Job Search Results for coding

REMOTE BCBS Outpatient Facility Claim Follow-Up Representative

Insight Global is looking for an Outpatient Facility Claim Follow Up Representative to support a large hospital system in the Maryland/DC area. This person is responsible for managing post-billing,... More specifically for Blue Cross Blue Shield, claim activity, for three acute hospital centers in Washington, DC. This role focuses on resolving underpayments, denials, and contract interpretation issues?not clinical denials or patient balances. The representative ensures accurate reimbursement by analyzing Explanation of Benefits (EOBs), identifying discrepancies, and initiating corrective actions with payers. This team focuses on facility claims only, and this role is focused only on outpatient claims follow up, specifically to BCBS. The role focuses on resolving technical denials (underpayment or partial payment issues, authorization issues, COB issues, coding issues, misinterpretation of contract issues, etc.).Primary Responsibilities:Claims Management:?Take ownership of outpatient hospital claims after billing, especially those that are denied or underpaid.?Determine what was paid, what was denied, and why.?Identify and resolve technical denials related to coding, coordination of benefits (COBs), charge discrepancies, contract interpretation, etc. Payer Interaction:?Handle all outpatient claims for Blue Cross Blue Sheild CareFirst and/or BlueCard. ?Understand and navigate multiple contracts. ?Utilize BCBS portal to follow up and resolve outstanding claim issues.Analytical Review:?Differentiate between pricing errors vs. payment errors.?Accurately price claims based on contract terms and identify variances.Scope of Work:?Outpatient facility claims ONLY ?Technical denials ONLYWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Data Architect - India

Insight Global is seeking a seasoned Data Architect with 10?12 years of experience specializing in Microsoft Dynamics 365 CRM, Power Platform, and data migration. The ideal candidate will have deep... More expertise in D365 CRM architecture, SSIS-based ETL processes, and Dataverse, with a strong ability to lead data engineering teams and collaborate across cross-functional groups.________________________________________Key Responsibilities:?Architect and design data solutions for D365 CRM and Power Platform implementations.?Lead the development and deployment of SSIS packages for data integration and transformation.?Manage data import/export, cleansing, and transformation processes.?Draft and execute data conversion plans in coordination with clients and internal teams.?Analyze legacy systems and perform data mapping between source and destination systems.?Facilitate planning, design, and mapping discussions; schedule and lead related meetings.?Coordinate between development and data migration teams to ensure seamless execution.?Ensure adherence to coding best practices and technical requirements per industry standards and client methodologies.?Work directly with clients and Microsoft stakeholders to align on data architecture strategies.?Mentor and manage a team of data engineers, ensuring timely delivery and quality outcomes.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Senior Java Developer - INTL Mexico

A large global retailer is seeking a highly skilled Senior Java Developer to join our team for Point-of-Sale migration projects. The ideal candidate will have a strong background in developing... More backend services, building scalable microservices, and ensuring high reliability and performance. This role involves migrating old POS systems to new ones, setting up pipelines, and pushing updates to production.Key Responsibilities:Migrate old POS systems to new ones, ensuring seamless integration and minimal disruptionDevelop and maintain backend services using Java and Spring BootBuild highly reliable and scalable microservicesUtilize Splunk, open Observe, and Grafana for alerting, dashboard creation, and log searchImplement CI/CD pipelines using JenkinsWrite unit tests using Mockito for Java functions and componentsWrite regression tests using Cucumber and integration tests to ensure service reliabilityDeploy microservices and manage clusters using KubernetesPerform requirement and scoping analysis, including creating traceability matrices, conducting risk analysis, and understanding business objectivesPrepare requirement traceability matrices and maintain traceability between business requirements, functional requirements, design, and test casesContribute to the creation of user stories for agile methodology, ensuring scalability and alignment with business needsReview and adhere to coding standards and guidelinesProvide production deployment and support for clientsWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Clinical Documentation Specialist RN

