Remote TPA Claims Lead - Medicaid & Data
$68.8k - $94kPublic Consulting Group
- Remote job
A consulting firm is seeking a TPA Claiming Lead in Albany, NY to lead claims management operations within the School-Based Services team. The ideal candidate will have strong data analysis, communication, and leadership skills. Responsibilities include overseeing claims, managing a team, analyzing claims for accuracy, and training staff. A Bachelor's degree and 6+ years of experience in claims management, particularly in Medicaid, is preferred. This position is remote with a compensation range of $68,800 - $94,000. #J-18808-Ljbffr Public Consulting Group
- A leading public sector solutions firm is seeking a TPA Claiming Lead to oversee claims management within the Education sector.... ...relationships. The role requires strong data analysis skills, effective... ...and a thorough understanding of Medicaid policies. This position supports...Remote jobDataClaims
- A leading public sector solutions firm in Raleigh is seeking a TPA Claiming Lead to manage claims operations and develop a consistent... ..., and a deep understanding of Medicaid policies. The successful candidate... ..., ensure accuracy of claims data, and collaborate closely with...Remote jobDataClaims
$68.8k - $94k
A leading public sector solutions provider is seeking a TPA Claiming Lead in Boston, MA. This role involves overseeing claims management... ...team, ensuring adherence to Medicaid policies, and providing... ...background in claims analysis, data management, and project management...Remote jobDataClaims$68.8k - $94k
A leading public sector solutions firm is seeking a TPA Claiming Lead in Washington, DC to manage claims operations within the education sector. The role involves... ..., leading a team, and ensuring compliance with Medicaid policies. Candidates should have 6+ years of claiming...Remote jobDataClaims$68.8k - $94k
LE10 Public Consulting Group LLC (Education) is seeking a TPA Claiming Lead responsible for directing claims management within the School-... ...has 6+ years of claiming experience and strong knowledge of Medicaid policies. Compensation ranges from $68,800 to $94,000, with...Remote jobDataClaims$68.8k - $94k
A public sector solutions firm is seeking a TPA Claiming Lead in Oklahoma City. You will lead claims management efforts and collaborate across... ...experience, strong leadership capabilities, and excellent data analysis skills. The position requires effective communication...Remote jobDataClaims$68.8k - $94k
A public sector solutions firm located in Providence, RI, is looking for a TPA Claiming Lead to oversee claims management within the School-Based Services sector. The candidate will ensure efficiency and compliance in TPA claiming processes, supervise staff, and work closely...Remote jobDataClaims$68.8k - $94k
A leading public sector solutions firm is seeking a TPA Claiming Lead to oversee claims management and ensure the accuracy of TPA processes. This role requires at... ...stakeholders. The TPA Claiming Lead will work remotely and will need to understand both federal and state...Remote jobDataClaims$100.14k - $150k
...are currently seeking a Medicaid Enterprise Architect to... ...will assist the (Lead) Medicaid Enterprise Architect... ...business, application, data, integration,... ...engagement. The position is remote, with the possibility of... ...plan data management, claims and encounter data....Remote workDataClaimsTemporary workFlexible hours- ...Description Job Description Medicaid Business / QA Analyst ~7–12+ Month Contract | Remote | No ThirdParty Firms | Medicaid... ...matter expert (SME) for Medicaid data and processes while performing... ...program knowledge—eligibility, claims, encounters, provider enrollment...Remote workDataClaimsContract work
$68.8k - $94k
Position Overview The TPA Claiming Lead will lead all efforts of the TPA Claiming... ...and integrating claims, data and project management to... ...Understand Federal, State, and local Medicaid policies and lead continuous... ...and government agencies. Remote office setting; overtime and...Remote workDataClaimsH1bWork at officeLocal area- TPA Supplemental Products Team Lead (Health Insurance) Join to apply for the TPA Supplemental... ...products insurance claims to ensure that claims are... ...accuracy and authenticity of data between claims systems, eligibility... ...Office). Work Schedule & Remote Work Full-time, remote...Remote workDataClaimsFull timeWork at officeWork from homeHome office
$68.8k - $94k
...Group LLC (PCG) is a leading public sector solutions... ...Learning Solutions Data Systems IT Solutions... ...Recovery Services The TPA Claiming Lead will lead all efforts... ..., State, and local Medicaid policies as they pertain... ...Office Setting- Remote The above is intended...Remote workDataClaimsFor contractorsH1bWork at officeLocal area- Molina Healthcare is seeking a Lead Business Analyst to enhance health... ...payment integrity and provider claims accuracy. The ideal candidate... ...organization, is proficient in data analysis, and has a solid understanding of Medicare and Medicaid programs. A competitive...Remote jobDataClaims
