High-Dollar Claims & DRG Integrity Specialist
Brighton Health Plan Solutions, LLC
Brighton Health Plan Solutions, LLC is seeking a High Dollar Specialist to review high dollar claims for accurate billing, pricing and adjudication, supporting the Quality Department and coordinating with internal and external stakeholders. The role requires expertise in DRGs, hospital billing, and drug reimbursement methods, with strong communication, organization, and independent work abilities. #J-18808-Ljbffr Brighton Health Plan Solutions, LLC
- ...the Role Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high dollar claims for appropriate and accurate billing, pricing and adjudication... ..., units billed for drugs and procedures. Review DRG for accuracy as compared to billed procedures,...Claims
- ...The Role Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high dollar claims for appropriate and accurate billing, pricing and adjudication... ..., units billed for drugs and procedures Review DRG for accuracy as compared to billed procedures,...ClaimsFlexible hours
- Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high-dollar claims for accurate billing, pricing, and adjudication. This role supports... ...has significant facility-based billing experience, DRG expertise, and 3-5+ years in coding and claims...Claims
- Brighton Health Plan Solutions is seeking a High Dollar Specialist to review high dollar claims for accurate billing, pricing and adjudication. This role contributes... ...stakeholders. Responsibilities include verifying DRG accuracy, validating procedures and charge items, and...Claims
$44.65k - $60k
...Posting Open Date: 06/30/2026 Application Deadline: 07/14/2026 Position Type: Permanent Staff (SHRA) Position Title: High Voltage Dist Specialist - Contributing Working Title: Power Line Technician Position Number: 00031159, 00036012 Vacancy ID: P021157 Hours per...SuggestedPermanent employmentFull timePart timeFor contractorsRelocation packageMonday to FridayNight shift$21 - $33 per hour
...Coding Specialist Job Category: Patient Financial Services Requisition Number: CODIN001229 Posted... ...databases # Ensure the accuracy and integrity of medical record abstract data prior to billing interface and claims submission. # Code outpatient, emergency department...ClaimsFull timeRemote workFlexible hoursShift work$500 per month
...excellent experience for guests? As the Deli Specialist , you willprovidedeli department... ...experience whilemaintainingoperational integrity. You willsupportdeli inventory accuracy,... ...years of age. Preferred Qualifications: High school diploma or equivalent. Retail, culinary...Seasonal workFlexible hoursAfternoon shift$64k - $68k
...Staff (SHRA) Position Title Human Resources Specialist - Advanced Salary Grade Equivalent NC09... ..., innovative work processes and high-quality customer service. Benefits The Benefits... ...review, while maintaining the integrity of leave records and promoting compliance...Permanent employmentFull timePart timeLive inWork at officeRemote workMonday to FridayFlexible hoursAfternoon shift- POSITION SUMMARY Eventus WholeHealth delivers an integrated model of care to adults who reside in skilled nursing, assisted living facilities... ...operations of Eventus. EDUCATION AND/OR CERTIFICATIONS High School Degree required. Associates degree or equivalent work experience...Work experience placementWork at officeLocal areaMonday to FridayFlexible hours
$22.66 - $30.66 per hour
...Flexibility: Field-based As an Endoscopy OnSite Specialist, you will play an essential role in... ...using independent judgment to maintain high service reliability and reduce downtime.... ...up Stryker towers, booms, lights, and integrated suite systems per surgeon preference....Hourly payFor contractorsWork experience placementWork at officeImmediate startFlexible hoursNight shiftWeekend work- ...2 offices who plan, design, and deliver high-performance, innovative, holistic engineering... ...and award-winning projects. As a BIM Specialist I/II in our Chapel Hill office, you will... ...and development, as well as project integration of BIM services. Expertise of our most...Work at officeFlexible hours
$18.12 - $25.51 per hour
...duties, including but not limited to, working outstanding insurance claims follow up for no response from payors, and/or claim denials.... ...Productivity and Quality standards. Education Requirements: High School Degree Licensure/Certification Requirements: None...ClaimsHourly payFull time$50.31k - $67.61k
...Dental Biller is responsible for the accurate and timely billing, claims processing, payment posting, and collections activities for... ...operations. Other duties, as assigned. Qualifications Education: High school diploma or equivalent. Associate degree in healthcare administration...ClaimsTemporary workWork at officeLocal areaMonday to Friday- ...process Work both retail and insurance claim projects, including meeting with... ...Represent the company with professionalism and integrity Work company-provided leads while also... ...opportunity employer committed to building a high-performing team aligned with our core...ClaimsBase plus commissionWeekly payFor contractorsRemote workMonday to FridayFlexible hoursWeekend workAfternoon shift
