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"remote technical systems analyst healthedge claims adjudication" in "None"

Claims System Configuration Quality Review Senior Analyst - eviCore - Remote

CIGNA Franklin Tennessee United States
(No Timezone Provided)

Do you want to Drive Growth and Change Lives? EviCore, a division of the Cigna Group is hiring a Claims Systems Configuration Quality Review Senior Analyst. This role requires the review of our claims system to ensure all configurations were input correctly per the specifications of the provider. Th...

REMOTE Claims Analyst

Insight Global Clackamas Oregon United States
(No Timezone Provided)

A large healthcare client is looking for a Claims Analyst to work REMOTELY on their configuration and support team. This team is fully responsible for end-to-end operational performance of core business systems utilized by internal operations staff and insurance customers. These responsibilities inc...

Wfh claims administrator

Randstad Laguna Woods California United States
(No Timezone Provided)

REMOTE CLAIMS ADMINISTRATOR - WFH IN PACIFIC TIME Do you want to be part of a Company that helps people achieve lifetime financial security and live healthier lives worldwide? While working from the comfort of your home? If you have Claims experience this is your opportunity. APPLY NOW and join us....

Remote Audit Senior Consultant

CSI Companies Irving Texas United States
(No Timezone Provided)

The CSI Companies is actively seeking a Remote Audit Senior Consultant for our well known client, an accounting organization and one of the largest professional service networks in the world. The CSI Companies understands that an attractive benefits package is important for recruiting above-average...

Remote Audit Senior Consultant

CSI Companies Irving Texas United States
(No Timezone Provided)

The CSI Companies is actively seeking a Remote Audit Senior Consultant for our well known client, an accounting organization and one of the largest professional service networks in the world. The CSI Companies understands that an attractive benefits package is important for recruiting above-average...

Remote SQL Data Analyst

Saxon Global Eden Prairie Minnesota United States
(No Timezone Provided)

Job Description Job Description Must understand Medicaid EligibilityMaybe previous state of Maryland job experienceMedicaid enrollmentAble to query very complex data setsArticulate to the businessWork very closely with the customerRetro eligibilityEx. State makes people eligible into the pastThen ma...

Provider Installation Administrator, Load Analyst - Remote

UnitedHealth Group Moline Illinois United States
(No Timezone Provided)

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and...

Provider Installation Administrator, Load Analyst - Remote

UnitedHealth Group Atlanta Georgia United States
(No Timezone Provided)

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and...

Senior Data Analyst - Remote (Anywhere US)

Change Healthcare None Arkansas United States
(No Timezone Provided)

Plans, conducts, and directs the analysis of both internal and external business problems to be solved with automated systems. Works with clients to develop analyses for the purpose of pre-sale software evaluation, claims editing optimization, or ad hoc reporting. Leads analytic engagements for a...

Senior Data Analyst - Remote (Anywhere US)

Change Healthcare Washington District of Columbia United States
(No Timezone Provided)

Plans, conducts, and directs the analysis of both internal and external business problems to be solved with automated systems. Works with clients to develop analyses for the purpose of pre-sale software evaluation, claims editing optimization, or ad hoc reporting. Leads analytic engagements for a...

Senior Data Analyst - Remote (Anywhere US)

Change Healthcare Wyoming Iowa United States
(No Timezone Provided)

Plans, conducts, and directs the analysis of both internal and external business problems to be solved with automated systems. Works with clients to develop analyses for the purpose of pre-sale software evaluation, claims editing optimization, or ad hoc reporting. Leads analytic engagements for a...

Senior Data Analyst - Remote (Anywhere US)

Change Healthcare None Ohio United States
(No Timezone Provided)

Plans, conducts, and directs the analysis of both internal and external business problems to be solved with automated systems. Works with clients to develop analyses for the purpose of pre-sale software evaluation, claims editing optimization, or ad hoc reporting. Leads analytic engagements for a...

Senior Data Analyst - Remote (Anywhere US)

Change Healthcare None Washington United States
(No Timezone Provided)

Plans, conducts, and directs the analysis of both internal and external business problems to be solved with automated systems. Works with clients to develop analyses for the purpose of pre-sale software evaluation, claims editing optimization, or ad hoc reporting. Leads analytic engagements for a...

Senior Claims Examiner (Remote)

UST Columbus Ohio United States
(No Timezone Provided)

Job Description Senior Claims Examiner/Auditor UST HealthProof is looking for Sr. Claims Examiner, reporting to the Claims Team Leader; the Examiner is responsible for the adjudication of healthcare claims utilizing group and payer-specific policies and procedures. Responsible for reviewing the...

Remote Reimburse Admin (Must Have Medical Coding)

Aston Carter West Des Moines Iowa United States
(No Timezone Provided)

Description:+ Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.+ Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies,...

Technical Product Owner - REMOTE

MATRIX Resources Atlanta Georgia United States
(No Timezone Provided)

We are seeking a Product Owner / Business Analyst who will be responsible for documenting process flow and requirements for our healthcare insurance claims adjudication application. In this role, you will be working with key architects, engineers and business partners to ensure that business, quali...

