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Clinical Support Representative | Remote | Contract

Walker Healthforce

Remote

Contract

Clinical Support Representative | Remote | Contract Walker Healthforce is seeking a Clinical Support Representative with 1-3+ years of experience. This is a contract opportunity. CORE REQUIREMENTS: Understanding of plan benefits and products/Understanding of URAC, NCQA, Rule 10, DOL, and other regulatory standards pertaining to Case/Care Management Understanding of medical terminology and medical coding, to include ICD-9, HCPCS, and CPT4 Understanding of claims adjudication and data systems Co

Supplemental Benefits Medical Director (Physician Reviewer) | Remote | Contract to Hire

Walker Healthforce

Remote

Contract

Supplemental Benefits Medical Director|10+ years | Remote | Contract Walker Healthforce is seeking a Supplemental Benefits Medical Directorwith 10+ years experience to support a healthcare client based out of Nashville, TN. This is a 6-month contract opportunity. START DATE: ASAP CORE REQUIREMENTS: TheMedical Director will be a Board-certified physician with current unrestricted medical license Minimum of 10-years of clinical practice experience. Candidates must be able to obtain medical lice

Java Developer with Healthcare Claims Processing - ONLY W2

nTech Solutions

Remote or Reston, Virginia, USA

Contract

ONLY W2ONLY W2ONLY W2 MUST HAVE experience with Healthcare Claims processing Title: Java Developer with Healthcare Claims Processing Location: Reston, VA (Hybrid) Duration: 6 Months Contract + Extension Job Description: Terms of Employment Contract, 6 Months This position is hybrid. Candidates should be comfortable working onsite in Reston, VA up to once per week. Overview & Responsibilities We are seeking a skilled Java Developer with strong experience in healthcare claims processing and mode

Healthcare Economics Consultant or Hospital Claims Data Analyst - Remote

UnitedHealth Group

Remote or Ontario, California, USA

Full-time

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Optum is looking for a motivated, self-starter to join our Institutional Contracting Analytics team. In this role, you will support contract negotiations and unit-cost pricing initiatives for institutional provider types (ie. hospitals, skilled nursing facilities, a

Pharmacy Technician | Remote | Michigan | Contract

Walker Healthforce

Remote

Contract

Pharmacy Technician | Remote | Michigan |Contract Walker Healthforce is seeking a Pharmacy Technician with 2-4+ years of experience in Michigan. This is a 6-month contract opportunity. CORE REQUIREMENTS: 2-4 years Specialty and/or Retail Pharmacy- knowledge ofspecialty prescription drug names, NDC drug codes, therapeutic classes and/or claims processing Experience in provider/member call center or helpdesk with high volume call experience Analyzing written, faxed, and verbal inquiries which may

Managed Care Coordinator | Hopewell, NJ | Hybrid | Contract

Walker Healthforce

Pennington, New Jersey, USA

Contract

Managed Care Coordinator | 2 Years of Experience | Hopewell, NJ | Hybrid | Contract Walker Healthforce is seeking aManaged Care Coordinator with 2Years of Experienceto support a Healthcare Payer Clientbased out of New Jersey. This is a 6 monthContractopportunity. RATE RANGE: $18 - 21 Hourly HOURS/SCHEDULE:Monday-Friday 8:30am-5pm EST WORKER TYPE: W2 CORE REQUIREMENTS: 1-2 years customer service or medical support related position. Exposure to Utilization Management functions High volume Call

Interim Operations Manager - Revenue Integrity

GHR Healthcare

Remote

Contract

Interim Operations Manager - Revenue Integrity | Remote Healthcare Jobs Interim Operations Manager - Revenue Integrity Join our dynamic healthcare team as an Interim Regional Operations Manager specializing in Revenue Integrity. This remote healthcare job involves leading Release of Information (ROI) operations while ensuring compliance with revenue cycle integrity initiatives. Ideal candidates will possess strong leadership skills, operational oversight, and expertise in Health Information Mana

Supplemental Benefits Medical Director | Remote | Contract to Hire

Walker Healthforce

Remote

Contract

Supplemental Benefits Medical Director|10+ years | Remote | Nashville, Houston, or Alabama| Contract Walker Healthforce is seeking a Supplemental Benefits Medical Directorwith 10+ years experience to support a healthcare client based out of Nashville, Houston, or Alabama. This is a 6-month contract opportunity. START DATE: ASAP CORE REQUIREMENTS: TheMedical Director will be a Board-certified physician with current unrestricted medical license Minimum of 10-years of clinical practice experienc

Implementation Consultant - Payer/Provider/Healthcare

w3r Consulting

Chicago, Illinois, USA

Contract

BASIC FUNCTION This position is responsible for leading client focused implementations of accounts and legislative and regulatory initiatives within sales operations and product. Implements account and legislative initiatives (of high complexity), monitors compliance and conformity of implementations. Forms key partnerships with other client's business areas, and work to coordinate the implementations response required to support the solution. Work with all business areas that impact the client

