +25

Entry Mid Full Time

USD 55K+

Healthcare Billing Specialist - REMOTE
USA - NC - Burlington - 458 S Main Street, United States

Alpha-numeric data entry 10-Key Healthcare Billing Insurance Verification Medical Billing Standard Operating Procedures Revenue Cycle Management Claims HR +11

Entry Full Time

USD 30K+

Remote PRN Medical Director - Missouri
Remote-MO, United States

Centene Corporation

Clinical quality improvement Pediatrics Health financing Clinical programs Personnel management Clinical Quality Medical Review Health administration Medical Services +24

Exec Mid Part Time

USD 212K+

Member Escalations Team Lead
Remote

Escalations Insurance experience Workflow improvement Technology Platform Lean Six Sigma Administrative Tasks KPIs Claims processing Six Sigma +23

Senior Mid Full Time

USD 54K+

Medical Coding Auditor, SIU
Remote

Provider Contracting Insurance Billing Technology Platform Medical Coding Medical Records HCPCS Fraud detection Report Writing ICD-10 +23

Entry Mid Full Time

USD 56K+

Senior QNXT Developer
Any city, TX, US, 99999

Gainwell Technologies

Platform Configurations Web Forms Payer Systems Qnxt Design and development .NET framework Posting Claims Adjudication Processes +36

Senior Full Time

USD 61K+

Consultant, Brokerage Casualty Underwriting - E&S/Specialty (Brokerage Primary Construction)
Arizona-Work from Home-1, United States

Actuarial support Reinsurance Placement Underwriting policies Technical Underwriting Broker management Business knowledge Insurance Law Loss control Customer Value +31

Senior Full Time

USD 94K+

Remote P&C Licensed Insurance CSR
MI-Detroit Downtown/New Center, United States

PC Navigation Emergency road service Cross-selling Insurance Products Claims Call Center Data Entry Underwriting Billing +6

Entry Mid Full Time

USD 43K+

Data Analyst II Medical Economics
Remote-FL, United States

Centene Corporation

Claims pricing Clinical outcomes Claims payment Data verification Contract Analysis Healthcare Analytics Risk Adjustment Actuarial Actuarial science +44

USD 55K+

Territory Specialist - Personal Lines (P&C Insurance Territory Relationship Specialist)
Texas-Work from Home-2, United States

Comparative Rater Quoting Systems Strong Communication Personal Lines P&C Insurance Customer Value State law Property and casualty Closing Issue Resolution +28

USD 70K+

Product Operations Specialist
Remote-IL, United States

Centene Corporation

Grievances Operational performance Contact center Appeals Reporting tools Regulatory Affairs Claims Pharmacy Root Cause Analysis +33

USD 55K+

Claims Consultant, Property - E&S/Specialty (CLESS Property Litigation)
Florida-Work from Home-1, United States

Property claims handling Property damage claims Complex claims Litigation management Customer Value State law Investigative Property and casualty Insurance Claims +22

Senior Full Time

USD 95K+

Data Analyst III Healthcare Analytics
Remote-FL, United States

Centene Corporation

Clinical outcomes Claims payment Data verification Microsoft Power BI Healthcare Analytics Risk Adjustment Actuarial Actuarial science Healthcare administration +46

Senior Mid Full Time

USD 68K+

Humana Healthcare Research Spring 2025 Internship
Remote US, United States

Quantitative healthcare research Statistical coding languages Manuscript authorship Causal inference methods Pharmacoepidemiology Time Series Health Services Research Real-world data analysis Time Series Analysis +41

Entry Internship Part Time

USD 37K+

Medical Director - Pacific SW
Remote US, United States

Health claims review Community Groups Outpatient services Grievance and appeals processes Clinical group practice management Commercial health insurance Inpatient rehabilitation Post-acute care Humana policies +84

Exec Senior Full Time

USD 223K+

Provider Engagement Account Manager (BH Exp)
Remote-MS, United States

Centene Corporation

Cost and utilization Network performance Quality measures Provider education Provider engagement HEDIS Health Plan Provider Relations Issue Resolution +26

USD 55K+

Business Analyst III Benefit Oversight
Remote-MO, United States

Centene Corporation

Provider reimbursement methodologies Structured Testing Regulation interpretation Managed Care Information Process redesign Claims payment Reimbursement methodologies Operational performance Microsoft Applications +32

Senior Mid Full Time

USD 68K+

Business Analyst I
Remote-MO, United States

Centene Corporation

Claims payment Business Process Analysis Microsoft Applications Business solutions Microsoft Access Requirements Gathering User Acceptance Testing Procedures Claims +13

Entry Mid Full Time

USD 52K+

Revenue and Billing Specialist Remote
USA - NC - Burlington - 458 S Main Street, United States

Remittance Lcbs EOB interpretation EOBs Cash Posting Financial data analysis EOB Healthcare Billing Revenue Management +19

USD 30K+

Senior Accountant
Remote-MO, United States

Centene Corporation

Income Statement Claims liability Claims Liability Reports Profit and Loss Statement Treasury Functions Balance sheet Accounting Methods Computerized accounting Recordkeeping +26

Senior Mid Full Time

USD 68K+

Correspondence Analyst - Remote Indiana
Indianapolis, IN, US, 47906

Gainwell Technologies

Health Care Claims Billing ICD-10-CM Grammar HCPCS Routing ICD-10 Claims processing CPT Claims +21

Entry Mid Full Time

USD 35K+

Encounter Data Management Professional
Remote US, United States

Encounter data Medical claims processing Medical claims Microsoft Office Applications CAS Compliance Standards Reconciliation Claims processing Analytical Problem Solving +44

USD 65K+

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