Healthcare QA Lead — Facets, EDI & Claims Expert
$80k - $100kTata Consultancy Services Limited
Tata Consultancy Services Limited is seeking a Lead with expertise in Healthcare Claims Processing and QA. The role involves leading testing for Claims, Enrollment, and Billing modules with a salary range of $80,000 - $100,000 annually. Candidates should possess strong knowledge of EDI formats and Azure DevOps. The ideal candidate will have extensive experience in functional testing and lead a team in a collaborative environment. Comprehensive benefits package offered. #J-18808-Ljbffr Tata Consultancy Services Limited
- ...professional for a role focused on Healthcare Claims Processing. The position involves leading end-to-end testing for... ...acting as a Subject Matter Expert for Claims Processing and EDI transactions. The ideal... ...expertise in EDI formats and Facets, ensuring compliance with...EDIClaims
$80k - $100k
...Kansas City, MO Job Role Lead Technical/Functional... ...Strong SME knowledge in Healthcare Claims Processing lifecycle Expertise in EDI formats - 837 (P/I/D), 8... ...Hands‑on experience in Facets (Claims + Enrollment modules... ...Azure DevOps (ADO) for QA tracking Knowledge of...EDIClaims- ...opportunity to perform billing claim edits and insurance follow up.... ...with claims. Responsible for 277 EDI transactions/rejections.... ...charge, or escalate to the team lead and/or another medical billing... ...for becoming a subject matter expert on the payor policies. Responsible...EDIClaimsLive inMonday to FridayFlexible hours
- ...Senior Living and Health Care is seeking a detail-oriented MCR Billing Specialist in Kansas City. The role includes submitting Medicare claims, ensuring compliance, and tracking payments. Candidates should have 3-5 years of experience in billing, knowledge of payer...Claims
- A leading AI training company in the United States is seeking an RCM Operations Manager to help train AI models in healthcare. This role requires fluency in English and a healthcare-related degree. Responsibilities include evaluating AI chatbot outputs for accuracy and...SuggestedRemote jobHourly payFor contractorsFlexible hours
- ...Claims Business Analyst Duration-6 – 12 months ++ Hybrid 3 Days a week: Charlotte, NC; Chicago, IL; Colorado Springs, CO; Conshohocken... ...– for each jurisdiction there's different compliance req edi calls; Verisk exp VERY HELPFUL, pbm, medical bill mngt, etd to adjudicate...EDIClaims3 days per week
$53.5k - $69k
Safety National is seeking an EDI Operations Specialist to ensure the accuracy and integrity of EDI data. The role requires skills in validating claims data, problem-solving, and collaboration with both internal and external stakeholders. Candidates should have a Bachelor...EDIClaims- ...measurable on a regular basis. Supervise Lead Material Planner, Material Planners and Material... .... General customer obsolescence claims. Communicates any supplier discrepancies to... ...system and communication issues. Manage all EDI set up, maintenance, and troubleshoot any...EDIClaims
- ...delivery Initiate order entry into Oracle via EDI, DRC, downloads from customer portals, or... ..., and complaints in a timely manner, leading inter-departmental teams to identify and... ...Marketing, and others as required Calculate claim or rebate amounts on specified accounts...EDIClaimsFull timeContract workWork at office
- ...is seeking a Senior Systems Engineer (Angular) to develop a cloud-based Web Dashboard application for processing healthcare Electronic Data Interchange (EDI) transactions. The role demands strong experience in Java, NodeJS, and Angular, along with a focus on integrating...EDIRemote work
- The Travelers Indemnity Company is seeking a Technical Specialist in Overland Park, Kansas, to manage complex General Liability claims. The ideal candidate will have a Bachelor’s Degree and five years of claims experience. Responsibilities include managing a caseload of...Claims
$48k - $55k
Tata Consultancy Services Limited in Kansas City, MO, seeks a Claims Manager to handle absence case management and adjudicate claims. The role requires at least 1 year of claims experience, particularly in disability and FMLA claims, along with strong analytical and communication...Claims- ...recommendations to reduce losses. The role requires strong consultative skills, proficiency with MS Office, and the ability to collaborate with underwriting, sales, and claims teams. Travel is required and a valid driver's license is needed. #J-18808-Ljbffr EMC Insurance CompaniesClaimsRemote job
$53.5k - $69k
Role Description We are seeking an EDI Operations Specialist who will take ownership of... ...role includes validating and analyzing claims data, partnering with internal stakeholders... ...to investigate and resolve anomalies, leading root‑cause investigations, implementing corrective...EDIClaimsWork at officeWork from home3 days per week$85.39k - $116.98k
