Pega QA Tester: Healthcare Claims & Compliance
TechDigital Group
TechDigital Group in the United States seeks a Pega Tester to ensure quality, functionality, and regulatory compliance of Pega applications supporting healthcare claims processing, including Facets integration. You will create test plans, design test cases, execute manual testing, track defects, and collaborate with developers, business analysts and stakeholders to validate requirements and HIPAA/EDI standards. #J-18808-Ljbffr TechDigital Group
$20 - $21 per hour
...policies to ensure quality, consistency, and compliance. Performs other duties as assigned.... .../benefits and checking on the status of claims/authorizations. Key Requirements... ...with multiple systems simultaneously Healthcare/Insurance Knowledge claims, eligibility,...ClaimsContract workLocal areaImmediate startRemote workShift work- ...Ace IT Careers is currently hiring motivated candidates for Remote Junior QA Tester opportunities supporting U.S.-based client projects across Healthcare, Banking, Telecom, and E-Commerce domains. This opportunity is ideal for: Entry-level candidates Career switchers...SuggestedRemote jobFull timeCurrently hiringFlexible hours
- ...Revenue Cycle and focuses on ensuring compliant coding and accurate billable services. The position involves ongoing education of the claims team and practitioners, staying current with coding guidelines, and implementing strategic protocols for coding review and...Claims
- ...junior analysts and contributing to process improvements. The role emphasizes strong communication, problem-solving, and regulatory compliance, including HIPAA, with opportunities to collaborate across internal teams to drive client savings and #J-18808-Ljbffr Vālenz...Claims
$45 - $55 per hour
...Join to apply for the Healthcare Senior Business Analyst (Homecare Homebase focus) role at... ...cross-functional collaboration between IT, compliance, clinical, and operational teams. Lead... ...Account Health Support Business Analyst - Claims & Encounters Processing Phoenix, AZ $50,...ClaimsFull timeContract workRemote work$45 - $55 per hour
...Join to apply for the Healthcare Senior Business Analyst (Homecare Homebase focus) role at... ...cross-functional collaboration between IT, compliance, clinical, and operational teams. Lead... ...Account Health Support Business Analyst - Claims & Encounters Processing Phoenix, AZ $50,...ClaimsFull timeContract workRemote work- ...to oversee back-end revenue cycle operations, including timely claim submissions, collections, reimbursements, and handling denials.... ...staff, set priorities, monitor performance, and ensure policy compliance across the department. The role emphasizes leadership, training...Claims
- CBIZ, Inc. in Phoenix, AZ seeks a data/healthcare analyst with 1-3 years of related experience to analyze Medicaid-related claims data and deliver client-ready reports. The role involves developing materials, managing timelines, and presenting findings in client meetings...ClaimsLocal area
- ...Blue Signal Search Director of Staffing | Healthcare, Revenue Cycle Management, Accounting,... ...insurance reimbursements, and regulatory compliance. As a critical team leader, you will... ...coordinate resolution strategies for outstanding claims, and monitor metrics to optimize cash...ClaimsFull timeContract work
- ...Manager, Compliance and Regulatory Affairs Suvida Healthcare LLC Phoenix, Arizona, United States About this position Who We Are At Suvida Healthcare, we are... ...Participation OIG Compliance Program Guidance Stark Law False Claims Act Experience working in healthcare quality,...ClaimsContract workTemporary work
$18 - $22 per hour
...ExamWorks is a leading provider of innovative healthcare services including independent medical... ..., peer reviews, bill reviews, Medicare compliance, case management, record retrieval,... ...insurance carriers, law firms, third-party claim administrators and government agencies...ClaimsHourly payFull timeWork at officeLocal area- Resilient Health in Phoenix, AZ is seeking a Claims Specialist to support the day-to-day operations of the claims department by gathering information and processing medical and psychiatric healthcare claims. You will verify insurance eligibility, scrub claims for accuracy...Claims
- Industrial Commission of Arizona is seeking a W/C Insurance Claims Specialist 2 to audit incoming claims for compliance with workers' compensation laws and to issue appropriate awards when indicated. Some remote work within Arizona may be available based on performance...ClaimsRemote job
$85k - $110k
...Reimbursement + Full BenefitsA rapidly growing multi-specialty healthcare organization is seeking a Physician Liaison to support referral... ...liaison or medical sales Personal injury case management Insurance claims adjusting Legal or plaintiff-side injury support Healthcare...ClaimsLocal areaRemote work- Medical Billing Manager - eClinicalWorks (eCW) Serenity Healthcare Location Lehi, UT or Phoenix, AZ Job Type Full-Time Department Revenue... ...team of billing specialists while personally working escalated claims, denials, and payer issues. eClinicalWorks (eCW) experience is...ClaimsFull time
