Remote Clinical Operations Specialist - Claims & Care
GEHA
- Remote job
G.E.H.A, headquartered in the Kansas City area, seeks an administrative Associate to support Clinical Operations. You will engage with members and providers to explain GEHA benefits and programs, and identify cases for internal and external clinical programs. Posted as a full-time role with hybrid work options in Lee's Summit, MO. The position requires basic healthcare knowledge, strong communication skills, and proficiency with MS Office tools. #J-18808-Ljbffr GEHA
$100k - $125k
...how health systems use clinical AI to capture the full value of patient care delivered. Built by physician... ...revenue cycle operations. As a Smartian, you'll... ...a Clinical Operations Specialist at SmarterDx, you will... ...**This role is fully remote within the US** Responsibilities...Remote work$85k - $102.5k
Deliver best-in-class support for our clinical solutions. Operate as a swiss army knife across customer... ...excellent writer. Details: Full-time remote, Monday-Friday 9am-5pm EST. Base salary... ...culture that leverages AI to improve care delivery. #J-18808-Ljbffr Healthie IncRemote jobFull timeMonday to Friday- Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review or related areas. You...Remote jobClaimsWork from home
- ...and helps define personalized care pathways for every woman we... .... We are looking for a Clinical Specialist who is eager to take ownership... ...ScreenPoint brand. This is a new and remote role in our growing team in... ...strength of our clinical claims. You will be part of a...Remote workClaimsWorldwideFlexible hours
- ...- 3 days Onsite and 2 days Remote Job Description:... ...Duties: The eCommerce Operations Specialist supports the day-to-day health... ...payment disputes, delivery claims, and account discrepancies in... ...over the world! Our goal is to care for you while you care for our...Remote workClaimsWork from home
$70.2k - $105.32k
...personalized health care experiences and partner... ...and Grievances Clinical Specialist III position is responsible... ...clinical staff, and operational teams to support timely... ...medical records, claims, and related documentation... ...This position is a Remote role. To be eligible...Remote workClaimsFull timeWork experience placementWork at office- UnitedHealth Group is seeking a SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims, document... ...from anywhere in the U.S. and a chance to impact member care. The position expects an Associate's degree, an unrestricted RN...Remote jobClaims
$83.1k - $120.36k
...of or delivery of clinical and non-clinical services... ...The A&G Clinical Specialist is the subject... ...handle clinical claim appeals that come... ...This is either a remote or on-site position... ...attendance at A&G/ Operations divisional meetings... ...degree Quality of Care Experience in...Remote workClaimsContract workWork at officeLocal area- ...Summary The Registered Nurse (RN) – Clinical Operations Specialist supports providers and clinical staff... ..., and promoting consistent patient care across the organization. This position... ...Support Chronic Care Management, Remote Patient Monitoring, Transitional Care...Remote workWork at office
$86.1k - $107.85k
...transforming cancer care for patients across... ...experienced Senior Clinical Reimbursement Specialist to serve as a clinical... ...Clinical Reimbursement Operations team. In this role,... ...management and claims adjudication), fluency... ...MSN, MHA, MBA). #LI-Remote The final salary offered...Remote workClaimsShift work$46 per hour
...immediately hiring for a RN Clinical Appeals Specialist Position type:... ...PA 19103 (Remote) As a RN Clinical... ...authorization history claims information medical policy... ...Utilization Management Care Management Claims Provider... ...and appeals operations or related managed care...Remote workClaimsHourly payFull timeContract workTemporary workFor contractorsWork experience placementWork at officeImmediate startWorldwideFlexible hours$69.8k - $125.9k
...unrestricted license in state of operations. 5 years combine knowledge of... .... Knowledge of managed care processes. Organizational skills... ...management experience. Health claims and mainframe system experience... ...weekends/holidays. #LI-FW1 #LI-Remote This is a Remote/Work-From-Home...Remote workClaimsWork from homeMonday to FridayRotating shiftAfternoon shift- ...experience The Marketing Operations & MLR Specialist is responsible for... ..., Marketing, Sales, Clinical Services, and other... ...improvement References & Claims Management Own and... ...and PDF tool Remote, or CND Life Sciences... ...mission to advance the care of patients who face...Remote workClaimsWork at office
$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances... ...may also handle clinical claim appeals from providers. This position... ...filing systems; experience with care management systems like CCMS,...Remote jobClaimsFull timeMonday to FridayShift work- ...current E.1 Reports To Clinical Nurse Coordinator or assigned APRN/RN; operationally accountable to the GROW Program... ...-site-, telehealth-, and remote-patient-monitoring-enabled care coordinated with regional... ...contribution, not for claiming sole causation of population...Remote workClaimsContract workImmediate startWork from home
