Job Search Results for healthcare payer

Job DescriptionInsight Global is seeking an Epic HB Claims Analyst for a healthcare organization preparing for an Epic go-live this fall. This consultant will serve as the primary Hospital Billing... More (HB) Claims subject matter expert, supporting claims administration, reimbursement workflows, payer posting, contract billing, and third-party claims integrations. The ideal candidate has extensive hands-on Epic HB Claims experience, including Epic build and configuration, claims optimization, denial management, and reimbursement processes. This individual should have experience supporting Epic implementations through testing, training, go-live, and post-live stabilization, while partnering closely with revenue cycle, operational, and technical teams to ensure successful adoption and long-term claims performance. The consultant will play a critical role in supporting implementation milestones, ensuring claims processing accuracy, and driving workflow optimization before, during, and after go-live. The ability to work onsite during key phases of the implementation are required.Day-to-Day?Serve as the Epic HB Claims SME supporting implementation, optimization, and operational readiness activities.?Build, configure, and maintain Epic Hospital Billing claims workflows and functionality.?Support claims administration processes, including claim generation, editing, submission, reconciliation, and reimbursement workflows.?Manage payer posting processes and support contract billing functionality to ensure accurate claims adjudication and reimbursement.?Collaborate with internal and external stakeholders to support third-party claims integrations and resolve interface-related issues.?Analyze claim denials, reimbursement variances, and claims processing failures to identify root causes and implement corrective actions.?Participate in Epic payment group initiatives and workflow design sessions to align system functionality with business requirements.?Support system testing, validation, defect resolution, and go-live readiness activities across the HB Claims application.?Assist with end-user training, workflow adoption, and knowledge transfer efforts before and after go-live.?Provide command center, at-the-elbow, and post-live stabilization support during critical implementation phases.?Identify opportunities to improve claims workflows, reimbursement outcomes, and overall revenue cycle performance.?Partner with revenue cycle, operational, and IT teams to establish best practices and optimize claims-related processes.?Work onsite as needed during key implementation, go-live, and stabilization milestones.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

8+ years Salesforce experience, leading enterprise implementations. Health Cloud expertise?Salesforce Platform Developer 1 (PD1) Certification?Agent force Specialist Certification?5+ years of SFDC... More Developer/Admin experience with Salesforce Technologies Salesforce CRM, Apex Language, Apex Classes, Apex Triggers, SOQL, Visual Force Pages, Workflow & Approvals, Dashboards, Custom Objects, Package Installations, Email Templates, Formulas, Validation Rules, AppExchange Apex Data Loader, Roles & Profiles?8+ years of experience with Programming languages APEX, Core Java, Java Script. Salesforce Lightning web component development experience?5+ years of experience working with tools Force.com IDE, Apex Data Loader and ANT, AutoRABIT preferred.?Experience in Agentforce building AI agents?Experience in Agile methodology with preferred experience in SAFe methodology ?Good communication and collaborative skills?5+ years of Health insurance/healthcare background (payer/provider, claims intake/routing)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

We are seeking an experienced RCM Leader / Operating Director to own and scale revenue cycle and operational functions across multiple client engagements. This individual will operate as a hands-on... More leader and strategic partner, directly supporting clients while driving internal execution across billing, credentialing, and HR/operations.Key Responsibilities? Own end-to-end RCM operations for client practices (billing, collections, credentialing, payer enrollment)? Lead and oversee 2?3 core departments (billing, credentialing, and HR/operations) supporting multiple practices? Serve as a client-facing partner, delivering a high-touch, consultative experience to independent physicians? Drive client onboarding and implementation, including practice launch/setup and workflow design? Manage onboarding and offboarding of clients, ensuring seamless transitions and continuity? Act as an operating director, implementing scalable processes, KPIs, and reporting across engagements? Own financial performance, helping clients understand revenue drivers, profitability, and practice health? Partner with clients on business strategy, including growth planning, operational efficiency, and revenue optimization? Step in tactically as needed in a lean, startup environment to support execution across teamsWe 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

Insight Global is seeking a Senior Manager of Independent Dispute Resolution (IDR) Operations to join one of our largest healthcare clients and sit near Wilkes-Barre, PA - sitting onsite 3... More times/week. This person will oversee the day-to-day execution of the client's rapidly growing IDR business. This individual will be responsible for leading a mid-large sized team, while ensuring operational excellence, regulatory compliance, and successful delivery of services under the IDR law (e.g. the No Surprises Act). The Senior Manager will own operational performance across the organization, monitoring key metrics, identifying process improvement opportunities, and ensuring cases move efficiently through the dispute resolution lifecycle. This person will serve as a senior operational leader and primary escalation point for complex case issues, customer concerns, and process-related challenges. They will work closely with leadership to develop, refine, and scale operational procedures while ensuring compliance with CMS regulations and federal IDR requirements. The ideal candidate is highly operationally focused, comfortable managing large teams in a production environment, and capable of navigating nuanced regulatory requirements. This role is expected to quickly evolve and will play a significant role in shaping the future direction of the IDR organization.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