...cloud-based Web Dashboard application that processes healthcare Electronic Data Interchange (EDI) transactions Design, build, and maintain Representational... ...Electronic Data Interchange X.12 (EDI) Medical Claims X.12 medical claims (837, 834, 277, etc) Familiarity...EDIClaimsFull timeRemote work$90k - $120k
...Expert Demo Specialist - Hospital Financials & Clinicals / Remote Altera, a member... ...Digital Health is driving a new era of healthcare, in which innovation and expertise can elevate... ...verification, medical necessity checks, claims adjudication, and denial management....ClaimsRemote jobWork experience placementLocal areaAfternoon shift- ...transportation, energy, water, healthcare, and more. Learn more about... ..., and other property‑related claims. Responsibilities Conduct forensic... ..., coordinate with other experts, and produce client reports promptly... ...facing skills and ability to lead cross‑functional project...ClaimsWork at officeLocal areaNight shift
$18.5 - $42.35 per hour
...more than 7,600 CVS/pharmacy stores; its leading pharmacy benefit manager serving more than... ...for: Managing a high volume of medical claims that have denied by refuting the denials... ...familiarity with Electronic Data Interchange (EDI) transmission, Electronic Health Record...EDIClaimsHourly payFull timeContract workTemporary workWork at officeLocal area- ...manufacturing company in the business of providing high-quality healthcare products to Retailers, Professionals and direct to consumers... ...orders, covering the front desk, invoicing orders in SAGE, ASN in EDI and check emails in customer service Add up commission...EDICasual workWork at office
- A healthcare facility in Overland Park, KS, is seeking a Radiologic Technologist responsible for performing diagnostic procedures, communicating with patients, and ensuring radiation safety. The ideal candidate must be registered with the American Registry of Radiologic...
- Priority Dispatch Corp. is seeking a Quality Assurance Specialist in Missouri to support its quality assurance program. The role involves developing procedures, assisting in audits, and performing measurement tool calibrations. The ideal candidate should have at least an...
$64.9k - $108.1k
...driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services... ...Informatica, or similar) Experience with secure file transfer, EDI, or managed file transfer tools Familiarity with Python for...EDITemporary work- A major healthcare provider is seeking a Technical Specialist to support high-quality patient care. This role requires 3-5 years of experience in laboratory settings, specifically in Hematology and Coagulation. As a key resource, you will ensure compliance, manage quality...Day shift
- A leading healthcare technology provider is looking for an experienced Clinical Imaging Analyst to support imaging systems across various markets. This remote contract role requires 3-7 years of experience in healthcare imaging systems, with expertise in tools like PACS...Remote jobContract work
- A healthcare institution is seeking a Professional Billing Lead Coder for a remote position. This role requires coding expertise in professional services with responsibilities including accurate coding of medical records and leading coding staff. Candidates should have...Remote job
$26.5 per hour
...Workers' Compensation Claims Examiner Associate AmTrust is a major player in the commercial... ...the key link between injured workers, healthcare providers, employers, and legal teams,... ..., and negotiation skills. Exposed to facets like Underwriting, Loss Control, Managed...ClaimsWork at officeWorldwideMonday to FridayFlexible hoursWeekend work- Integrated Resources Inc. is looking for a professional to educate patients and healthcare providers about their products and services. The ideal candidate will have experience in medical claims, patient cost navigation, and a background in healthcare or call center...Claims
$17 - $18 per hour
A national healthcare services provider is looking for a Medical Claims Processor to work remotely. Responsibilities include processing claims, reviewing policies, and ensuring compliance with regulations. Ideal candidates will have at least 2 years of medical claims experience...ClaimsHourly payRemote work- BJC HealthCare is seeking a Patient Accounts Representative II to join our team in Missouri. You will follow up with commercial payors to resolve unpaid claims and ensure timely resolution of patient accounts, while mentoring junior staff. The role focuses on verification...Claims
$45 per hour
...Cares and make a difference! As a direct care professional in home healthcare, you will get the opportunity to provide compassionate care to... ...of the United States Armed Services, Workers Compensation Claims, and former energy workers who want to remain independent and live...ClaimsHourly payPart timeLive inFlexible hours
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