Claims Processing Jobs in USA

DescriptionJob SummaryThe Billing Specialist I is responsible for performing insurance claim processing billing and follow-up to ensure timely and accurate reimbursement. This position serves as the primary contact for insurance companies and other payers researching and resolving claim issues while...

EDW Medicaid Subject Matter Expert/Data Specialist (Federal Reporting) Primary Responsibilities: Provide direction guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations. With the specialized knowledge of the Medicaid and Childrens...

Role Brief:We are looking for Forward Deployed AI Engineers (FDEs) to partner with one of the largest healthcare payers in the U.S. to redefine business processes using AI and agentic workflows.This role goes beyond traditional engineering. You will work directly with business and technology teams t...

Virginia Union University (VUU) is a distinguished private institution founded in 1865 that proudly upholds a legacy of academic excellence and community engagement. With a historic 86-acre campus it offers a dynamic and nurturing environment for its 1568 undergraduate and graduate students. Virgini...

To be considered for this position you must complete the state application and attach all required documents through the Montana State Careers site at .The Montana Department of Public Health and Human Services (DPHHS) has a career opportunity within the Public Health and Services Division in Helena...

Interested in joining a growing company where you will work with talented colleagues enhance a supportive and energetic culture and be part of the climate solution At Energy Solutions we focus on the big impacts. And we believe that market-based programs can be a powerful force to deliver large-scal...

SummaryThe Authorizations Representative is responsible for obtaining written electronic and telephone prior authorizations as requested by insurance payers/providers for our patients within established timeframes and guidelines. This position also completes data entry and provider notification to e...

Help us change livesAt Exact Sciences were helpingchange how the world prevents detects and guides treatment for cancer. We give patients and clinicians the clarity needed to make confident decisions when they matter most. Join our team to find a purpose-driven career an inclusive culture and robust...

The Opportunity: We are seeking an HR Benefits Administrator for our client the Faison Center. Located in Richmond Virginia the Faison Center is a non-profit educational and treatment center providing autism services to individuals and families impacted by autism. Position Summary: The HR Benefits A...

Job Summary (List Format): - Lead implementation and optimization of EDI 837 and proprietary healthcare claims files for multiple health plans - Analyze existing claims data to identify issues and perform root cause analysis to resolve ingestion errors - Recommend and implement process improvements...

Position :: SCB C# Developer Contract to Hire role requires Green Card or U.S. Citizen We are searching for a quality C# developer to program maintain code solutions for our this role you will be required to design write and maintain C# program code for our future and ongoing projects. You will a...

POSITION SUMMARY:The Patient Accounts Representative Manager (PAR Manager) is responsible for the management of Patient Accounts Representatives and Business Services. The PAR Manager is the initial contact for patient employee and physician concerns relating to account information. The PAR Manager...

We areAt Synechron we believe in the power of digital to transform businesses for the better. Our global consulting firm combines creativity and innovative technology to deliver industry-leading digital solutions. Synechrons progressive technologies and optimization strategies span end-to-end Artifi...

SummaryThe Market People Partner serves as a trusted HR advisor and leader for the NAPA People (HR) team in their assigned area to implement high impact people initiatives. Reporting to the Director People they partner closely with leaders to develop strategic alignment and guidance on core People f...

We are seeking an experienced MuleSoft Integration Developer with a strong background in healthcare (specifically health plan environments) to join our growing integration engineering this role you will design build and maintain API-led connectivity solutions that power critical business and clinic...

Employment Type:Part timeShift:Description:Casual position to cover weekends and vacationPosition Purpose: Retail Pharmacy Technician within the scope of the Ohio Administrative Code will provide timely accurate cost effective and patient-centric pharmaceutical care under the direct supervision of a...

Our CompanyPharMericaOverviewJoin our PharMerica team! PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer anon-retail pharmacy environment. Our organization is in high growth mode which means advan...

The Phia Group is a service- oriented organization assisting employee health plans nationwide. We provide our clients with innovative cost-cutting solutions and constantly expanding service offerings. We continue to enjoy growth thanks to our most valuable resource our talented and committed team.A...

Employment Type:Full timeShift:Day ShiftDescription:POSITION PURPOSEWork 100% Onsite in Davenport Iowa(Pay Range: $17.1538-$25.7307)Performs day-to-day billing and follow-up activities within the revenue operations of an assigned Patient Business Services (PBS) location. Serves as a member of the bi...

The Phia Group is a service- oriented organization assisting employee health plans nationwide. We provide our clients with innovative cost-cutting solutions and constantly expanding service offerings. We continue to enjoy growth thanks to our most valuable resource our talented and committed team.A...