Claims Processing Jobs in USA

The Clinical Authorization Specialist will take the lead in securing medical authorizations from third party payers (commercial and government) for outpatient clinic inpatient admission ancillary services and/or chemotherapy and other infused treatments as needed in assigned service line. The Specia...

Anticipated End Date:Position Title:Manager II EngineeringJob Description:Manager II EngineeringLocation:This role requires associates to be in-office 3 days per week including either a Monday or Friday fostering collaboration and connectivity while providing flexibility to support productivity and...

OverviewWho we areCollaborative. Respectful. A place to dream and do. These are just a few words that describe what life is like at Toyota. As one of the worlds most admired brands Toyota is growing and leading the future of mobility through innovative high-quality solutions designed to enhance live...

DescriptionJOB SUMMARY: The Senior Financial Analyst supports the financial operations regulatory reporting and analytical functions of the Redwood Coast PACE program. Under the direction of the Director of Finance this role is responsible for financial forecasting operational analysis healthcare cl...

SummaryReviews and adjudicates complex or specialty claims. Determines whether to return deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiar...

Hello There My name is Himanshu and I serve as the Recruitment Manager at Nexiva INC. I am reaching out to share an excellent career opportunity for the role of Sr. Business System Analyst with our esteemed client. If you are interested then please share your updated resume at Job Description...

Hi This is Aditya Staffing Expert from Nexiva Inc . Im reaching out regarding a Role that aligns well with your experience. Let me know if youre open to discuss .Please check below role and share me your updated Resume with contact details or You can share me a References if any one your known...

The Hospice Clinical Manager has direct responsibility for patient care services provided by the Home Health program. Acts as alternate Nursing service line leadership. This position serves as a pivotal point in communication with field staff support staff referral sources other managers/departments...

Job ID: TX- () Hybrid/Local (AUSTIN ONLY) TX Govt Medicaid BA (15) with BO cost/benefit Azure DevOps Agile/Scrum experience Location: Austin TX (HHSC) Duration: 12 Months Position will be 3 days remote with 2 days (Mon & Tues) required to be onsite at the location listed above. **Subject to change p...

We are seeking an Associate Software Engineer to join our Technology organization supporting the Pharmacy line of business. This role is ideal for an early-career engineer who is excited to build foundational data and software skills while contributing to solutions that support pharmacy initiatives....

SummaryProvides direction and guidance to customer service claims processing and/or appeals staff for multiple operational areas.DescriptionLogistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.Location: This position is full-time (40-hours/week) Monday-Friday in...

Job DetailsRevenue Cycle Representative IIJob Description The Revenue Cycle Representative II is responsible for ERA and EFT enrollment to ensure accurate reimbursement operational efficiency and compliance across the revenue cycle.Essential Functions Interacts with co-workers visitors and other sta...

Summary of Responsibilities:The Durable Medical Equipment (DME) Coodinator is responsible for fitting patients with prescribed orthopedic braces and other durable medical equipment. This role involves direct patient interaction equipment management and coordination with clinical and administrative t...

Job Title: Systems Analyst 2Category: Applications / Software Development Location: Austin TX 78751 Work Model: Hybrid (3 days remote 2 days onsite Monday & Tuesday; subject to change) Interview Mode: Microsoft TeamsEstimated Hours: Up to 696 hoursPosition OverviewWe are seeking an experienced Syst...

Department: ITLocation: 7070 American Veterans Parkway Middleburg Heights OH 44130 Hybrid schedule - 2 days onsite per week if living within commutable distanceSalary: $75k-$85kBuilt on a foundation of service and technology Quadax has grown to become a leader in the healthcare industry. Our...

The work we do matters!Hiring Agency:Health & Human Services - Agency 25Location: Lincoln NEHiring Rate:$31.567Job Posting:JR2026- MMIS Business Analyst Team Lead (Open)Applications No Longer Accepted On (If no date is displayed job is posted as open until closed):0Job Description:Nebraska DHHS is s...

INDUSTRIAL COMMISSIONAre you ready to work for an exceptional state agency that works to protect the life health and welfare of the employees in the State of Arizona Apply with us! The Industrial Commission of Arizona (ICA) is committed to the highest standards of compliance demonstrating leadership...

Stop Loss Underwriting Specialist Work from home within Oregon Washington Idaho or UtahBuild a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.Who We Are Looking For:Every day Cambias dedicated team of Stop Loss Underwriting Specialists...

Site: Mass General Brigham Health Plan Holding Company Inc.Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and com...

AgencySafetyDivision Dept of Public SafetyJob Classification TitleLaw Enforcement Program Specialist (S)Position NumberGradeNC15About UsThe Department of Public Safetys mission is to safeguard and preserve the lives and property of the people of North Carolina through preparation prevention and prot...