Job Search Results for healthcare payer

Epic HB Contract Reimbursement Analyst

Insight Global is seeking an IT Application Analyst Level III ? Epic Resolute Contract Management professional for a top healthcare client. This individual will play a critical role in building,... More maintaining, and optimizing complex payer contracts across multiple Epic Resolute applications. The ideal candidate is a seasoned Epic analyst with strong revenue cycle expertise who enjoys partnering with business and operational leaders to ensure accurate reimbursement, regulatory compliance, and system excellence. This role offers high visibility, meaningful impact, and a flexible remote or hybrid work environment.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

Billing Specialist

Insight Global is looking for a billing specialist for one of their healthcare clients in New Jersey. Billing specialists will spend their day actively working assigned A/R and suspended claim work... More queues within Epic, focusing on denied, rejected, and stalled claims that are contributing to the collections backlog. They will research claim failures by reviewing payer responses, clearinghouse rejection codes, eligibility and authorization issues, and missing or incorrect clinical or demographic data, then take corrective action such as rebilling claims, submitting appeals, or escalating payer issues as needed. On a daily basis, they will prioritize high-dollar and aged accounts, document all follow-up activity clearly within Epic, and ensure timely resubmission to meet payer filing requirements. Billing specialists will collaborate closely with the Financial Project Manager to flag recurring issues, workflow gaps, or system configuration problems, participate in daily or weekly backlog review huddles, and adjust priorities based on recovery targets. They will also post payments and adjustments accurately, monitor account balances for resolution, and follow standardized procedures designed to improve cash flow, reduce future denials, and support compliance throughout the cleanup effort.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 Solutions Engineer

We are seeking an experienced Solutions Architect to join a high-visibility digital health initiative focused on expanding and enhancing a healthcare platform that connects patients, providers,... More pharmacies, payers, and external healthcare technology partners.This individual will serve as the technical lead for complex integration efforts, helping evaluate, design, and implement secure, scalable solutions that connect the platform with third-party vendors, Electronic Health Record (EHR) systems, healthcare providers, and external partners.The ideal candidate combines strong cloud architecture expertise with deep knowledge of healthcare integrations, APIs, identity/security protocols, and provider connectivity. This person will own the solution from requirements gathering through rollout, partnering closely with engineering, product, and business stakeholders to evaluate options, conduct proof-of-concepts, and drive architectural decisions.While this is not a hands-on development role, candidates must be highly technical and capable of guiding engineering teams through design, implementation, troubleshooting, and production deployments.Key Responsibilities?Design end-to-end solutions for integrating healthcare providers, payer systems, pharmacies, EHR platforms, and third-party technology vendors.?Evaluate integration approaches and conduct proof-of-concepts (POCs) to determine optimal technical solutions.?Make architectural recommendations around APIs, interface design, cloud infrastructure, security, authentication, and data exchange patterns.?Define secure connectivity strategies between internal platforms and external healthcare organizations.?Partner with product, engineering, and business stakeholders to translate requirements into scalable technical solutions.?Present architectural options, tradeoffs, and recommendations to leadership teams and drive alignment on final designs.?Guide engineering teams through implementation and production rollout activities.?Support troubleshooting and issue resolution during implementation and post-launch activities.?Architect solutions across cloud and hybrid environments, leveraging primarily Google Cloud Platform (GCP) services.?Drive standardization and reusable integration patterns across multiple ongoing initiatives.Compensation:$60/hr Exact compensation may vary based on several factors, including skills, experience, and education. Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.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 FHIR Java Developer

We are seeking a highly motivated FHIR Java Developer to support the design, development, and implementation of healthcare interoperability solutions for a critical enterprise healthcare application.... More This individual will be responsible for developing and enhancing FHIR-based APIs and integration services that enable secure, standards-based data exchange across internal and external healthcare systems. The ideal candidate will possess strong hands-on experience with Java, Spring Boot, RESTful APIs, and HL7 FHIR standards, along with a deep understanding of healthcare data models and interoperability frameworks. In this role, you will work closely with business analysts, product owners, architects, QA teams, and other engineering stakeholders to understand complex business requirements, translate them into technical solutions, and drive end-to-end delivery of interoperability initiatives. The successful candidate will be expected to take ownership of the solution, provide guidance on FHIR resource design and data mapping, support testing and validation efforts, troubleshoot integration issues, and serve as a key technical lead throughout the project lifecycle. Strong communication skills, the ability to coordinate cross-functional teams, and a proactive approach to driving requirements, solution design, and project execution are essential for success in this role.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