A growing specialty medical group is seeking a Patient Referral Coordinator to support high-volume patient intake and scheduling operations. This role is critical in ensuring a seamless experience... More for new patients by coordinating referrals, verifying insurance eligibility, and scheduling appointments efficiently and compassionately.Key Responsibilities- Manage incoming referrals and convert them into patient records within the EMR system (eClinicalWorks)- Verify insurance coverage, referral requirements, and authorization details (including primary/secondary coverage and claims information)- Handle high-volume inbound calls (approximately 40/day) on the dedicated new patient line- Schedule new patient appointments in accordance with clinical guidelines and provider availability- Communicate clearly and empathetically with patients, including educating them on appropriate care pathways (e.g., benefits of seeing a Nurse Practitioner based on diagnosis)- Prioritize and coordinate scheduling for referring partner offices, maintaining strong relationships with ~10 external clinics- Ensure accuracy and compliance with internal processes and payer requirements- Deliver exceptional customer service and go above and beyond to support patient needsWe 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

A client of Insight Global is seeking a Physician Relations Manager to support an acute care hospital in Sebastian, Florida. This individual will be responsible for promoting physicians and clinical... More services to employed, network, and non-employed referring providers within an assigned market. The role focuses on developing, executing, and closing strategic clinical sales campaigns aligned with facility and service line initiatives. This position serves as the primary liaison between the hospital and referring providers, acting as a subject matter expert across service lines. The Physician Relations Manager will build strong provider relationships, communicate competitive differentiators, and address operational or access-related issues impacting referrals. Responsibilities include coordinating physician education, shadowing providers to stay current on clinical offerings, supporting CME events, and presenting at leadership meetings.The role requires strong analytical capabilities to evaluate referral and claims data, identify high-potential physician groups, and develop strategic account management plans. The Physician Relations Manager will conduct effective, consultative sales meetings, perform pre-call planning, anticipate objections, and tailor messaging to provider needs. Collaboration with marketing, community relations, PR, and internal physician leadership is critical to drive awareness and growth. This individual will also be responsible for tracking all activities, opportunities, and outcomes within a Physician Relationship Management system, reporting ROI metrics, and communicating market trends and growth opportunities to leadership. Regular travel within the assigned territory and consistent attendance in alignment with organizational policies are expected.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

Inpatient social workers provide comprehensive and holistic care through the completion of a biopsychosocial assessment. They address contextual factors impacting a person?s overall health and... More well-being. Assessing and providing interventions that pertain to health-related social needs offer an augmented transitional plan by improving access to psychosocial supports and community resources. The social worker increases relationship-based care that allows for improved communication and shared decision-making among the care team. The social worker will collaborate closely with inpatient case management and additional care team members to enhance patient transitions and experiences. Their role includes psychoeducation, crisis intervention, supportive counseling, resource facilitation and strong advocacy in supporting a person's rights to self-determination to meet their goals. This role parallels and enhances the discharge plans of the inpatient case management team.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

Insight Global is seeking a Billing Specialist for a rapidly growing healthcare technology client in the medical device space. This individual will play a vital role in ensuring accurate and timely... More billing operations across Medicare, Medicaid, and commercial payers. The ideal candidate is detail-oriented, proactive, and experienced in navigating complex insurance processes, including claims submission, payment posting, and denial resolution. This role offers the opportunity to contribute to a mission-driven organization while helping optimize revenue cycle operations and improve overall billing efficiency in a fast-paced, collaborative 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

We are seeking a Senior Financial Analyst with strong data and visualization capabilities to support complex reporting, analytics, and insight generation initiatives. This individual will work... More hands-on with large, raw datasets?transforming them into clear, actionable insights that drive operational and financial decision-making. This is a highly technical, business-facing role requiring a blend of financial acumen, data manipulation expertise, and the ability to communicate insights visually to stakeholders.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

This Product Manager will serve as the strategic owner of the Salesforce Health Cloud product vision, roadmap, and business outcomes. On a daily basis, they will partner with business stakeholders to... More identify opportunities, define objectives, establish OKRs, and prioritize initiatives that deliver measurable value. They will lead product discovery efforts, conduct stakeholder interviews, analyze current-state processes, and define future-state solutions to support organizational goals. The Product Manager will collaborate closely with Architecture, Engineering, UX, Agile Delivery, Product Owners, and Business Analysts to evaluate solution options, align priorities, and guide execution of product initiatives and program epics. They will drive roadmap planning, facilitate cross-functional decision-making, oversee release readiness and business adoption efforts, and continuously monitor product performance to ensure outcomes align with strategic objectives. Acting as the primary liaison between business and technology teams, this individual will champion the product, measure value realization, and adjust product strategy based on customer feedback and business results.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