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Claims processing Remote Jobs

155 fresh jobs found

Appeals and Grievances Clinical Specialist – RN, LPN, or Dental Hygienist - 100% Remote
Remote - NY, United States

Clinical Case Development Macess Dental Hygienist Hyland Medicare Guidelines Care Management Systems TruCare Case Resolution CCMS +18

USD 71K+

Specialist, Pharmacy Relations
United States

Navitus Health Solutions, LLC

PBM knowledge Pharmacy relations Pharmacy Technician Healthcare Industry Knowledge Claims processing Health Pharmacy Contract management Health care +7

USD 51K+

Product Manager - Payment Integrity (COB)
Remote, United States

Payment accuracy Feature prioritization Roadmap planning Payment Integrity Reimbursement methodologies Payment Metrics Tracking Claims Adjudication Exchange +56

USD 88K+

Claims Processing Operations Lead
Remote, OK, United States

Backend Revenue Cycle Management Healthcare claims clearinghouse Billing workflows Analytical expertise Workflow issues Cerner Client Success Intelligent Automation Workflow Orchestration +20

Senior Mid Full Time

USD 47K+

Oncology Sales Specialist- Non - Malignant Hematology- San Francisco- Remote
Field Sales (USA), United States

PA-Claims Processing Data Reporting Tools EMRs Sales Data Reporting Cross-functional work Analytic Abilities Pathways Ethical Leadership Commercial Excellence +41

Senior Mid Full Time

USD 92K+

Follow-Up Associate II
Remote, UT, United States

Technical appeals Icd-9 coding Edi billing Research analysis Charge master EOB Healthcare Billing Denials ICD-9 +21

USD 48K+

Large Loss Property Adjuster - Field Estimating - Maryland
USA - MD (Remote), United States

Allstate Remote-first

Virtual claims handling Property adjusting Property adjuster Video collaboration Claimsx Field Estimating Site inspections Working independently Estimate tools +34

USD 52K+

Payment Cycle Analyst III
Mississippi WFH, United States

Claims Payment Systems Claims operations Apc Payment methodologies Health Plan Operations Health Plan Experience Facets DRG Microsoft Visio +35

Senior Mid Full Time

USD 63K+

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+

Reimbursement Specialist - Order Entry (Remote, 3-Days Hybrid, and 5-Days Onsite Options - 9:30 AM - 6:00 PM PST, Tuesday through Saturday Shift)
Palo Alto, CA, United States

Guardant Health

Xifin Laboratory billing Payer Portals Billing Processes Insurance Verification HIPAA Compliance Claims processing Data Entry Oncology +13

Entry Mid Full Time

USD 38K+

Claims Examiner I
Remote, United States

Flexible spending accounts Self-Starter Claims processing Confidentiality Data Entry Teamwork Customer service

Entry Mid Full Time

USD 30K+

Principal Fraud & Abuse Investigator
Sentara Health Plans Florida- Remote, United States

Legal support Healthcare Compliance Health Plan Microsoft Access Verification Fraud Investigation Claims processing Pharmacy Auditing +16

Senior Full Time

USD 72K+

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+

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+

Configuration Analyst III - (SDET/Automation experience)
Dayton WFH, United States

ICD-CM Codes HCPCS codes DRG reimbursement HIPAA codes Reimbursement methods Apc Database relationships APC reimbursement Clinical editing +41

Senior Full Time

USD 81K+

Complex Claim Advisor
Recruiting Only - Telecommuter, United States

Jurisdictional expertise ADR Casualty claims Liability Claims Arbitration Mediation Liability Interpretive Action plans +25

Senior Mid Full Time

USD 85K+

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+

Specialist II, Pharmacy Relations
United States

Navitus Health Solutions, LLC

Pharmacy relations Pharmacy audits Pharmacy Claims Pharmacy Technician Claims processing Health Contract management Creativity Quality Assurance +9

USD 47K+

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+

Field Auto Adjuster - Concord, NC
USA - NC (Remote), United States

Allstate Remote-first

Auto estimating programs Audatex Auto Collision Estimates Liability insurance Auto Estimating CCC One Auto insurance claims Auto Claims Handling Virtual inspections +46

USD 52K+

Estimate Share - Virtual Adjuster - Consultant I - Remote
USA - TX (Remote), United States

Allstate Remote-first

Auto Collision Estimates Audatex CCC One Auto Estimating CCC Complex claims Damage Assessment Policy interpretation Settlement platforms +29

USD 47K+

Field Automotive Technical Adjuster - Wilmington NC
USA - NC (Remote), United States

Allstate Remote-first

Auto Claims Handling Virtual inspections Auto collision estimating Mitchell CCC Auto Claims Technology Utilization Estimate tools Settlement platforms +36

USD 52K+

Automotive Virtual Triage Total Loss Adjuster - Remote
USA - TX (Remote), United States

Allstate Remote-first

Auto Collision Estimates Auto Estimating Audatex CCC One Mitchell CCC Complex claims Policy interpretation Settlement platforms +28

USD 47K+

Technical Review Waiver Adjuster Consultant I - Remote
USA - FL (Remote), United States

Allstate Remote-first

Auto technical CCC portal Desk management Estimate review Auto collision estimating CCC Settlement platforms Estimate tools Job aids +32

USD 47K+

Senior Manager, Field Reimbursement Manager (FRM) PBC/Liver - Northeast
US - MA - offsite, Estados Unidos

Gilead Sciences

Reimbursement processes Therapies Patient Support Prior authorization Patient Access Claims processing Vision Dental Medical +19