Denial Coordinator

Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals and Performance team, a centralized... More hospital denial team serving 10 hospitals. This role is hospital-based and denial-type driven, with work assigned via CARC codes rather than by inpatient or outpatient setting. Denials primarily include no-authorization (technical) and medical necessity / level-of-care (clinical) denials. Denial Coordinators work closely with RN reviewers and fellow technical staff in a fast-paced, collaborative environment.This is a production-focused role, with an expected daily volume of approximately 40 appeals per day, varying in complexity. Primary Responsibilities:- Work hospital denial accounts routed through proprietary system based on denial reason- Review denial letters to determine appeal feasibility and next steps- Draft and submit clear, detailed appeal letters for: ? No-authorization denials (technical)? Medical necessity and level-of-care denials (in partnership with RNs)- Collaborate daily with: ? RN reviewers? Other denial coordinators? Leadership and managed care partners as needed- Maintain timely follow-up on appealed accounts to ensure resolution- Identify denial trends and escalate issues appropriately- Participate in: ? Daily huddles? Case review meetings? Interdisciplinary denial discussions- Support special projects related to denial trends, payer behavior, or backlog reduction- Adapt to evolving workflows as the DAP team continues to build and scaleWe 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

Denial Coordinator

Insight Global is looking for a Denial Coordinator to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals and Performance team, a centralized... More hospital denial team serving 10 hospitals. This role is hospital-based and denial-type driven, with work assigned via CARC codes rather than by inpatient or outpatient setting. Denials primarily include no-authorization (technical) and medical necessity / level-of-care (clinical) denials. Denial Coordinators work closely with RN reviewers and fellow technical staff in a fast-paced, collaborative environment.This is a production-focused role, with an expected daily volume of approximately 40 appeals per day, varying in complexity. Primary Responsibilities:- Work hospital denial accounts routed through proprietary system based on denial reason- Review denial letters to determine appeal feasibility and next steps- Draft and submit clear, detailed appeal letters for: ? No-authorization denials (technical)? Medical necessity and level-of-care denials (in partnership with RNs)- Collaborate daily with: ? RN reviewers? Other denial coordinators? Leadership and managed care partners as needed- Maintain timely follow-up on appealed accounts to ensure resolution- Identify denial trends and escalate issues appropriately- Participate in: ? Daily huddles? Case review meetings? Interdisciplinary denial discussions- Support special projects related to denial trends, payer behavior, or backlog reduction- Adapt to evolving workflows as the DAP team continues to build and scaleWe 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

AR Specialist

DAY TO DAY:The Accounts Receivable Specialist follow up with insurance carriers on denied, underpaid, or unresolved insurance claims. This position requires a comprehensive understanding of the... More entire revenue cycle and appropriate actions to take to resolving claim issues with payers in a timely manner.RESPONSIBILITES: *Successfully navigate multiple vendors including but not limited to, payer websites and clearinghouse(s) *Produces and maintains department policies, procedures, documentation, and training materials for role specific activities *Upholds "best practices" in day-to-day processes and workflow standardization to drive maximum efficiencies across the team *Must maintain professional and consistent communication with the team and clients to ensure that all needed items are received in a timely manner *Routinely collaborate with department managers to correct problems and improve services *Accurately documents collection activity performed *Identifies inaccurate claim denials, under or over payments, billing errors, and discrepancies to correct to ensure resolution *Informs manager of identified issues or trends *Manages inbound and outbound calls for multiple clients, this may include handling different topics and being a contact between patients and clients *Provides timely resolution of assigned accounts for multiple clients *Successfully submits appeals to insurance companies to obtain reimbursement *Successfully navigates multiple vendors including, but not limited to, payer websites and clearinghouse(s) *Meets specified department performance requirements *Resolves support tickets submitted by clients and assigned to department according to metrics assigned *Manages time and multi-tasks appropriately to meet expectations of management and peers *Remote employee is responsible for sufficient internet connectivity and equipment necessary to complete assigned job duties in efficient manner *Remote employee is responsible to keep work area quiet and organized during scheduled working hoursWe 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