$120.29k - $197.11k
...Description Clinical Nurse Specialist (Nurse Informaticist) This is a full-time permanent remote position. Employees may occasionally be... ...Medicaid connects clinical care and technology. The Clinical... ...make prior authorization and claim payment determinations using...Remote workClaimsPermanent employmentFull timeContract workWork at officeMonday to FridayFlexible hours$80 - $125 per hour
...$80–$125/hour \n \n Location: Remote \n \n About the Opportunity \n We... ...AI training project focused on inpatient care, clinical documentation, and medical record accuracy... ...Verify that clinical information and claims are supported by the medical record. \n...Remote jobClaimsFor contractors$500 per month
...GC AI People Operations Coordinator GC AI is the legal intelligence platform built for... ...resourcefulness and ambition over constraint. ~ Care: be direct, like an honest friend, even... ...If you are contacted by someone claiming to be from GC AI via an unofficial channel...Remote workClaimsPermanent employmentFull timeCurrently hiringWork at officeImmediate startHome officeRelocation packageShift work$14.54 - $18.18 per hour
...Visionworks retail stores. Pay Class and Pay Pay Class: Full Time and Remote Pay Rate: $14.54 - $18.18 Essential Responsibilities # Prepare and submit clean claims to various insurance companies either electronically or by paper in accordance with...Remote workClaimsFull timeContract workWork experience placementLocal areaImmediate startWork from homeFlexible hours$65k - $115k
Remote Remote IL Remote SD Remote VA Remote NC Remote OH Remote... ...dealerships to drive fixed operations profitability and elevate customer... ...abilities to breakdown claim information into trends Proven... ...caregiver leave, Dependent Day Care FSA back-up child and adult/elder...Remote workClaimsFull timeTemporary workPart timeWork experience placementWork at officeRelocation packageFlexible hours$50.89k - $63.61k
...EmpiRx Health is the leading clinically-driven pharmacy benefits... ...pioneer in value-based pharmacy care, EmpiRx Health puts its... ...skilled and experienced Clinical Operations Specialist. In this critical role, The... ...accurate and timely processing of claims overrides and prior...ClaimsWork at office- ...Providing operational and administrative support, the full-time Clinical Operations Specialist will coordinate clinical programs and formulary management functions remotely, ensuring effective communication and execution of processes across multiple teams. Key responsibilities...Remote workFull timeWork at office
- Job SummaryApplies extensive knowledge of ambulatory care clinics clinical, regulatory, and operational practices to improve access efficiency and... ...high degrees of complexity.The Clinical Operations Specialist analyzes and determines clinical coverage needs of Parnassus...Full timeWork experience placementLocal areaWorldwideShift work
$65k - $75k
...diagnostics company advancing care in transplant,... ...organizations to help inform clinical decision-making and... ...care. As a Clinical Operations Associate at CareDx,... ...management, efficient claims processing, and uninterrupted... ...with us. #LI-REMOTE This is the anticipated...Remote workClaimsFull timeWork at office- ...based CNE will serve as a clinical and educational resource to Infusion Center Care Teams in support of... ...or even text messages claiming to be a legitimate company... ...based on business and operational considerations. For a full... ...LinkedIn Twitter Remote Work : Yes...Remote workClaimsFull timeLocal areaShift workNight shift
$26 per hour
...evidence-based mental health care, serving more than 20... ...in terms of access, clinical effectiveness, and cost... ...in overall healthcare claims costs. Lyra is transforming... ...independently in a remote environment while managing... ...As a full-time Billing Operations Associate, you will be...Remote workClaimsFull time- ...Clinical Denials Specialist Role: Clinical Denial Specialist Schedule: M - F 8 AM - 4:30 PM EST GENERAL... ...Specialist is to successfully manage claim denials related to referral,... ...(RN) Certification with experience in care management, utilization review, prior...Remote workClaimsContract workLocal area
- ...Clinical Operations Specialist This is a remote full-time hourly position. We are currently able to employ team members who live in the following states:... ...prior authorization, utilization management, clinical care coordination, scribing, or other roles that involve deep...Remote workHourly payFull timeLive inRelocation
$88k - $110k
...Clinical Operations Specialist At Zimmer Biomet, we believe in pushing the boundaries of innovation and driving our mission forward. As a global... ...88,000 - $110,000 base salary per year plus performance bonus This is a fully remote role EOE/M/F/Vet/Disability...Remote workFlexible hours$74.68k - $97.09k
...Supervisory Facility Operations Specialist ~ Schedule: Occasionally work outside of regular tour... ...copy of your transcript(s) to support claimed education if substituting education... ...4678 – $97087/yr. Is this position remote or telework eligible? This position...Remote workClaimsTemporary workWork at office
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