UNKNOWN

FEED

PHISHING SCAM WARNING: Goodwill of Central and Northern Arizona/Goodwill Industries of Monocacy Valley, Inc. (“GCNA/GIMV”) are among several companies recently made aware of a phishing scam involving con artists posing as hiring managers recruiting via email, text and social media. As a key member of the ELT, the CLO balances legal risk with business objectives, ensuring the organization operates with integrity, compliance, and sound governance while supporting strategic initiatives, mergers and acquisitions, expansion efforts, and stakeholder interests.

Goodwill of Central & Northern Arizona

SVP Chief Legal Officer

This is accomplished by leveraging a deep understanding of Oscar''s claim infrastructure, workflows, workflow tooling, platform logic, data models, etc., to work cross-functionally to understand and translate friction from stakeholders into actionable opportunities for improvement. Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services.

YEAR

Oscar Health Inc

Associate, Payment Integrity IBR

Position Summary The Senior Internal Human Resources Specialist - People Relations & HR Partnerships will play a critical role in fostering a positive work environment by managing employee relations, conducting thorough investigations, assisting in reviewing and providing guidance to the team on termination consultation escalations, and offering performance management and discipline training and coaching to managers. • Create investigation plans, send investigation notices, schedule investigation interviews, prepare investigation interview questions based on the specific details of the complaint, conduct investigation interviews, take detailed investigation notes, ensure signed statements and/or interview notes are signed off on by the investigation participants, prepare investigation summary report and exhibit list to document findings and evidence collected, update the investigation tracker, and ensure investigation files are complete and organized.

HOUR

Distro

Sr Internal HR Specialist, People Relations - AZ, GA - On Site

ea_via_bold

Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans. Responsible for system maintenance of Athena master files including referring provider information, accurate insurance plan information and payer enrollments.

Healthcare Outcomes Performance Company

Billing Specialist

The Account Follow-up Representative II is required to learn multiple hospital systems, conduct research analysis, utilize intermediate skills to work basic to complex outstanding insurance claims, work closely with third party payors to answer relevant questions and obtain appropriate information in pursuit of resolving unpaid claims. Timely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient's insurance, proration to correct financial class and notation of patient accounts with steps taken for resolution.

Harris Computer Systems

(Remote) Account Follow-Up Representative I

GS-08: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: interpreting and applying federal, state, Tribal, and third-party program regulations to determine eligibility and ensure compliance for programs such as Purchase Referred Care, Medicare, Medicaid, Affordable Care Act, Veterans Affairs Healthcare, and other alternate resources; conducting in-depth patient interviews to assess eligibility, verify coverage, and complete applications; registering eligible patients in various assistance programs; resolving claim denials and eligibility issues through coordination with patients, healthcare providers, and outside agencies; reviewing Medicaid eligibility information and supporting billing requirements; and utilizing effective oral and written communication to explain program requirements, provide referrals, and resolve complex patient service issues. MINIMUM QUALIFICATIONS: GS-06: our resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: determining patient eligibility for alternate resources programs; interpreting and applying Medicare, Medicaid, VA, and other third-party payer policies and procedures; conducting patient interviews to identify available healthcare coverage and funding sources; assisting patients with enrollment and claims processes; researching and resolving eligibility, denial, and reimbursement issues; maintaining effective working relationships with patients and resource agencies; and safeguarding confidential patient information in accordance with Privacy Act and HIPAA requirements.

US Department of Health and Human Services

Contact Representative (Benefits Coordinator)

You will resolve denied claims, handle payment posting and refunds, verify patient eligibility, and collaborate closely with clinicians to ensure a seamless, supportive billing experience. In recruiting for our team, we welcome the unique contributions that you can bring in terms of your education, opinions, culture, ethnicity, race, sex, gender identity and expression, nation of origin, age, languages spoken, veteran status, color, religion, disability, sexual orientation and beliefs.

