Medicare jobs in Camden, NJ

Senior Data / Business Systems Analyst in healthcare (payer: Medicaid/Medicare)

Hybrid in Philadelphia, Pennsylvania

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2d ago

Hi Professionals, Title:Senior Data / Business Systems Analyst (Healthcare Payer domain) Locaion:Hybrid (Philadelphia) Duration: CTH JD: 8+ years in data/business analysis & project work 5+ years in healthcare (payer: Medicaid/Medicare) Experience with EDI & care management data Technical Skills: Strong SQL Expertise in Azure Databricks (Delta Lake, DLT, Unity Catalog) Knowledge of ETL processes Familiarity with BI tools (Power BI/Tableau) Understanding of data governance, PII, Coll

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Contract, Third Party

Depends on Experience

Medicare Appeals Professional with Licensed nurse

Remote

•

Today

Responsibilities: Reviews medical records/case file, writes a reconsideration decision letter that is clear, concise, andimpartial and supports the determination made, and documents review.Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation,rulings, and policy.Responds to and ensures that all appeal issues raised by the beneficiary/patient, representative, andprovider/supplier have been addressed.Provides a fair and impartial decision based on cu

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Contract

Depends on Experience

HEALTHCARE ACCESS QUALITY ANALYST

Camden, New Jersey

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Today

About us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental,

Full-time

Data Engineer (Healthcare)

Remote

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17d ago

Hello Everyone, Greetings from Dizer! We are currently looking for a Data Engineer with at least 5+ years of recent experience in the Healthcare domain. This is a 100% remote role, so no relocation or travel is required. The clients key requirements are: Claims Processing experience Healthcare / Medicaid / Medicare domain experience Please share suitable profiles at . Thanks, Kenny.

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Contract

Burgess Source Configurator - HealthEdge / HRP modules

Remote

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Today

Configuration Analyst The Burgess Source Configurator is responsible for configuring, maintaining and optimizing the Burgess Source claims pricing and payment integrity platform. This role ensures accurate reimbursement logic, regulatory compliance and seamless integration with payer systems. The configurator works closely with business, compliance and IT teams to deliver accurate pricing outcomes and support operational efficiency. RESPONSIBILITIES: Understanding of HRP modules and Burgess Sour

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Full-time

$75,000 - $85,000

Medical Biller

Remote

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Yesterday

Medical Biller (Inpatient/Medicare) for Physician Network (Remote) Our client is seeking a detail-oriented and knowledgeable Medical Biller (Remote) to join their team. This role is responsible for accurate and timely billing of inpatient, skilled nursing facility (SNF), and Medicare claims. The ideal candidate will have strong knowledge of healthcare billing regulations, coding guidelines and reimbursement processes, along with a commitment to compliance and accuracy. This organization is a reg

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Full-time

$50,000 - $60,000

Senior Migration Architect

Remote

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22d ago

Title:Senior Cloud Migration Architect Location: Remote Preference to Chicago, IL/Wisconsin Region for Client Travel Duration: 1 year Contract Compensation: $75-87/HR Based on Experience, Location, and Other Factors Work Requirements: , Holders or Authorized to Work in the US IT Managed Services Client Senior Cloud Migration Architect Our client is seeking two Senior Migration Architects to support a large-scale cloud migration initiative. This program has been in planning and discovery for ove

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Contract

$75 - $87

Master Scheduler with Project Management / PMO experience

Remote

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27d ago

We are seeking to hire several Master Schedulers with Project Management and PMO backgrounds, preferably in Healthcare / Medicare projects, to join our team working on a new multi-year award we have within State Govt clients, modernizing their Medicare/Medicaid claims systems. These roles are 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 w

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Full-time

Depends on Experience

Project Manager - PBM - PMP - Claims Adjudication

Remote

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7d ago

PBM is a must. Pharmacy or Health PlansClient PortalsProvider Network Management and/or Clinical Programs. Claims Adjudication is always a plus.