Manager, Medical Claim Adjustments (Medicaid) (remote)

Conduent Florham Park New Jersey United States
(No Timezone Provided)

Job Description About Conduent Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them. You hav...

Data Analyst - Risk Adjustment - Remote

PopHealthCare, LLC Tempe Arizona United States
(No Timezone Provided)

Company DescriptionAt PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people!Job DescriptionAt PopHealthCare, our mission is simple - to lead the effort in reimagin...

Remote Claims Adjudicator - Temp

NTT DATA Services Tampa Florida United States
(No Timezone Provided)

Job DescriptionIn this Role you will be Responsible for :• Reviewing and researching insurance claims to determine possible payment accuracy.• Validating Member, Provider and other Claims information.• Determining accurate payment criteria for clearing pending claims based on defined Policy and Proc...

Remote Claims Adjudicator - Temp

NTT DATA Tampa Florida United States
(No Timezone Provided)

In this Role you will be Responsible for :• Reviewing and researching insurance claims to determine possible payment accuracy.• Validating Member, Provider and other Claims information.• Determining accurate payment criteria for clearing pending claims based on defined Policy and Procedure.• Coordin...

Revenue Cycle Management Analyst (Remote)

Everside Health Charlotte North Carolina United States
(No Timezone Provided)

Essential Duties & Responsibilities • Process encounters and post charges daily.• Verifies completeness and accuracy of all claims prior to submission to carriers and clearing houses• Communicate with clinic staff to ensure proper coding of records prior to submission• Review file data batches and s...

REMOTE Reimbursement Admin

Aston Carter Phoenix Arizona United States
(No Timezone Provided)

Description:This position will be 100% remote Daily Duties:Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. Reviews company specific, CMS specific, and competitor specif...

Associate Claims Business Analyst - Irvine, CA or Telecommute

UnitedHealth Group Irvine California United States
(No Timezone Provided)

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care dat...

Business Analyst II/ Remote (Denver, CO) 7 mth+ contract

Suncap Technology, Inc. Denver Colorado United States
(No Timezone Provided)

Job Description Must be local to Colorado. Remote work. (Must move to CO if not in CO) BA positions are responsible for implementing system changes for the PBMS, Business Intelligence Data Management (BIDM) and Colorado Interchange (iC) related to prescription drug benefits. They will demonstrate ex...

Senior Provider Installation Admin - Remote or Nashville, TN

UnitedHealth Group Nashville Tennessee United States
(No Timezone Provided)

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and...

Senior Provider Installation Admin - Remote or Nashville, TN

UnitedHealth Group Atlanta Georgia United States
(No Timezone Provided)

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and...

REMOTE Senior .Net Developer

Insight Global Beaverton Oregon United States
(No Timezone Provided)

-Working as an effective team member in an Agile Scrum or Kanban team.-Providing technical expertise and mentoring to their fellow Agile team members and members of other teams.-Gather and analyze complex business requirements.-Specify and implement technical plans for complex solutions.-Combine bus...

REMOTE Reimbursement Admin

Aston Carter Orlando Florida United States
(No Timezone Provided)

Description:This position will be 100% remote Daily Duties:Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria. Reviews company specific, CMS specific, and competitor specif...

RPG Technical Lead-Hartford, CT/Remote

Georgia IT Inc. Hartford Connecticut United States
(No Timezone Provided)

RPG Technical Lead Location: Hartford, CT/Remote Duration: Contract Rate: DOE     US Citizens and Green Cards Preferred. No Third party Corp to Corp   What You Will Do: Provide leadership and direction to the development team. Lead status meetings with the development and manageme...

Claims Quality Analyst - Remote - 2020241

UnitedHealth Group Dallas Texas United States
(No Timezone Provided)

You’ll enjoy the flexibility to telecommute* from anywhere within the The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it’s reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and...

Associate Claims Business Analyst - Irvine, CA or Telecommute

UnitedHealth Group Irvine California United States
(No Timezone Provided)

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care dat...

Data Analyst - Risk Adjustment - Remote

PopHealthCare Fort Worth Texas United States
(No Timezone Provided)

Company DescriptionAt PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people!Job DescriptionAt PopHealthCare, our mission is simple - to lead the effort in reimagin...

Data Analyst - Risk Adjustment - Remote

PopHealthCare Fort Worth Texas United States
(No Timezone Provided)

Company DescriptionAt PopHealthCare, our mission is simple - to lead the effort in reimagining how healthcare is delivered. We are bold innovators, dedicated to making a difference and we hire wicked smart people!Job DescriptionAt PopHealthCare, our mission is simple - to lead the effort in reimagin...

Bill Review Analyst - Remote Schedule

Paradigm Management Services L Walnut Creek California United States
(No Timezone Provided)

About ParadigmParadigm is an accountable care management organization focused on improving the lives of people with complex and catastrophic injuries and diagnoses. We have been a pioneer in value-based care since 1991, offering deep clinical expertise, high-value specialty networks, behavioral heal...

