Healthcare Claims Rules & Edits Specialist
Waystar, Inc
Waystar, Inc in Louisville, Kentucky is seeking an Enterprise Rules & Edits Analyst to improve claim billing and coding processes. The role involves collaborating with various teams to deliver timely configurations, analyzing data trends, and optimizing claim edits. Applicants should have a Bachelor's degree or relevant experience, problem-solving skills, and knowledge of healthcare regulations. This position offers a customizable benefits package, including generous paid time off and a 401(K) program. #J-18808-Ljbffr Waystar, Inc
- A leading healthcare technology firm is seeking a smart, technical, and creative Enterprise Rules & Edits Analyst. This full-time role involves working with claim billing, coding, and authorization rules. Key responsibilities include collaborating with client support and...ClaimsFull timeFlexible hours
- ...corrects mistakes. Enters, codes, stores, edits, and retrieves database records and files... ...forms for FMLA, worker's compensation claims, injured employees, and OSHA reports.... ...is responsible for enforcing all safety rules and regulations. In addition, they are responsible...ClaimsHourly payFull timeImmediate startNight shiftWeekend work
- ...Description Day-to-Day: Insight Global is hiring a Healthcare Enrollment Specialist to support a large, enterprise‐level healthcare services... ...internal teams including operations, revenue cycle, and claims to troubleshoot enrollment‐related payment issues and ensure...Claims
- ...Job Description Insight Global is hiring a Healthcare Enrollment Specialist to support a large, enterprise-level healthcare services organization... ...internal teams including operations, revenue cycle, and claims to troubleshoot enrollment-related payment issues and...Claims
- ...integrity (PI) and provider claims accuracy. Makes... ...requirements are met for pre-pay edits, post-payment... ...of Diseases (ICD), Healthcare Common Procedure Coding... ...state Medicaid payment rules. Strong data analysis/... ...) or Certified Coding Specialist (CCS) certification. Project...ClaimsTemporary workWork at officeRemote work
- ...a smart, technical and creative Enterprise Rules & Edits Analyst seeking a chance to grow their career and work with claim billing & coding/authorization rules. This analytical... ...authorization rule configurations. Studying healthcare industry standards and staying up-to-date on...ClaimsLocal areaFlexible hours
- ...seeking a smart, technical, and creative Enterprise Rules & Edits Analyst to grow their career working with claim billing, coding, and authorization rules. The... ...claim edit/authorization rule configurations. Study healthcare industry standards and stay up‑to‑date on...ClaimsFull timeLocal areaFlexible hours
- ...Norton Healthcare is seeking a qualified candidate for a fully remote coding position. The role focuses on resolving billing edits and conducting audits to ensure compliance with revenue integrity standards. Applicants must have three years of coding experience and...Remote work
- ...The Licensure and Provider Enrollment Specialist will be a member of the Corporate Legal... ...required next steps, and potential impacts on claims processing. · Coordinates and... ...high-need individuals and reducing overall healthcare system costs. For more information, please...ClaimsFull timeWork from home
$15.25 per hour
...responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with... ...at typing, and have advanced technical skills Experience in healthcare billing environment (pharmacy preferred) Familiarization with...ClaimsLive inWork at officeHome officeMonday to FridayFlexible hoursShift work- ...HealthCare Analyst Location: Louisville, Kentucky (Onsite Only) Note: Epic Compass Rose... ...the creation of templates, workflows, and rules. • Implementation knowledge and... ...electronic authorizations, ADTs, PAF and claims exchange) • Implementing, configuring,...Claims
- ...appointment scheduling, pre-authorization for procedures, and general healthcare information. Patient registration and demographic updates:... ...: Confirming patient insurance coverage and benefits. Claims processing and follow-up: Assisting with submitting insurance...Claims
$16 - $22.85 per hour
...Requisition number: 2364759 Job category: Healthcare Delivery, Patient Services Explore... ...Growing together. As the Scheduling Specialist you will managing patient referrals and... ...by local, state, or federal laws, rules, or regulations. UnitedHealth Group is...Hourly payMinimum wageFull timeWork experience placementLocal area$23 per hour
...time, please check again later. Position: Prior Authorization Specialist Location: Louisville, KY Job Id: 660 # of Openings: 1 Pharmacy... ...by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests. How...ClaimsFull timeTemporary workLocal areaRemote workRelocation package- Elevance Health is seeking a Subrogation Examiner to work virtually with flexibility, conducting research and examination of health claims related to various recovery cases. Responsibilities include initiating calls to determine claims potential for reimbursement,...ClaimsRemote work