The Clinical Documentation Specialist (CDS) is responsible for supporting and facilitating the overall quality of medical record documentation by improving the completeness, accuracy, and reliability... More of clinical documentation. A key success factor of this process is educating providers through the query process and independently supporting them with education and feedback to accurately reflect the patient's true clinical picture within the medical record. In partnering with the coding team, the CDS will be an expert with ICD-10, NS-DRG and APR-DRG assignment. The CDS's primary responsibility will be to obtain appropriate clinical documentation through extensive review of provider, nursing, ancillary, and other patient caregivers' documentation, to ensure that appropriate documentation and reimbursement is received for the level of services rendered to patients. The CDS exercises their judgment and discretion to ensure the clinical information utilized in analyzing and reporting outcomes is complete and accurate. On an ongoing basis, the CDS is responsible for supporting the direction and focus of education for providers and the coding staff within their assigned scope of work. The CDS must exercise independent judgment, critical thinking, ability to work independently while interpreting and following CMS guidelines, organizational policies, and procedures.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Lead Java Developers

In this role, candidates will be a hands-on developer responsible for coding and building robust Java-based applications while also serving as a coach and player for the team. You will oversee and... More manage the development team, providing guidance and support on daily workloads while contributing directly to coding tasks. A significant part of your responsibilities will involve designing and implementing APIs, ensuring seamless integration across systems, and maintaining high-quality standards in code delivery. You will actively participate in technical discussions, troubleshoot issues, and collaborate with cross-functional teams to deliver scalable solutions. Additionally, you will ensure adherence to best practices in containerized development, CI/CD pipelines, and cloud deployments, while fostering an Agile environment that promotes continuous improvement and innovation.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Remote Senior Software Engineer

A large Healthcare client is looking for a Senior Fullstack Software Engineer who is passionate about solving real-world business problems to join our team. As a Senior member of the team, you will... More be working on developing solutions that help our customers integrate with our product suite. You will be working as a problem solver with plenty of unique assignments within the department. You will be a key member involved with design discussions, coding on both the backend and frontend, and working heavily with the database and J2EE/integration technologies.Your Impact: ?Work as part of an agile team to implement new features according to the requirements while adhering to the best coding development standards. ?Conduct detailed designs and lead design whiteboarding and creation of solution architecture. ?Lead in work-breakdown of tasks. ?Lead peer reviews of design and code. ?Coordinate release management and bug triaging. ?Lead technical discussions with customers to find the best possible solutions. ?Conduct bug fixing, implement configuration migration processes, and other UAT readiness technical tasks. ?Perform data loads for UAT readiness and during UAT as requested by the UAT plan. ?Support resolution of UAT identified issues and their triage. ?Contribute to authoring the Implementation Operational Information and companion spreadsheet for feeds. ?Perform configuration migration processes and other PROD readiness technical tasks. ?Perform data loads for PROD readiness. ?Perform all job functions consistent with HealthEdge policies and procedures, including those which govern handling PHI and PII.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Lead JAVA AWS Full Stack Engineer

A client of Insight Global seeks a Full Stack Software Engineer Lead that will drive design and conversion of legacy systems using JAVA APIs using AWS cloud native applications for Medicare... More beneficiaries. Working as part of an agile team, this position will develop front and back-end application components and APIs to support development and enhancement of cloud-based solutions, and support integration testing to validate the Medicare claims processing workflow. The successful candidate will be a strong collaborator to deliver a best-in-class customer experience. We are looking for someone who thrives in a fast-paced environment, is customer-focused and team oriented, and demonstrates interpersonal skills that encourage creativity and continuous improvement. ?Effectively collaborate in a technical lead position of an agile team to deliver software components, participating in sprint ceremonies such as backlog refinement, sprint planning, daily stand up, retrospectives, etc. ?Provide expertise and direction in the development, testing, and enhancements of AWS-based Web applications and APIs?Provide requirements analysis, software design, development, coding, testing, and debugging of custom solutions?Enable automated deployments to AWS through the creation and use of CI/CD Pipeline?Document solutions and specifications in Confluence, create and complete user stories via Jira, and collaborate with team members and stakeholders via Slack.?Collaborate with Operations and Site Reliability Engineering team to leverage available platforms, infrastructure as code templates, and continuously optimize application performance?Create front end components using Java, Java Scripts, Springboot, React or similar languages?Assist with the development of database entities like Amazon RDS, DynamoDB, and Flyway?Perform peer reviews of application codeWe are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Front End Developer - Cority

