Senior Facets Tester - Healthcare Claims & Enrollment
Tekgence
Tekgence inc is seeking a candidate in New York for a healthcare testing role. Applicants should have at least 7-8 years of healthcare experience, specifically in Facets testing various modules including Member Enrollment and Eligibility, as well as Claim Processing. The ideal candidate must also be able to create comprehensive test strategies and plans, while being well-versed in Health Care regulations such as HIPPA, EDI, and x12 data formats. Note: USC, GC, GC_EAD, L2EAD, and H1B can apply for this role. #J-18808-Ljbffr Tekgence
- Job Description At least 7-8 years healthcare experience Experienced in Facets testing different modules Member Enrollment and Eligibility, Claim Processing Good testing concept and able to create test strategy, test plan, test cases and test case execution Well versed...ClaimsH1b
$110k - $150k
Remote Jobs is looking for an Insurance Claims Specialist to manage healthcare-related claims. The ideal candidate will have a valid P&C Brokers' license or adjuster license, along with 7-10 years of experience in the field. Responsibilities include researching policy...SeniorClaimsRemote work- ...need to develop code for the team. Must Have Expertise in Facets (Claims, Provider, Members) Expertise in .NET, SQL, API, Cloud (Azure... ...C#.NET and SQL programming languages. Solid understanding of healthcare payer systems, claims processing, and EDI standards....SeniorClaims
$23.16 - $35.88 per hour
A major healthcare provider is seeking a Stop Loss Claims Analyst who will review, evaluate, and process claims. This role involves building client relationships, analyzing claims, and ensuring compliance with standards. The ideal candidate must have at least 5 years of...SeniorClaimsHourly payWork at office$65k - $95k
...oriented Medical Billing Accounts Receivable Senior Associate to join their Revenue Cycle... ...involves following up with insurance claims, resolving issues, and preparing reports... ...has at least 2-3 years of experience in healthcare accounts receivable, proficiency in Microsoft...SeniorClaimsWork at office- ...strong analytical skills are also required. Knowledge in healthcare membership, provider, claims data as well as familiarity with 834/837 EDI... ...years’ experience in complex healthcare data like Claims, Enrollment, Providers. Previous experience in business intelligence...SeniorClaims
$68.04k - $118.8k
...depth investigations of reported fraud involving the full range of healthcare products. Develop and maintain relationships with law... ...from various sources to review for suspect activity. Review claim files and develop action plans for the investigation. Conduct...SeniorClaimsWork experience placement- RSC Insurance Brokerage, Inc. is seeking a skilled individual to provide ultimate claim service for insurance matters. Responsibilities include receiving loss reports, advocating for clients, and overseeing claims with carriers to ensure timely resolutions. The ideal candidate...SeniorClaims
- A healthcare organization in New York is seeking a Senior Provider Configuration Analyst responsible for configuring systems to ensure accurate claims processing. The ideal candidate will have a Baccalaureate Degree, six years of experience in data processing configuration...SeniorClaims
$81.1k - $117.47k
...Senior Product Strategy Specialist of Medicaid Products The Senior Product Strategy... ...wants to make a lasting impact in healthcare. This role leads special initiatives,... ...such as Sales, Finance, Marketing, Enrollment & Billing, Claims, Member Services, Compliance, Clinical...SeniorClaimsTemporary workWork experience placementLocal area- Molina Healthcare is looking for a professional to provide senior-level support for claims recovery activities. This role involves researching claim payment guidelines, collaborating with health plans, and ensuring timely settlement of claims. Applicants should have at...SeniorClaims
- Alaffia Health is seeking a Senior Data Engineer to join our healthcare AI startup. The ideal candidate will have 5-10 years of experience in data engineering... ...expertise in healthcare data, including payer claims. This role involves developing innovative solutions using...SeniorClaims
- ...Senior Full Stack Software Developer Judi Health Judi Health is an enterprise health technology... ...Platform (EHP), which consolidates all claim administration-related workflows in one... ...our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure...SeniorClaimsLocal areaRemote work
- Health Business Solutions LLC seeks a Senior Manager in Healthcare Revenue Cycle Management to lead a team of specialists in analyzing and preventing claim denials. You will develop effective denials management programs and collaborate with clients to enhance revenue integrity...SeniorClaims
$89.17k - $142.68k