Senior Full Time

USD 153K+

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+

Supervisor - Claims Quality Assurance (Accountable Care)
Remote - USA, United States

Stanford Health Care

Staff Supervision C-i-care Operational reporting Claims Adjudication Audit Management Claims processing Medical terminology Training Development Performance Management +8

USD 121K+

Pharmacy Client Operations Manager
Portland, OR, United States

Cambia Health Solutions

Sales team training Healthcare coding Product integration Pharmacy benefits Pharmacy operations DO Pharmaceutical products Client onboarding Proposal Management +19

USD 64K+

Implementation Manager, Payer Operations
New York, NY (Remote)

Implementation management Client Support Mental healthcare Therapy Claims processing Confluence Mental Health Jira Product Management +6

USD 80K+

Property Adjuster - Inside (Uniondale NY)
USA - NY (Remote), United States

Allstate Remote-first

Virtual assessments Settling claims Property adjuster Video collaboration Claimsx Working independently Organizing Property & Casualty License Settlement platforms +34

Entry Mid Full Time

USD 36K+

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+

PFS Representative CBO
Remote Greeley CO, United States

Banner Systems FinThrive Cerner Medical Records Claims processing Accounts Receivable Critical thinking Microsoft Office Research +3

USD 52K+

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+

Associate Director, Revenue Cycle Management
Sun Life Wellesley, United States

Dentrix Technology Utilization Healthcare administration KPI Monitoring Risk KPIs Revenue Cycle Management Claims processing Team Development +26

Senior Mid Full Time

USD 106K+

Bilingual (Burmese) Customer Care Specialist I - (Must Live in Indiana)
Indiana WFH, United States

Professional phone etiquette Phone Etiquette Computer Proficiency Credentialing Claims processing HIPAA Compliance Typing Contracting Multitasking +13

USD 35K+

PI Medical Coding Reviewer II (CPC or RHIT or RHIA required)
Dayton WFH, United States

Healthcare claim system configuration Diagnosis codes OPPS Reimbursement methodology Apc Anatomy and physiology Facets DRG Physiology +25

USD 53K+

Physician Coder CQA Ambulatory
Remote Fort Collins CO, United States

Ambulatory coding Third-party payer compliance Coding proficiency Medicaid reimbursement Denial prevention Medicare reimbursement Billing codes Coding Guidelines EDI +15

USD 88K+

Customer Care Associate I - Remote
Home, United States

Prime Therapeutics

Benefits explanation Call handling Eligibility verification Crisis Management Eligibility Claims processing Problem Resolution Claims Care management +12

Entry Mid Full Time

USD 34K+

Medical Coder
Greenville, SC, United States

Healthpro Heritage

Waystar Net Health OIG CMS standards Insurance denials Medical Coding Medical Records HCPCS ICD-10 +7

USD 56K+

Claims Production Professional I
Portland, OR, United States

Cambia Health Solutions

Keyboard DO Basic math Claims processing Health Insurance MS Office Attention to detail Interpersonal Customer service +2

Entry Full Time

USD 39K+

Claims Specialist II, Workers Compensation
Iowa-Work from Home-2, United States

Medical examinations Agribusiness Claims systems Customer Value State law Investigative Property and casualty Reinsurance Claims handling +28

USD 61K+

Claims Liaison I
Remote-TX, United States

Centene Corporation

Reimbursement interpretation Provider contracts Provider Billing Claims Adjudication Adjudication Provider Relations Information systems Claims processing Claims +12

USD 77K+

Business Analyst III (Implementation)
Remote-MO, United States

Centene Corporation

Managed Care Systems Managed Care Information Claims payment Process redesign Operational performance Microsoft Applications Business solutions Healthcare Knowledge User Acceptance Testing +23

Senior Mid Full Time

USD 68K+

Claims Systems Senior Analyst - eviCore - Remote
Tennessee Work at Home, United States

The Cigna Group

MPPR OPPS FFS MC400 MCNET Configuration design RC3 HCPC RBRVS +32

Senior Full Time

USD 53K+

Cash Posting Rep I
Remote, PA, United States

Patient accounting systems Cash Posting Accounting Systems Trend Analysis Reconciliation Revenue Cycle Management Revenue Cycle Claims processing Root Cause Analysis +11

Entry Full Time

USD 44K+

RCIS Crop Claims Specialist- IL (Lawrence, Richland, Clay, Jasper, or Crawford Counties)
Virtual, IL, US

Zurich Insurance

Agricultural knowledge Fact-finding Crop insurance Crop claims Field Inspections Casualty insurance Insurance Industry Claims processing Claims +11

USD 48K+

Liability Determination Adjuster - Remote (Recent Grad)
USA - TX (Remote), United States

Allstate Remote-first

Claims assessment Claim processing Liability determination Insurance Knowledge Insurance policies Settlement platforms Estimate tools Job aids Insurance Claims +28

Entry Mid Full Time

USD 36K+

Specialist, Formulary Operations
Madison, WI, United States

Navitus Health Solutions, LLC

Pharmacy claims software Pharmacy Practice Pharmacy Claims Formulary management Prior authorization Client Services Claims processing Health Utilization management +10

Entry Full Time

USD 46K+

Encounters Systems Analyst III (Prefer 837 file experience)
Ohio WFH, United States

Data Usability Claims operations Database Querying Billing Processes Hcpcs coding Reimbursement methodologies Healthcare Analytics SSIS Regulatory reporting +37

Senior Full Time

USD 81K+

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