Pega LSA (Lead System Architect) || Contract at TX and NJ

IT First Source

Austin, Texas, USA

Contract

Pega LSA (Lead System Architect) || Contract at Austin, TX or Morristown, NJ LSA Certification is Mandatory Job Requirement: 10+ years of experience ,Pega Lead System Architect (LSA) is responsible for architecting and designing business applications using Pega PRPC and other Pega frameworks.Provides architecture and design guidance to project teams developing BPM/BRE solutions using Pega.,Provide thought-leadership to client across business and technical project dimensions solving complex busin

Medical Claims Examiner - M

Next Step Systems

Tucson, Arizona, USA

Full-time

Medical Claims Examiner, Tucson, AZ The Medical Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of

Medical Claims Coder - M

Next Step Systems

Tucson, Arizona, USA

Full-time

Medical Claims Coder, Tucson, AZ The Medical Claims Coder needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medica

Claims Examiner - M

Next Step Systems

Tucson, Arizona, USA

Full-time

Claims Examiner, Tucson, AZ The Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Claims Examiner

Member Care Coordinator | Farmington, NM | Contract to Hire

Walker Healthforce

Albuquerque, New Mexico, USA

Contract

Member Care Coordinator| 2+ Years of Experience| Remote/Fieldwork| Farmington, NM| Contract to Hire Walker Healthforce is seeking a Member Care Coordinatorwith 2+ years of experienceto support a healthcare clientbased out of Farmington, NM.This is a 6 month contract to Hireopportunity. START DATE: June 5, 2025 HOURS/SCHEDULE: Monday - Friday; 8:00 AM to 5:00 PM MST (Will be in the field 4-5 days a week) WORKER TYPE: Full-Time CORE REQUIREMENTS: Candidate is required to meet one of the followi

Implementation Consultant | Chicago, IL | Contract to Hire

Walker Healthforce

Chicago, Illinois, USA

Contract

ImplementationConsultant| 5+ Years of Experience| Hybrid| Chicago, IL| Contract to Hire Walker Healthforce is seeking a ImplementationConsultant with 5+ years to support a healthcare clientbased out of Chicago, IL. This is a 6-monthcontract to hire opportunity. PAY RATE: $60- $64 START DATE: ASAP HOURS/SCHEDULE: M-F; 8:00 AM - 5:00 PM CST (3 day onsite, 2 days remote) WORKER TYPE: Full-Time W2 CORE REQUIREMENTS: Bachelor degree and 5 years of experience in business or project management expe

Senior Provider Network Consultant | Chicago, IL | Contract to Hire

Walker Healthforce

Chicago, Illinois, USA

Contract

Senior Provider Network Consultant| 3+ Years of Experience| Hybrid| Chicago, IL| Contract to Hire Walker Healthforce is seeking a Senior Provider Network Consultant with 3+ years to support a healthcare clientbased out of Chicago, IL. This is a 6-monthcontract to hire opportunity. PAY RATE: $41 - $43.50 START DATE: ASAP HOURS/SCHEDULE: M-F; 8:00 AM - 5:00 PM CST (3 day onsite, 2 days remote) WORKER TYPE: Full-Time W2 CORE REQUIREMENTS: Bachelors Degree OR limited experience gathering and ass

Enrollment Specialist, Bilingual English and Spanish Preferred - M

Next Step Systems

Tucson, Arizona, USA

Full-time

Enrollment Specialist, Bilingual English and Spanish Preferred, Tucson, AZ Under direct supervision, the Enrollment Specialist is responsible for serving as the initial point of contact for community members inquiring about health services and making appropriate referrals to internal and/or external resources. Be responsible for timely enrollments and facilitation of initial screening of clients per contract. This position is 100% Onsite and NOT Remote. Enrollment Specialist Responsibilities:

QA Data Validation Engineer

Galax-Esystems Corp

Remote

Contract

QA Data Validation Engineer Location: Remote Contract 2 Hire Visa: USC/Ead W2/Fulltime The Data team is seeking a meticulous and detail-oriented QA Data Validation Specialist to ensure the accuracy, integrity, and reliability of our data. You will play a critical role in maintaining high data quality standards by designing, implementing, and executing validation processes. Your work will directly impact the quality of our products, services, and decision-making processes. Essential Functions:

Business Analyst

GreyCell Labs, Inc

Albany, New York, USA

Contract, Third Party

84 months experience eliciting business requirements from business customers or system artifacts and maintaining such requirements. 84 Months experience developing business requirements and process documentation such as use cases, process flows, screen mock-ups, and data dictionaries. 84 months of QA experience including the following: Create Test Plans, Test Cases, and Test scripts Execute functional and system tests including regression tests using manual testing tools and record results using

Medical Support Specialist

Pyramid Consulting, Inc.

Hawaii, USA

Contract

Immediate need for a talented Medical Support Specialist. This is a 06+months contract opportunity with long-term potential and is located in Maui, HI (Mahalani St, Wailuku, HI)(Hybrid). Please review the job description below and contact me ASAP if you are interested. Job ID: 25-71153 Pay Range: $20 - $25/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Requirements and Techno