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
$106.78k - $153.41k
...takes on the biggest moments in healthcare, raises the standard of... ...love to meet you!OverviewThe Senior Medical Director is an emerging... ...review accountability: defending claims, annotation and claims... ...celebrate all identities, across all facets of intersectionality, and it...SeniorClaimsTemporary workFreelanceFlexible hours$70k - $85k
..., we're dedicated to helping healthcare providers thrive through expert... ...Position Summary The Senior Billing Associate – Enterprise... ...operations for high-volume, multi-faceted enterprise clients. This role... ...Manage full-cycle claim intake through charge release...SeniorClaimsTemporary workFlexible hours$230k - $285k
...Senior Software Engineer New York City, New York What You'... ...mission to transform the U.S. healthcare system — and we're the only proven... ...embrace AI in every facet of our operations and norms.... ...have been contacted by someone claiming to be a Garner recruiter or a...SeniorClaimsWork at officeFlexible hours3 days per week- Senior Business Analyst - Healthcare Payer (Claims & Benefits Systems) Role Summary: The Senior Business Analyst is responsible for driving requirement analysis... ...for healthcare payer systems across claims, enrollment, and care management modules Collaborate with clients...SeniorClaims
$230k - $285k
...mission to transform the U.S. healthcare system — and we’re the only... ...We are seeking an exceptional Senior Software Engineer to join our... ...aggressively embrace AI in every facet of our operations and norms.... ...been contacted by someone claiming to be a Garner recruiter or a...SeniorClaimsWork at officeFlexible hours3 days per week$190k - $240k
...mission is to transform the healthcare economy, delivering high-quality... ...are seeking an exceptional Senior Software Engineer to join our... ...aggressively embrace AI in every facet of our operations and norms.... ...been contacted by someone claiming to be a Garner recruiter or a...SeniorClaimsWork at officeFlexible hours3 days per week- ...products for the automotive and healthcare industries.Together with DIC,... ...Position Summary The Senior Manager of US Benefits will lead... ...actuaries to analyze monthly claims data, evaluate stop-loss coverage... ...for life events and open enrollment. Compliance, Leave & Risk Mitigation...SeniorClaimsContract workTemporary workWorldwide
- ...Senior Staff Dentist, Utilization Management (Remote) NY Fully... ...appropriate adjudication of dental claims and prospective service... ...Demonstrated success managing oral healthcare costs and utilization... ...cost for eligible dependents enrolled in the plan. ~100% employer...SeniorClaimsRemote jobWork at officeImmediate startFlexible hours
- Meduit is seeking a Senior Insurance Specialist to resolve insurance processing errors and denials, focusing on patient billing, claims submission, and payer guidelines for Medicare, Medicaid, and commercial payors. This remote role serves colleagues in Mountain or Pacific...SeniorClaimsRemote job
- CVS Health is seeking a Healthcare Encounter Analyst - Senior to handle Medicaid encounter reconciliation within the State Medicaid Encounters team. You will investigate and correct rejected Medicaid encounters, examine configurations, and deliver client-facing metrics....SeniorClaims
- ...About Amperos Amperos is healthcare's first AI-native denial management and revenue recovery platform. Our agentic AI works claims end-to-end, from portal follow-ups and payor calls... ...About the Role We're looking for a Senior Accounts Receivable Specialist to join...SeniorClaimsPermanent employmentFull timeWork at officeImmediate startFlexible hours
- Progyny is seeking a Senior Client Onboarding Manager in New York to lead end-to-end client implementations... ...carrier and vendor integrations and claims processing. Ideal candidates have 6+ years in a similar role, healthcare/benefits experience, and a Bachelor's degree....SeniorClaims
- Infinite Computer Solutions is looking for a Senior Business Analyst to drive requirement analysis and functional design for healthcare payer systems. This role requires deep expertise in claims processing and benefits configuration, collaborating with clients and development...SeniorClaims
$65k - $85k