- ...Job Summary The Leave Specialist administers and manages employee leave programs, ensuring compliance with regulations and company policies. They provide guidance to employees and managers, process claims, maintain accurate records, and analyze leave trends to improve...ClaimsLocal area
- A leading engineering firm is seeking a FEMA - Program Delivery Specialist to handle applicant data and support the claims process. You will coordinate communication with FEMA applicants, ensuring timely completion of tasks and validations. The ideal candidate will have...Claims
$60.93 per hour
...Unit: FSU Job Description: The Disaster Program Delivery Specialist: • Collects, coordinates and/or reviews applicant data to... ...needed throughout the program delivery process. • Supports the claims process by reviewing and validating damage details, scopes of...ClaimsFull timeContract workTemporary workFor contractorsH1bWork at officeFlexible hours- ...Claims Follow Up Specialist This position is responsible for the timely follow up of technical or professional medical claims to insurance companies that have been denied, left pending or require remittance. Working aged receivable reports; identify errors and work...ClaimsWork at office
- ...and every day. The Precertification Specialist sets the precedence to ensure a positive... ...timely fashion in compliance with plan rules including appropriately utilizing the CMS... ...preferred Preferred Qualifications Healthcare experience preferred. Electronic Health...Local areaShift workDay shift
$25 per hour
...Benefits/Billing Verification Specialist for our Patient Services... ...billing and coding for 1500/1450 claim forms. Clearly... ...certificate program in pharmacy or healthcare. Work Experience ✓Required... ..., and federal pharmacy laws, rules and regulations. Superior level...ClaimsFull timeTemporary workWork experience placementWork at officeLocal areaMonday to Friday$51k - $54k
...a highly motivated and detail‑oriented Cable & Telecom Damage Specialist in the New Albany, IN area. In this hands‑on role, you will collect... ...and email it to the local handling office. Assist the Claims Recovery team with follow-up actions after damage site reviews....ClaimsTemporary workFor contractorsWork at officeLocal areaNight shift- ...Seven Counties Services is looking for a detail-oriented medical billing specialist in Louisville, KY. The role involves completing insurance forms, following up on unpaid claims, and maintaining patient confidentiality. Qualified candidates must have at least two years...Claims
- ...Receives, researches, and resolves provider inquiries such as claims, eligibility, and other inquiries, and represents as a liaison... ...across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk. Molina HealthcareClaimsWork at office
- ...improvement Conduct precursor analyses (claims repricing, rebate forecasting, disruptions... ...strategies RFP Support Validate, edit, and draft narrative responses to financial... ...business, finance, or economics 5+ years of healthcare analytics experience including 3+ years...ClaimsContract workWork at officeRemote work
- ...boards, Metropolis offers a confidential experience for both the healthcare facilities and the candidatesMetropolis does not allow... ...operates off sincerity and integrity; job postings will never claim a job is located in the city when it is actually over an hour away...ClaimsPermanent employment
$62.93k - $94.4k
...through identification of hazards and control measures. Assist in the investigation and communication of near misses, incidents and claims to make certain that Company interests are preserved. Perform periodic checks to ensure plans, corrective actions and deficiencies...ClaimsWork experience placementWork at officeLocal areaImmediate startFlexible hours- ...Norton Healthcare is seeking a candidate responsible for billing and rebilling primary and secondary claims in accordance with payor requirements. The role requires maintaining productivity and quality standards while adhering to compliance regulations. Qualified candidates...Claims
- ...your daily endeavors will carry profound meaning. Each imaging session you conduct serves the purpose of delivering clarity in the healthcare journey of your patients. Meanwhile, your evenings unfold in a city brimming with culture, where from the stunning backdrop of...Local areaImmediate startFlexible hoursWeekend workAfternoon shift
- ...team of 10-12 clinical reviewers and oversee Facility clinical claim denials by developing strategies to overturn insurance payor processing... ...the UofL Health System. Clinical support will include pre-bill edits, payment denials, and pre/post-payment audits from insurance...ClaimsShift workDay shift
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