Claims Management Specialist Jobs

Senior Manager, Software Development Engineering (Claims Adjudication) — TX - Richardson. Apply via Workday.

Become a part of our caring community Humana is committed to helping people achieve their best health by delivering innovative technology solutions that enable exceptional member and provider experiences. The Director, Segment Quality Engineering is a strategic technology leader…

Who we are About Stripe Stripe's mission is to increase the GDP of the internet. We build the most powerful and flexible tools for running an internet business — handling billions of dollars each year and enabling millions of businesses worldwide to scale faster by building on…

Position Summary The Senior Analyst, Compliance COE will be a key member of the Compliance Monitoring team and will execute assigned compliance monitoring activities. This role applies healthcare compliance, billing, coding, and risk adjustment knowledge to execute assigned…

Become a part of our caring community The Product Manager, Workflow Solutions is responsible for the strategy, roadmap, and performance of provider-facing workflow products delivered through EHR platforms. This role owns the Claims Status and Happy Together with Health Plans…

Data Scientist II, Cohere Health, Inc., Boston, Massachusetts (Remote) Duties: Gather business requirements and apply trend analysis to identify actionable insights using analytic tools. Analyze healthcare claims and authorization data to identify outliers, interpret patterns,…

End to end responsible for: • budget governance and cost predictability by driving planning, reforecasting and variance controls across SBUs/projects. • cost-to-complete and contingency discipline with early-warning insights to protect margins and cashflows. • financial impact…

Help leading insurers rethink how underwriting, claims and operations work The Role Capco is growing its Insurance practice in Hong Kong and is looking for a Principal Consultant to lead transformation initiatives with major Life, Health and General Insurance clients across Hong…

BILLING INDUSTRY Employment is expected to grow faster than average. Job prospects is very good; persons with a strong background in medical billing and coding will be particularly high demand. PLACEMENTS & PAY DETAILS FOR TRAINED After successful completion of the Training job…

PLACEMENTS & PAY DETAILS FOR TRAINED After successful completion of the Training job offer will be provided in Leading MNC's. Placements will be in Chennai. 9500/- to 12000/- PM initially with assured career growth (Excluding Special Allowances & Other Benefits). For further…

A Licensed Surveyor assesses damaged property (primarily vehicles, equipment, or commercial assets) to determine the cause, extent, and financial cost of loss for insurance claims. An active Insurance Regulatory and Development Authority of India (IRDAI) License is mandatory for…

Job Title Senior Global Product Manager Acute PI Job Description Senior Global Product Manager – Acute Patient Interfaces will lead the global Acute Patient Interfaces portfolio, translating hospital and acute-care customer needs into portfolio strategy, lifecycle priorities,…

As a Clinical Claim Review Nurse you will be responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems and uses clinical decision making to apply appropriate clinical…

Position Summary As a Senior Investigator you will conduct high level, complex investigations of known or suspected acts of healthcare fraud and abuse. Routinely handles cases that are sensitive or high profile, those that are complex cases involving or cases involving multiple…

Position Summary The Senior Integrated Service Specialist serves as the primary point of contact for customers seeking assistance with claims-related inquiries. This role is responsible for providing clear and accurate information regarding claims submissions, status updates,…