Bill Review Analyst - Remote Schedule

Paradigm Management Services L Lombard Illinois United States
(No Timezone Provided)

About ParadigmParadigm is an accountable care management organization focused on improving the lives of people with complex and catastrophic injuries and diagnoses. We have been a pioneer in value-based care since 1991, offering deep clinical expertise, high-value specialty networks, behavioral heal...

Senior IT Project Manager/REMOTE (Contract-to-hire to $60/hour)

Novus Group Pittsburgh Pennsylvania United States
(No Timezone Provided)

The Senior IT Project Manager defines, plans, and delivers of complex programs that require cross-functional collaboration and management of inter-dependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget. Includes the management of a...

Claims Business Analyst - Irvine, CA or Telecommute

United Health Group Inc. Irvine California United States
(No Timezone Provided)

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care dat...

Denials Specialist - Remote

Tenet Healthcare Frisco Texas United States
(No Timezone Provided)

Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIES - Include the following. Others may be assigned. Val...

Contract Management Analyst - Net Down Team (REMOTE).

Shared Services Center - Nashville Nashville Tennessee United States
(No Timezone Provided)

Job Description The Analyst is responsible for accurately coding, testing and maintaining managed care contracts from assigned facilities into the contract management system in conformance with the language of the legal document. The Contract Analyst also works with expression building tools a...

Regulatory Affairs Analyst

CareerBuilder Los Angeles California United States
(No Timezone Provided)

Los Angeles , CA | Work from home flexibility Posted: 03/13/2024 Industry: Laboratory - Food & Beverage Job Number: 73.24KK Pay Rate: 90,000 - 105,000 Experience: Job Description Regulatory Affairs Analyst The Regulatory Affairs (RA) Analyst is responsible for ensuring compliance of raw material doc...

Senior Claims Examiner (Remote)

UST Columbus Ohio United States
(No Timezone Provided)

Senior Claims Examiner/Auditor UST HealthProof is looking for Sr. Claims Examiner, reporting to the Claims Team Leader; the Examiner is responsible for the adjudication of healthcare claims utilizing group and payer-specific policies and procedures. Responsible for reviewing the data in the claims...

Senior Claims Examiner (Remote)

UST Global Columbus Ohio United States
(No Timezone Provided)

Senior Claims Examiner/AuditorUST HealthProof is looking for Sr. Claims Examiner, reporting to the Claims Team Leader; the Examiner is responsible for the adjudication of healthcare claims utilizing group and payer-specific policies and procedures. Responsible for reviewing the data in the claims pr...

Quality Control Specialist - Remote - 2021070

UnitedHealth Group Hartford Connecticut United States
(No Timezone Provided)

You’ll enjoy the flexibility to telecommute* from anywhere within the Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join u...

Quality Control Specialist - Remote - 2021070

UnitedHealth Group Dallas Texas United States
(No Timezone Provided)

You’ll enjoy the flexibility to telecommute* from anywhere within the Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join u...

Billing Representative - Work From Home

UnitedHealth Group Atlanta Georgia United States
(No Timezone Provided)

If you are located in Norristown, PA you will have the flexibility to telecommute* as you take on some tough challenges.Healthcare isn't just changing. It's growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it ...

Billing Representative - Work From Home

UnitedHealth Group Norristown Pennsylvania United States
(No Timezone Provided)

If you are located in Norristown, PA you will have the flexibility to telecommute* as you take on some tough challenges.Healthcare isn't just changing. It's growing more complex every day. ICD - 10 Coding replaces ICD - 9. Affordable Care adds new challenges and financial constraints. Where does it ...

Claims Examiner - Workers Compensation - Remote Nationwide

Sedgwick None null United States
(No Timezone Provided)

PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and spec...

Remote Texas Experienced Claims Level III Adjuster (Houston)

Elephant Insurance Services, LLC. Houston Texas United States
(No Timezone Provided)

** Remote Texas Experienced Claims Level III Adjuster****Job Category****:** Claims **Requisition Number****:** EXPER001447 Showing 1 location **Job Details****Description****About Our Texas Experienced Claims Level III Adjusters:**Level III Claims Adjusters at Elephant are our mid to senior level c...

Remote Texas Experienced Claims Level III Adjuster (Dallas)

Elephant Insurance Services, LLC. Dallas Texas United States
(No Timezone Provided)

** Remote Texas Experienced Claims Level III Adjuster****Job Category****:** Claims **Requisition Number****:** EXPER001447 Showing 1 location **Job Details****Description****About Our Texas Experienced Claims Level III Adjusters:**Level III Claims Adjusters at Elephant are our mid to senior level c...

Remote Texas Experienced Claims Level III Adjuster (San Antonio)

Elephant Insurance Services, LLC. San Antonio Texas United States
(No Timezone Provided)

** Remote Texas Experienced Claims Level III Adjuster****Job Category****:** Claims **Requisition Number****:** EXPER001447 Showing 1 location **Job Details****Description****About Our Texas Experienced Claims Level III Adjusters:**Level III Claims Adjusters at Elephant are our mid to senior level c...