Blackbird Health

GreenHouseAPI

BASIC REQUIREMENT(S): All applicants must meet the following basic requirements for all grade levels: Graduation from a physician assistant educational program, accredited by the Accreditation Review Committee on Education for the Physician Assistant (ARC-PA) or its predecessors, at a college, university, or educational institution that is accredited by an accrediting body or organization recognized by the U.S. Department of Education at the time the degree was obtained. Examples of work experience includes: providing comprehensive preventive and therapeutic healthcare services to all age groups that includes assessment, diagnosis and treatment of various illnesses; formulating and implementing treatment plans; prescribing medications; ordering and interpreting diagnostic tests; educating and counseling patients; and collaborating with physicians concerning patient care and management.

Physician Assistant

Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference. Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Provided primary eye care services by performing comprehensive ocular examinations.

Optometrist

A minimum of 8 years of experience in underwriting profitable Liability business, including specialized expert understanding of sub-LoB products and portfolio; Recognized, well-established long term relationship building with brokers at peer group level and within the local market; Specialized understanding of regional/local Liability insurance markets and competitor landscape, including global elements; Understanding of legal and regulatory framework; Ability to assess risk inherent exposures and natural hazards relevant to Liability; Ability to analyze current performance against benchmarks applying how the market operates and functions, the business needs and customer needs; Experience designing, developing and implementing consistent, robust wordings; Robust understanding of policy administration life cycle, information collection, policy issuance, premium bookings, credit control, and cancellation; Ability to analyze highly complex data, from multiple sources, in detail, identifying and resolving issues before they transpire; Excellent written and verbal communications skills, with an ability to influence others; Experience with MS Office tools; Significant experience in leadership and development of direct teams, including coaching, mentoring and developing team members and performance assessment; Ability to persuade and motivate others to act, without executive authority; A deep knowledge of artificial intelligence (AI) and machine learning (ML), with the ability to leverage AI-driven insights to shape strategic decisions and drive innovation across the organization; and. The Impact You Will Have: Reporting to the Head of National Accounts, Liability, the Liability Zone Leader - West will: Lead a team of underwriters/team leads to underwrite profitable new and renewal business to meet Liability targets regionally and/or globally; Lead team in negotiating participation, pricing and terms and conditions for large/critical clients; Take ownership of large/critical accounts/clients and will have ultimate responsibility for accounts within the team; Lead and manage a team, including training and development and act as the referral point for other underwriters; and.

Allianz SE

Liability Zone Leader - West

Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Prepares draft narratives, graphs, flowcharts, etc. for use in presentations and audits; researches claims appeals and grievances using support systems to determine appeals and grievances outcomes.

Molina Healthcare Inc

Lead Specialist, Appeals & Grievances (Remote)

Work collaboratively with all internal and external customers and departments to ensure timely and accurate patient registration and processing related to all aspects of the patient and revenue cycle process are followed. Responsible for reviewing and approving timesheets and paid time off requests in the time management system and will generate regular reports to the management team on staff adherence to schedule.

Director, Patient Access

This senior leader will oversee approximately 40 clinical professionals, including four direct-report managers, and drive proactive, data-driven workers' compensation medical case management performance, clinical quality, operational consistency, and claim outcomes in a fast-paced, high-change environment. Reporting to the Head of Managed Care and Clinical, the Director, Medical Case Management will lead Western Zone workers' compensation medical case management operations to improve claim outcomes, return-to-work results, medical management impact, quality, compliance, and team performance.

Amtrust Financial Services Inc

Director, Medical Case Management (Western Zone)

The ideal candidate possesses extensive experience negotiating and implementing large-scale settlements involving thousands of claimants and has a deep understanding of contract drafting principles, claims administration, settlement allocation methodologies, lien resolution, data management, reporting obligations and compliance issues, and settlement fund governance. This attorney will be responsible for leading and managing all aspects of complex product liability, toxic tort, and mass tort settlements from initial negotiations through final claim resolution and program closure.

Barnes & Thornburg LLP

Counsel – Settlement Team

TransPerfect Connect (TPC) is the world's leading provider of remote interpreting solutions, including over-the-phone interpretation (OPI), video remote interpretation, multilingual email and chat support, business process outsourcing, and global call center services. Customer Service Associates are responsible for processing in-bound calls with third party client displaying great customer service skills to ensure highest level of customer satisfaction.