My clients are looking for a Frontend Developer with expertise in coding for a EHS SAAS platform called Cority. The ideal candidate will have experience with Cority software and interface tools. This... More is a product support role that will be in charge of troubleshooting, bugfixes and software maintenance. You will be part of a scrum team consisting of Business Analysts, Developers, and Scrum Masters, totaling 8 members. Day to day breakdown includes 75% Individual contributor work and 20%-25% Team meetings and collaboration. Responsibilities include but are not limited to: Develop and maintain user-facing features on the Cority platform. Translate UI/UX design wireframes into code, producing visually appealing and user-friendly interfaces. Optimize applications for maximum speed and scalability. Collaborate with back-end developers and web designers to improve usability. Ensure high-quality graphic standards and brand consistency. Stay up-to-date on emerging technologies and best practices.We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form. The EEOC "Know Your Rights" Poster is available here. To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .Less

Automation Quality Engineer (QE)

An employer for a large insurance company is looking for a Senior Automation QE to join different project/sprint teams. This person should be strong technically in QA Automation (Java/Selenium, UI... More testing, API testing) and transfer to release to the functional side. 100% of this role will be focused on the Automation framework. Responsibilities include:? Developing/Coding on Automation Framework (implementing new functionality, rewriting/enhancing framework, etc)? Supporting the QE automation framework and migrating test cases to the V3 automation framework.**Role is 100% REMOTE but candidate preference is - LOCAL to anywhere in CA - required to come on site 1x a month or as needed to meet with team and collaborate**We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Principal Software Engineer ? Generative AI - Contract to Hire

Our Healthcare Insurance Client is looking to hire a Principal Software Engineer - Generative AI. This position is remote work from home and will convert to an FTE position after 1 year. Annual... More salary upon conversion to FTE will be $215-260K. We are seeking a Principal Software Engineer to lead the design and delivery of enterprise-scale Generative AI solutions that power next-generation healthcare experiences. This role goes beyond hands-on coding?you will define technical strategy, establish architectural standards, and guide multiple teams in building secure, scalable, and cost-effective AI platforms across AWS (Bedrock) and Google Cloud (Vertex AI API). You will partner with product, security, compliance, and enterprise architecture teams to ensure solutions meet business objectives, regulatory requirements, and performance goals.The ideal candidate combines deep technical expertise with leadership skills?capable of influencing cross-org architecture decisions, mentoring engineering teams, and driving responsible AI practices in production.Key Responsibilities?Lead end-to-end platform delivery of highly scalable, secure AI services and applications leveraging AWS Bedrock (Foundation Models, Knowledge Bases, Agents, Guardrails) and Google Cloud Vertex AI (Gemini via Vertex AI API, Agent Builder, Vector Search, Search & Grounding).?Architect and implement Retrieval-Augmented Generation (RAG) solutions, integrating proprietary data from sources like Amazon S3 and Google Cloud Storage/BigQuery, and using Bedrock Knowledge Bases and/or Vertex AI Search & Grounding with Vector Search to improve relevance and accuracy.?Design solutions that use function/tool calling and multimodal input processing across both platforms (e.g., Bedrock Converse API and Vertex AI API), and integrate with enterprise systems via secure, well-governed service interfaces.?Define reference architectures, golden paths, and guardrails for multi-cloud AI development; drive adoption through design reviews, Architecture Decision Records (ADRs), and clear SLOs for latency, resiliency, safety, and cost.?Champion Responsible AI: implement safety filters, policy-enforced guardrails, data minimization, and red-teaming playbooks using capabilities such as Bedrock Guardrails and Vertex AI Safety.?Partner with Security, Privacy, and Legal to ensure compliance with HIPAA/PHI, encryption, access control, and continuous auditability.?Build evaluation and observability frameworks (groundedness, hallucination rates, relevance, toxicity, drift, cost attribution, A/B testing) and drive FinOps practices (prompt optimization, caching, batching, model selection) across clouds.?Mentor Staff/Senior Engineers, elevate coding and design standards, and foster a culture of learning (design clinics, brown bags, communities of practice).?Monitor the rapidly evolving AI landscape (LLMs, agent frameworks, platform features) and translate advances into actionable platform strategy and roadmaps.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less