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LOCATION: Remote
GENERAL STATEMENT OF JOB
Responsible for all accounting functions related to a designated area of physical and behavioral health medical claims processing to ensure that providers receive timely and accurate payment. This position is responsible for claims adjudication through continuous monitoring and quality control measures. Responsibilities include finalizing c...

Duration: 2-3 months contract
Start Date: Feb 9th 2026
Overview
* Under the general direction of the Quality Program Manager(s), the Medical Claims Research Specialist(s) will review medical claims reports to help identify the appropriate medical record(s) and/or provider(s), and document follow-up actions during the HEDIS (Healthcare Effectiveness Data Information Set) reporting per...

The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers' compensation claims under close supervision, supporting the goals of claims department and of CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
* Receives claims, confirms policy coverage and acknowledgement of the claim
* Determines the v...

LOCATION: Remote – This is a home based, virtual position that operates Monday-Friday from 8:30am-5:00pm EST. Vaya Health welcome applications from NC, SC, GA, TN, VA, MD, and FL.
GENERAL STATEMENT OF JOB
Responsible for all accounting functions related to a designated area of physical and behavioral health medical claims processing to ensure that providers receive timely and accurate pay...

AHCCCS
Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork
The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid prog...

Become a part of our caring community and help us put health first
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized at the Initial and Appeals/Disputes level. All work occurs within a context of regulatory compliance, and work...

Become a part of our caring community and help us put health first
The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which m...

The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health servi...

Overview
Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving complex challenges in Health, Defense, and Civilian missions. Our proven Empower AI Platform® provides a practical, sustain...

Employment Type:
Full timeShift:
Description:
POSITION PURPOSE
Work Remote Position
(Pay Range: $16.1738-$24.1614)
Performs day-to-day payment posting reconciliation activities within the hospital revenue operations ($3-5B NPR) of an assigned Patient Business Services (PBS) location. Serves as a member of the Payment Posting team at an assigned PBS location responsible for ensuring accurate ...

Description
Liberty Mutual has an immediate opening for a Complex Claims Specialist to join our Miscellaneous Medical Facilities Unit. This is a high‑visibility, hands‑on role for an experienced professional‑liability claims handler with deep Miscellaneous Medical Facilities (MMF) and Long‑Term Care (LTC) facility PL expertise. With minimal supervision, the Complex Claims Specialist will manag...

Scheduled Hours
40
Position Summary
This position queries providers and works closely with the Pediatrics Coding Supervisors on coder and physician education as Lead Coder. Responsible for meeting with physicians and administrators as requested. Coding Coordinators are a resource to inpatient coders and assist in training new coders. Performs scheduled or Ad Hoc coder audits. Reviews and ...

About IKS Health
IKS Health takes on the chores of healthcare, reducing administrative, clinical, and operational burdens so that staff can focus on their core purpose: delivering exceptional care. Combining pragmatic technology and dedicated experts, IKS enables stronger, financially sustainable enterprises. Our Care Enablement Platform delivers data-driven value and expertise across the car...

Location:
Work from home (Pennsylvania)
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
Yes
Job Summary:
Acts as a leader, liaison, and resource working collaboratively with a diverse group, including management, physicians, clinical and non-clinical personnel utilizing the national correct coding standards, approaches, and industry stand...

Location:
Work from home (Pennsylvania)
Shift:
Days (United States of America)
Scheduled Weekly Hours:
40
Worker Type:
Regular
Exemption Status:
Yes
Job Summary:
Acts as a leader, liaison, and resource working collaboratively with a diverse group, including management, physicians, clinical and non-clinical personnel utilizing the national correct coding standards, approaches, and industry ...

JOB DESCRIPTION Job Summary
Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring claims reprocessing...

Job Description
JOB DESCRIPTION Job Summary
Provides analyst support for claims research activities including reviewing and researching claims to ensure regulatory requirements are appropriately applied, identifying root-cause of processing errors through research and analysis, coordinating and engaging with appropriate departments, developing and tracking remediation plans, and monitoring clai...

LOCATION: Remote
GENERAL STATEMENT OF JOB
The Claims Supervisor administers all accounting functions related to a designated area of physical and behavioral health medical claims processing to ensure providers receive timely and accurate payment. Supervision of claims adjudication through continuous monitoring and quality control measures. Finalize claims processed electronically ...

Job Type
Full-time
Description
Are you ready to make a real difference in healthcare? MIEC is searching for a dynamic Claims professional to join our passionate team and play a pivotal role in protecting medical professionals and advancing patient safety! Whether you step into the role of Claims Analyst or take on the expanded responsibilities of Claims & Patient Safety Specialist, you'll be a...

Description
*Must be located in Oregon*
POSITION SUMMARY:
The Senior Claims Adjuster is responsible for managing complex workers compensation claims and assisting the process of determining benefits due the injured worker, ensure ongoing adjudication of claims within company standards and industry best practices and comply with all statutory and regulatory requirements for the administratio...