AR Specialist

DAY TO DAY:The Accounts Receivable Specialist follow up with insurance carriers on denied, underpaid, or unresolved insurance claims. This position requires a comprehensive understanding of the... More entire revenue cycle and appropriate actions to take to resolving claim issues with payers in a timely manner.RESPONSIBILITES: *Successfully navigate multiple vendors including but not limited to, payer websites and clearinghouse(s) *Produces and maintains department policies, procedures, documentation, and training materials for role specific activities *Upholds "best practices" in day-to-day processes and workflow standardization to drive maximum efficiencies across the team *Must maintain professional and consistent communication with the team and clients to ensure that all needed items are received in a timely manner *Routinely collaborate with department managers to correct problems and improve services *Accurately documents collection activity performed *Identifies inaccurate claim denials, under or over payments, billing errors, and discrepancies to correct to ensure resolution *Informs manager of identified issues or trends *Manages inbound and outbound calls for multiple clients, this may include handling different topics and being a contact between patients and clients *Provides timely resolution of assigned accounts for multiple clients *Successfully submits appeals to insurance companies to obtain reimbursement *Successfully navigates multiple vendors including, but not limited to, payer websites and clearinghouse(s) *Meets specified department performance requirements *Resolves support tickets submitted by clients and assigned to department according to metrics assigned *Manages time and multi-tasks appropriately to meet expectations of management and peers *Remote employee is responsible for sufficient internet connectivity and equipment necessary to complete assigned job duties in efficient manner *Remote employee is responsible to keep work area quiet and organized during scheduled working hoursWe 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 Platform Architect

Our client is an innovative healthcare technology organization focused on transforming care delivery through the integration of clinical expertise, advanced analytics, digital engagement tools, and... More value-based operating models. The organization is evolving its next-generation operating framework, leveraging real-time patient intelligence, predictive analytics, and AI-driven decision-making to optimize outcomes, operational efficiency, and resource allocation.To support this evolution, the organization is investing in a modern data and AI ecosystem capable of ingesting, processing, scoring, and acting on complex healthcare data in near real time. This platform will serve as a foundational capability for future growth, expansion into additional care domains, and the continued development of proprietary analytics and decision-support systems.The Data Platform Architect will lead the strategy, design, and execution of this platform, partnering closely with data, engineering, product, clinical, and operational stakeholders. This is a hybrid strategy-and-architecture role reporting to data leadership, requiring the ability to navigate executive conversations while remaining deeply involved in technical architecture and platform design.Primary Responsibilities:Define Data Strategy-Own and evolve the organization's long-term data strategy, supporting operational optimization, advanced analytics, AI initiatives, and future business expansion.-Guide executive stakeholders through architecture, investment, and technology tradeoffs.-Help establish and protect strategic data assets, including patient and provider intelligence models, proprietary outcome frameworks, and decision-support capabilities.Architect the Data Platform-Design and oversee the end-to-end healthcare data architecture, including data ingestion, event-driven integrations, identity resolution, lakehouse environments, feature stores, decisioning systems, orchestration layers, and observability capabilities.-Establish enterprise standards for data architecture, including event taxonomy, schema management, metadata governance, and data contracts.-Ensure scalability, flexibility, and interoperability across a rapidly evolving data ecosystem.Lead Vendor and Technology Strategy-Evaluate, select, and manage strategic technology partners across healthcare data, claims processing, provider intelligence, AI, customer data platforms, and analytics solutions.-Drive architecture decisions that promote portability, interoperability, and vendor independence.-Partner with legal, security, and compliance teams on data-sharing agreements, governance standards, and business associate agreements.Establish Data Governance and AI Controls-Create and enforce standards for HIPAA compliance, PHI protection, data governance, and responsible AI practices.Implement controls for data classification, access management, data lineage, auditability, consent management, and training-data governance.-Ensure all AI and analytics initiatives meet enterprise security, compliance, and explainability requirements.Partner Across the Organization-Translate architectural vision into actionable roadmaps and delivery plans for engineering teams.-Collaborate with clinical stakeholders to support quality measurement, outcomes tracking, and analytics initiatives.-Partner with operations and product teams to improve data capture, workflow efficiency, and decision-making processes.-Align technology investments with business objectives and operational priorities.Additional Responsibilities-Perform other duties and strategic initiatives as assigned.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

Research Billing Specialist

A client of Insight Global is looking for a research billing specialist to support a large healthcare system. This position sits within a specialized Revenue Cycle team focused on clinical research... More billing. The team reviews charges associated with clinical trials to ensure they are billed correctly based on Medicare regulations, clinical trial protocols, and research billing guidelines. After coding is completed, reviewers determine whether charges should be billed to the study, insurance, or both, and investigate claim denials, edits, and reimbursement issues to ensure compliance and accurate revenue capture. This position will be interacting with multiple departments and research teams, so communication skills are very crucial for this role. This is a fully remote position but must live within these specific states AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.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