Facets QA Lead — Healthcare Claims & EDI Expert
Tata Consultancy Services
Tata Consultancy Services is seeking an experienced professional for a role focused on Healthcare Claims Processing. The position involves leading end-to-end testing for Claims, Enrollment, and Billing modules, and acting as a Subject Matter Expert for Claims Processing and EDI transactions. The ideal candidate will possess strong expertise in EDI formats and Facets, ensuring compliance with HIPAA regulations for all testing activities. Excellent stakeholder communication skills are essential. A comprehensive benefits package is included. #J-18808-Ljbffr Tata Consultancy Services
$80k - $100k
...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... ...years of experience as Test Lead in Facets projects Deep...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
$93k - $110k
...reporting. This role involves developing performance metrics, managing EDI production issues, and preparing communication materials for... .... The ideal candidate will have 5 years of experience in healthcare payer program management and a Bachelor's degree. The position...EDIRemote job- ...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$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- ...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
$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$85.39k - $116.98k
...Stack Developer (Angular/NodeJS) to join their remote team. The role involves building and supporting cloud-based applications for healthcare EDI transactions, designing RESTful APIs, and collaborating with engineers. A Bachelor’s degree and 8+ years of experience are...EDIRemote job$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
- ...join their team. This remote position focuses on building and supporting a cloud-based Web Dashboard application for processing healthcare EDI transactions. The ideal candidate should have extensive experience in Java and/or NodeJS, Angular, and RESTful APIs, with a...EDIRemote job
- 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...
- ...of the position within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in... ...and contact insurance companies to resolve claims that are not paid in a timely manner.... ...requirements. Maintain required productivity and QA standards. Document in the patient...ClaimsTemporary workWork from homeFlexible hoursShift work
- 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...
$68.2k - $102.3k
...life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates... .... The opportunity: The Senior Manager, Stop Loss and Health Claims leads our dynamic claims unit. In this critical role, you'll oversee...ClaimsWork at officeLocal areaRelocationFlexible hours$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$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- 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
- 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$48k - $71k
...‑targeted CTV, performance and lead generation campaigns. We are at the forefront of healthcare marketing, empowering clients to... ...model marries all facets of clinical commercialization,... ...e‑mails, or even text messages claiming to be a legitimate company. Some...ClaimsLocal area
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