- ...Manage supplier communication, issue resolution, and return or claim processes.Identify and evaluate new suppliers to expand... ...preferred.Professional certification (CPPM or similar) preferred.High level of integrity, accountability, and attention to detail.Why Join Us?Be part...ClaimsFull timeContract workH1b
- ...a Utilization Management Representative I, offering remote work with in-person training. Responsibilities include managing service claims, ensuring contract eligibility, and maintaining customer relations. Candidates must have a HS diploma or GED, with preferred experience...ClaimsRemote jobContract workFlexible hours
$17 - $25 per hour
...required documentation. Tracks and processes claims by returning damaged goods; handling... ...procedures, and standards of ethics and integrity by implementing related action plans;... ...Sam's Club facilities. Programs range from high school completion to bachelor's degrees,...ClaimsHourly payMinimum wageFull timeTemporary workPart time- Vitreo-Retinal Specialist/Clinician Scientist (Open Rank Faculty) Working Title: Vitreo-Retinal Specialist... ...learning within innovative and integrated curricula and team‑oriented interprofessional education to ensure a highly skilled workforce. Research: We develop and...Permanent employmentFull timePart timeFixed term contractLive inLocal area
- ...A leading insurance claims adjusting firm in Carrboro, North Carolina seeks Independent Insurance Claims Adjusters to join their team. The role offers the chance to make a meaningful impact while enjoying flexibility and competitive compensation. Candidates will be trained...ClaimsFlexible hours
- ...A national insurance claims adjustment firm is seeking Independent Insurance Claims Adjusters in Chapel Hill, NC. This opportunity is perfect for those ready to embark on a rewarding career path, helping others recover from disasters. The firm offers comprehensive training...ClaimsFlexible hours
$60k
...disciplined approach built on knowledge, integrity, and lasting trust. Our Core Values... ...and adjusters as needed throughout the claims process. Collect payment for... ...various conditions. What We Offer High earning potential Average reps earn $60K+...ClaimsLocal areaFlexible hoursWeekend workAfternoon shift$61.04k - $82.37k
...Conducts worksite job safety analysis, administrative and engineering controls, and hazard assessments in all work areas. Reviews claim loss runs and conducts analytical analysis of trends to identify appropriate workers’ compensation and safety program needs. Develops...ClaimsFull timeLocal area- ...The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and... ...light store equipment. Fluency in multiple languages (Spanish is highly desired). Total Compensation Package Competitive Wages & Paid...Local areaImmediate startFlexible hours
- ...Energy is a privately owned, vertically integrated renewable energy company headquartered in... .... Position Summary The Accounts Payable Specialist owns day‑to‑day invoice entry, matching,... ...AP knowledge and skills. Qualifications High school diploma or equivalent required. 0...
- ...building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. This is an entry level position...Full timeWork experience placementWork at office
- ...activities and enhancing client experiences. Successful candidates will have effective communication skills, a strong sales background, and the ability to nurture client relationships. A high school diploma is required, and a degree in business is preferred. #J-18808-Ljbffr...
- ...building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. This is an entry level position...Full timeWork experience placementWork at office
$20 - $22 per hour
...property, guide potential residents through the leasing process, and serve as a problem-solving resource. Candidates should have a high school diploma, valid driver's license, and ideally, leasing experience. This position offers competitive pay between $20 to $22 per...Hourly pay$85k - $159k
...place. We are seeking a Pitch and Proposal Specialist to join K&L Gates. Candidates must be... ...business services teams to develop persuasive, high-quality submissions that differentiate... ...pursuit materials, maintain content integrity, and leverage firm experience,...Temporary workLocal areaRemote workRelocationFlexible hours- ...Humanity of Orange County (Orange Habitat) is seeking a Grants Specialist to join the Development Department and support the organization... ...). Strong writing and editing skills with attention to detail. Highly organized with the ability to manage multiple deadlines and priorities...Full timeInternshipWork at officeLocal area
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