TransPerfect Inc

Customer Service Representative

Temporary Customer Service Representative

Join our team as a Claims Processing Executive in the healthcare sector where you will utilize your expertise in MS Excel to efficiently manage and process commercial claims. Your contributions will directly impact the accuracy and efficiency of our claims processing, enhancing customer satisfaction and operational excellence.

Ipolarity LLC

BPO TeamLead Operations - OPTLOP

Ceipal

OTHER

Our client is an American multinational information technology services and consulting company and is a leading provider of information technology, consulting, and business process outsourcing services, dedicated helping the world's leading companies build stronger businesses. TekWissen is a global workforce management provider headquartered in Ann Arbor, Michigan that offers strategic talent solutions to our clients world-wide.

WE THE TEKWISSEN PEOPLE TekWissen offers you a broader portfolio of services, industry-leading solutions, and the meaningful innovations that give you greater flexibility and speed to respond to market dynamics, reduced costs and risk to improve enterprise performance, and increased productivity to enable growth.To keep pace with global market demands, TekWissen keeps its finger on the pulse of change. Our organized approach to guiding a project from its inception to closure. Managing projects is becoming more and more important as we enter the digital era. To cope with the pace that this transition demands, a method is required to manage projects so they can yield quality work, while incorporating efficient use of time and resources. Project involves identifying which quality standards are relevant to the project and determining how to satisfy them. It is important to perform quality planning during the Planning Process and should be done alongside the other project planning processes because changes in the quality will likely require changes in the other planning processes, or the desired product quality may require a detailed risk analysis of an identified problem. It is important to remember that quality should be planned, designed, then built in, not added on after the fact. Capabilities and accomplishments in one TekWissen business enhance the opportunity for success in the others. Put simply, TekWissen's unique combination of attributes promotes success.

TekWissen LLC

The Risk Analyst maintains OSHA injury and illness records, monitors Total Recordable Incident Rate (TRIR) and other key risk metrics, coordinates risk-related training activities, and analyzes claims and safety trends to identify trends and opportunities for management review related to injury reduction, claims cost control, and risk exposure. This position functions as the central project coordinator for workers' compensation claims, coordinating activities among employees, Human Resources, Environmental Health and Safety (EHS), medical providers, insurance carriers, third-party administrators, and other stakeholders to ensure effective claim administration and communication.

Amkor Technology Inc

Risk Analyst (ATA)

And here’s what truly sets us apart: Felix is the only General Contractor in Arizona with in-house General Contracting, Electrical, and Industrial Controls UL508A-certified panel shop—all under one roof. As our Benefits Specialist, you'll play a key role in ensuring our employees and their families receive exceptional support while helping Felix make data-driven decisions about our benefits strategy.

Claims Manager Jobs in Scottsdale, AZ

SVP Chief Legal Officer Goodwill of Central & Northern Arizona

Associate, Payment Integrity IBR Oscar Health Inc

Sr Internal HR Specialist, People Relations - AZ, GA - On Site Distro

Billing Specialist Healthcare Outcomes Performance Company

(Remote) Account Follow-Up Representative I Harris Computer Systems

Contact Representative (Benefits Coordinator) US Department of Health and Human Services

Billing Specialist Blackbird Health

Physician Assistant US Department of Health and Human Services

Optometrist US Department of Health and Human Services

Liability Zone Leader - West Allianz SE

Lead Specialist, Appeals & Grievances (Remote) Molina Healthcare Inc

Director, Patient Access Healthcare Outcomes Performance Company

Director, Medical Case Management (Western Zone) Amtrust Financial Services Inc

Counsel – Settlement Team Barnes & Thornburg LLP

Customer Service Representative TransPerfect Inc

Temporary Customer Service Representative TransPerfect Inc

BPO TeamLead Operations - OPTLOP Ipolarity LLC

BPO TeamLead Operations - OPTLOP TekWissen LLC

Risk Analyst (ATA) Amkor Technology Inc

Benefits Specialist Felix Construction

Similar Job Searches

See More Jobs

Stand out to leading employers.