$129.1k
...this role is driving the organization's healthcare interoperability strategy by championing... ...programs, government quality programs, and claims processing. This job ensures the... ...required of employees to do this job. Compliance Requirement : This job adheres to the ethical...ClaimsFor contractorsWork experience placementWork at officeLocal area- ...professional seeking an exciting opportunity in healthcare? West Coast Ambulance is looking for a... ...processing and managing medical billing claims, ensuring timely reimbursements, and... ...Maintain billing records and compliance with regulations Assist in Order Intake...ClaimsFull time
- ...of life to help build the future of the healthcare and the life sciences industry. We... ...to corporate SOPs and ensure vigilant compliance with relevant legal and regulatory guidelines... ...e-mails, or even text messages claiming to be a legitimate company. Some of these...ClaimsLocal area
- ...address operational effectiveness in support of ValleyMetro’s claim and risk management program. Reporting to the Chief Legal Officer... ...of practices with agency standards. Supports contract and compliance activities by reviewing insurance and risk‑related provisions and...ClaimsContract workWork at officeLocal area
- ...legal risks, developing practical business solutions, and ensuring compliance with applicable laws and regulations. The Corporate Counsel... ..., including contract review and negotiation, construction law, claims management, litigation oversight, employment matters, corporate...ClaimsContract workTemporary workFor contractorsWork at officeLocal areaVisa sponsorshipWork visa
$86k - $124k
..., lockout/tagout (LOTO) program reviews, and industrial safety compliance.Assess client machine guarding systems for adequacy and regulatory... ...financial strength, underwriting excellence, superior claims handling expertise and local operations globally. At Chubb, we...ClaimsLocal area$80k - $125k
...communications and provide legal advice regarding workers' compensation claims. Develop case strategies and legal arguments to advocate for... ...negotiations, and administrative proceedings. Ensure compliance with all legal standards and regulations related to workers' compensation...ClaimsFull timeCasual workLive inWork at officeRemote workFlexible hours- ...medication management solutions to support healthcare organizations serving seniors and... ...processing customer bills and insurance claims in an accurate and timely manner. This includes... ...audits and ensure payer and company compliance. Accurately enter patient information into...ClaimsFull timeTemporary workWork at officeFlexible hours
- ...core, the department delivers powerful claims and insurance data analytics, including... ...expertise in support of a nationally-recognized healthcare leader. We offer stimulating and... ...and endorsements, and ensures regulatory compliance across complex multi-state requirements...ClaimsFull timeMonday to FridayShift workDay shift
- Company Overview: Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in insurance claim investigation. As a global leader,...ClaimsWork at officeLocal area
$23 - $27 per hour
...effective follow-up on outstanding insurance claims to ensure accurate and prompt... ...payer deadlines and account balance. Ensure compliance with federal, state, and payer-specific... ...equivalent required; Associate's degree in healthcare or business preferred. Minimum of 2 years...ClaimsRemote jobPermanent employmentFull timeTemporary workMonday to Friday- ...Job Description Job Description Overview Company Overview: Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation Services is the premier destination for a career in...ClaimsWork experience placementWork at officeLocal area
$64k - $90k
...be responsible to adjust attorney-involved, moderately complex claims or moderately complex to include confirming coverage, determining... ..., evaluating, negotiating, and adjudicating claims in compliance with state laws and regulations. Responsible for delivering a concierge...ClaimsContract workLocal areaWork from homeAfternoon shift3 days per week$63.59k - $114.45k
...investigate, evaluate, negotiate and settle complex property insurance claims presented by or against our members. You will confirm/analyze... ...liability exposure and negotiate equitable settlement in compliance with all state regulatory requirements. Adjusters recognize and...ClaimsWork at officeLocal areaAfternoon shift- ...staffing company based in Arizona that helps healthcare businesses across the United States... ...will manage the complete billing cycle: claim submission, payment posting, denial management... ...and rebilling claims as needed Ensure compliance with billing and coding regulations and...ClaimsFull timeWork at officeRemote workHome office
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