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Contract

$60+

Product Development Coordinator/Manager

Remote

•

Yesterday

Hiring a Product Development Manager with experiencein the Health Plan, PBM, or Medicare Advantage space; experience coordinating offshore development teams; strong Agile/Scrum and SDLC knowledge 100% remote in US only What Youll Do 1) Product Strategy & Roadmap Own the product strategy forclaims intake, validation, adjudication, pricing, payment, remittance, audit, and related integrations (EHR, Enrollment, UM, Risk, Quality/NCQA, Coding Scrubber). Define and maintain aquarterly roadmapaligne

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Full-time

$150000

Project Manager

Remote or Hybrid in Augusta, Maine

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22d ago

Primary Location: Live within the state of MaineWork will take place either in the field, in an office environment, or from a personal location and will depend on the need of the project.Travel Requirements: This position may require travel to complete work assignments or attend meetings.Essential Functions: Manage the implementation of RHTP projects / program as determined by the state, including day-to-day program governance and oversight of the grant. This includes issue escalation, recommend

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Full-time

Depends on Experience

Configuration Analyst

Remote or Hybrid in Jefferson City, Missouri

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Today

Hello Associates, Greetings from My3tech Inc Role: Configuration Analyst Burgess Source Location: Jefferson City, MO Or Remote Type: C2C/W2 Duration: Longterm Client: Wipro Job Description: We are looking for Health Edge Source Pricing Configuration Analyst. If you have anyone available, please share. The Burgess Source Configurator is responsible for configuring, maintaining and optimizing the Burgess Source claims pricing and payment integrity platform. This role ensures accurate reimburseme

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Third Party, Contract

Sr. SAS Programmer

Remote or New Jersey

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Today

Job Description: The senior programmer position will be responsible for manipulating large databases and generating reports to enable analysts to explore real world healthcare data assets. Candidates must have excellent SAS and SQL programming skills and the ability to implement complex logic. Candidates must be comfortable with creating complex analysis data sets derived from various data sources with a careful eye for outliers and errors. Prior experience building patient cohorts and evaluatin

Full-time

Manager, Data Analytics & Reporting

Remote or Arizona

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Today

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employmen

Full-time

USD 87,700.00 - 157,800.00 per year

Senior Data Scientist -- W2 ONLY

Remote

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9d ago

Title: Senior Data Scientist Location: Remote Terms of Employment: W2 Contract, 12 Months (Likely Extension) This position is primarily remote. Candidates must reside within a commutable distance of Reston, VA, to consider working onsite roughly six times per year for PI Planning purposes. This includes individuals up and down the East Coast. Travel would be at the expense of the individual. Overview & Responsibilities: Work with a leading healthcare solutions provider to revolutionize claim sy

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Contract

Depends on Experience

Senior Encounter Data Management Professional

Remote or Kentucky

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Today

Become a part of our caring community and help us put health first The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation of encounter submissions to Medicaid/Medicare. Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Sources data within the data warehouse aiding in the creation of new state layout e

Full-time

USD 78,400.00 - 107,800.00 per year

Utilization Management Specialist (Remote)

Remote or Oakland, California

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Today

Software Guidance & Assistance, Inc., (SGA), is searching for a Utilization Management Specialist for a Contract assignment with one of our premier Healthcare clients in Oakland, CA . Responsibilities : The Utilization Management Specialist (UMS) will play a pivotal role in supporting the Utilization Management (UM) team across all three AHS campuses. This multifaceted position will focus on both clinical and administrative functions within the UM department, ensuring seamless operations

Contract

USD 20.00 - 27.00 per hour

Senior Automation QA Engineer

Remote

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2d ago

Unissant, Inc.delivers innovative capabilities to the agencies that keep our nation healthy and safe. We apply our domain expertise, data acumen, and technology know-how to achieve breakthrough results for our clients. Working collaboratively, we advance missions and careers through a focus on honesty, integrity, and dependability. We continuously look for talent, excited to join that effort. To learn more about our exciting organization, please visit us at We are seeking a motivated, customer-o

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Full-time

Depends on Experience

Data Engineer (MS Azure/ Databricks/ Process Optimization)

Remote or Long Beach, California

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Today

Job Description Job Description Job Summary Database Developer is responsible for the overall development, maintenance, and integrity of various reporting database. You will be responsible for testing, reviewing SQL queries, stored procedures and facilitating code reviews for improving and maintaining new and existing datasets. You will be required to collaboratively work with other infrastructure and business stakeholders to adhere to data governance and ensure system integrity. Job Duties

Full-time

Medical Claims Auditor (Remote - Texas)

Remote or Dallas, Texas

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Today

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary The Medical Claims Auditor is responsible for reviewing and analyzing medical claims to ensure accuracy, compliance, and adhere

Full-time

USD 50,000.00 - 55,000.00 per year

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Medicare jobs in Camden, NJ, USA