- ...Job Title This is a remote position. We are seeking... ...Solution Architect Lead to design, configure, and... ...Medicare Advantage (MA) and Medicaid Architect and... ...workflows to ensure accurate claims adjudication and... ...depth knowledge of Facets data architecture and underlying...Remote workDataClaims
$83.25k - $155.51k
Molina Healthcare is seeking a Lead Analyst for health plan payment integrity in Columbus... ...operational initiatives and analyzing claims data to improve financial performance and... ...business analyst experience, knowledge of Medicaid/Medicare, and strong data analysis skills...Remote jobDataClaims- ...seeking an experienced professional to lead analytics and machine learning... ...of 5 years’ experience in Medicaid and healthcare claims analysis. The position offers flexibility with remote work options and aims to apply advanced data analysis techniques for impactful...Remote jobDataClaims
- ...deliver clinically excellent, data-driven care - at scale. Brellium... ...Prior experience as a Coding Lead, Coding Manager, or senior... ...stakeholders Familiarity with Medicaid and commercial payer... ...aware of fraudulent job offers claiming to be from Brellium. All legitimate...Remote workDataClaims
- ...Medicaid Subject Matter Expert This position is a Medicaid Subject Matter Expert for the Enterprise Data Warehouse supporting the State Medicaid program. This role requires significant... ...correct within the system, related to claims, provider, and recipient data....Remote workDataClaims
- Travelers Canada in Boston is looking for a qualified candidate to manage claims and ensure excellence in processes. Responsibilities include guiding TPA partners, monitoring KPIs, and conducting audits while having the opportunity to provide expert insights on claims....DataClaims
- ...This position is open to remote candidates who reside... ...Position Purpose The Coding Lead position is accountable... ..., Business office, Data Integrity department,... ...review and coding-related claim work queues to ensure... ..., including Medicare/Medicaid, private and commercial...Remote workDataClaimsContract workWork at office
$155k - $188k
...Description Lead Programs Counsel, North America Liberty Mutual'... ...across underwriting, distribution, claims, reinsurance, operations, compliance, and data. The attorney in this role will work... ...and other program arrangements, TPA and related services agreements, reinsurance...Remote workDataClaimsPrivate practiceLocal area- Humana is seeking a Supervisor for Encounter Data Management in California. This role... ...ensuring successful submission of data to Medicaid/Medicare and supervising a team to maintain... ...candidate has over 2 years of relevant claims processing experience and strong leadership...Remote jobDataClaimsWork from home
$110k - $140k
...Centers for Medicare & Medicaid Services (CMS), the American... ...where possible. Lead or co-lead development... ...CV) edits, and postpay data-mining concepts across... ...., Coding Insights and Claims Insights) using billing... ...candidate is selected. #LI-JB1 #LI-Remote #seniorRemote workDataClaimsWork at officeImmediate startHome office$147.6k - $196.8k
...Monitoring and Compliance Lead, Healthcare Innovations... ..., sociologists, data scientists, and public... ...Centers for Medicare & Medicaid Services (CMS) and the... ...the position may work remotely within the United States... ...underlying data sources (claims, administrative, practice...Remote workDataClaimsFixed term contractWork experience placementWork at officeLocal area$65k - $88.6k
Humana Inc is seeking an Encounter Data Management Professional to ensure data integrity for claims errors and develop processes for successful submission to Medicaid/Medicare. Candidates should have... ...in root cause analysis. This remote position may require occasional...Remote jobDataClaims- ...Friday, 8:00am - 5:00pm, Remote Role Remote Eligibility... ...follow-up of assigned claims. Processes claim for... ...Blue Cross, Medicare, Medicaid, etc.) and ensures that... ...finance, customer service or data analytics Preferred... ...Inova, Northern Virginia’s leading nonprofit healthcare...Remote jobDataClaimsFull timeMonday to FridayFlexible hoursDay shift
- Humana Inc is seeking an Encounter Data Management Professional to ensure data integrity in claims. This role involves developing... ...encounter submission to Medicaid/Medicare and ensure compliance... ...innovative strategies while offering remote work options and a supportive...Remote jobDataClaims
- ...Health Solutions, LLC is hiring a Claims Quality Analyst to validate Med D, Medicaid, and Exchange claims per regulations... ...include auditing claim data, assisting with monitoring and testing... ...off, and a 401K match. This role is remote except for certain states. #J-1880...Remote jobDataClaims
$147.6k - $196.8k
...economists, sociologists, data scientists, and public... ...and save lives by leading rigorous research and evaluation... ...Centers for Medicare & Medicaid Services (CMS) and the... ...the position may work remotely within the United... ...underlying data sources (claims, administrative, practicebased...Remote workDataClaimsFull timeFixed term contractWork experience placementH1bWork at officeLocal area
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