Job Description We are seeking a highly skilled Senior Data Analyst with deep expertise in Affordable Care Act (ACA) Risk Adjustment... ...candidate will have strong experience with ACA data flows (enrollment, claims, supplemental), HCC modeling, and reconciliation of EDGE...SeniorClaimsWork at officeLocal areaRemote workFlexible hours2 days per week- Alaffia Health is seeking a Senior Data Engineer to enhance the accuracy and efficiency of medical billing through innovative AI-driven... ...-paced environments. Join us to contribute to transformative healthcare solutions in New York City. This is a unique opportunity to shape...SeniorClaims
$18.5 - $42.35 per hour
A leading healthcare provider in the United States seeks a Medical Claims Specialist to review and adjudicate complex claims. The ideal candidate has at least 18 months of experience in medical claim processing within a high-volume environment and demonstrated attention...SeniorClaimsHourly payFull time$46.99k - $122.4k
...Enhancement is hiring for a position focused on investigating healthcare fraud cases. The ideal candidate will have a Bachelor’s degree... ...Responsibilities include handling complex cases, preventing fraudulent claims, and interacting with various stakeholders. This full-time role...SeniorClaimsFull time$65k - $95k
Healthcare Accounts Receivable Senior Associate About Us At Alteva RCM, we're dedicated to helping healthcare providers thrive through expert revenue... ...the insurance payer mix, and familiarity with the full claims lifecycle. Key Responsibilities Follow up with insurance...SeniorClaimsTemporary workWork at officeFlexible hours- Molina Healthcare is seeking a Supervisor for Configuration Oversight in the United States. The role entails leading a team responsible for accurate implementation and maintenance of claims databases along with auditing tasks within health plan requirements. The ideal...SeniorClaims
- ...New York is seeking an Accounts Receivable Senior Associate to join its Revenue Cycle... ...a minimum of 2-3 years of experience in healthcare accounts receivable, proficiency in Microsoft... ...detail. Responsibilities include managing claim follow-ups, resolving denials, and preparing...SeniorClaimsWork at office
- ...Pennsylvania is seeking a skilled professional to manage complex cases involving health care fraud. The candidate will investigate claims, collaborate with law enforcement, and ensure adherence to health care regulations. Interested individuals must hold a degree and possess...SeniorClaimsFull timeWork at office
- Beazley Group in New York is looking for a Life Science & Digital Health Claims Manager to independently oversee the claims process for healthcare professional liability policies. The role involves managing claims from initiation to resolution while ensuring compliance...SeniorClaims
$40 - $60 per hour
A healthcare solutions provider is seeking an experienced individual with strong QNXT configuration skills. The role requires at least 3... ...years of experience in QNXT functionalities such as Membership and Claim Processing. The ideal candidate will work independently, have...SeniorClaimsHourly pay- A government services firm is seeking a Senior Auditor in the United States to conduct forensic financial investigations and analysis related to healthcare claims. The ideal candidate has 5+ years of experience in forensic accounting and a strong understanding of legal...SeniorClaims
- A healthcare organization is seeking a Senior Provider Configuration Analyst to ensure the proper configuration of their systems for claims processing. This role requires 6+ years of experience in data processing within a healthcare or claims environment and focuses on...SeniorClaims
- ...individual to join their Ambient AI team in New York. The role involves revolutionizing healthcare technology by developing AI solutions that enhance the care journey from patient visits to claim processing. You will collaborate on building scalable infrastructure and work...SeniorClaims
- An established industry player is seeking a skilled Facets QA Test Automation Engineer to join their dynamic team. In this role, you... ...and execute test plans and test cases, ensuring the quality of healthcare solutions. Collaborating closely with both internal teams and clients...Senior
$125k - $150k
...conversational AI agents tailored for the healthcare industry. Since our founding, we've... ...eligibility checks, prior authorizations, claim status follow-ups, and patient scheduling... ...Role We’re looking for a high-performing Senior Account Executive to drive growth across...SeniorClaims- Axiom Software Solutions Limited is seeking a Senior Data Scientist for a remote position. The candidate will... ...designing and implementing analytical frameworks for healthcare and biopharma data sources, including claims data and prescription data. This role involves...SeniorClaimsRemote job
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