...Alteva RCM, we're dedicated to helping healthcare providers thrive through expert revenue... ...oriented Medical Billing Accounts Receivable Senior Associate to join our Revenue Cycle... ...mix, and familiarity with the full claims lifecycle. Key Responsibilities Follow...SeniorClaimsTemporary workWork at officeFlexible hours- Dataspace Incorporated is a leading healthcare management consulting firm in New York that is expanding its analytics team with a strong healthcare data analyst who can dive into claims data and drive actionable insights. The role involves cross-team collaboration, mentoring...SeniorClaimsRemote job
$134.5k - $190.5k
...Liability portfolio across a diverse range of healthcare segments, including Dentists, Nurses,... ...closely with business partners and senior actuarial leaders, you will develop analyses... ...Proactively monitors profitability/reserving and claim trends for Healthcare Pricing and shares...SeniorClaimsFull timeWork experience placementFlexible hours- ...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
$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- MetroPlus is seeking a detail-oriented candidate to manage healthcare claims processing in New York. The ideal applicant will have a bachelor's degree and at least three years of experience in a managed care or hospital setting. Responsibilities include processing complex...SeniorClaimsWork at office
- ...Department of Operational Support. The role supports the Division of Healthcare Management and Occupational Safety and Health (DHMOSH), Office... ...Operations (OSO), and the Advisory Board on Compensation Claims (ABCC) by reviewing and preparing medical evaluations and expert...SeniorClaimsWork at office
$195k - $250k
...Health, we're on a mission to revolutionize healthcare by solving one of its most complex and... ...that simplifies billing, enhances claims processing, and eliminates administrative... ...re looking for a passionate and skilled Senior Software Engineer to join our fast growing...SeniorClaimsFull time- ...Counsel’s mission is to multiply the world's healthcare capacity. We believe in a future in... ...About The Role We're looking for a Senior Backend Engineer to help define the future... ...process. If you receive suspicious outreach claiming to be from Counsel Health, please...SeniorClaimsFull timeRemote work
- Cotiviti is seeking a Senior Product Manager to serve as the liaison between business stakeholders and engineering. This role involves owning the product development lifecycle for healthcare enrollment, from requirements gathering to post-launch maintenance. The ideal candidate...SeniorRemote job
- Pivotal Health in New York, NY is seeking a Senior Software Engineer for the Case Execution team. You will own backend development across eligibility, batching, submissions, ops workflows, and claim orchestration. This role focuses on data-heavy decision logic and workflow...SeniorClaims
$125k - $150k
...Senior Account Executive At Prosper AI, we're pioneering the most advanced conversational AI agents tailored for the healthcare industry. Since our founding, we've successfully onboarded dozens... ...eligibility checks, prior authorizations, claim status follow-ups, and patient...SeniorClaims- ...is building the AI Operating System for healthcare, delivering autonomous AI to streamline... ...workflows and documentation. We seek a Senior Backend Engineer to own end-to-end AI feature... ...agents and copilots that automate claims and document extraction with compliance...SeniorClaims
- VillageCare in New York, NY is seeking a Senior Financial Data Analyst to build, document, and maintain reports and analytics that empower... ...has at least five years of actuarial-like experience in claims reserves and IBNR estimation, with advanced Excel, #J-18808-Ljbffr...SeniorClaims
- VillageCare seeks a HealthCare Claims Analyst to join our team in a full-time hybrid role, based in NY/CT. You will leverage SQL analytics, Excel, and BI tools to report on Medicaid/Medicare claims, identify gaps, and drive reimbursement insights. Strong communication and...SeniorClaimsFull time
- ...research, engineering, computer science) or a healthcare discipline4+ years of professional... ...colleaguesAbility to synthesize complex issues, engage senior leaders, and drive consensusExposure to... ...learningStrong analytical skills in claims, productivity, access, and volume data...SeniorClaimsApprenticeshipEasy work
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