Job Search Results for Federal Government

Claims Specialist II

? Specialist performs pre- and post-payment audits of external claims; ensures that the company rigorously manages claims for external services; ensures that claims are paid according to contracted... More rates, for approved services, and are otherwise appropriate and correct; reviews and responds to claims submitted on appeal.? Support a remote claims processing team, including coordination with an offshore team based in India. ? Assisting with end-to-end claims process, ensuring accuracy, timeliness, and compliance. ? Assist with Processing & Review on complex claims, including Physician and Facility claims, medical claims, Medicare based cpt codes for federal inmates, FBOP side of the business? Provide expert guidance on CPT codes, UB04s, HICFA forms, DRGs, ICD-10, and appeals. - Address and resolve escalated claims issues and inquiries. - Collaborate with internal teams via Microsoft Teams, phone, and email. - Maintain documentation and reporting for claims activities and quality metrics. Communicate to Claims Leadership any issues that would impede the accurate and timely processing of claims.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

Coding Educator

Insight global is seeking a Coding Educator for a healthcare system in Virginia. The educator will provide consulting services to physicians, residents, allied health professionals and billing staff... More to support patient care documentation, coding and billing practices according to federal, state and local regulatory compliance standards. Creates and delivers presentations to clinical faculty and billing staff.Develops training programs and delivers training and education sessions for physicians, allied health professionals, residents, and coding and billing staff to support compliance with third party documentation and billing regulatory standards, including but not limited to classroom training, web-based training and one-on-one provider observation and training sessions.Participates on clinical department Billing Quality Councils as a member of the respective councils and acts as the primary resource providing technical and regulatory expertise to the Councils.Presents findings and recommendations from internal and external audits to clinical departments and recommends solutions for implementing appropriate changes.Conducts internal reviews and provides quality review of external billing quality audits.Works with providers and department billing staff to address and resolve documentation deficiencies.Develops and implements Clinical Documentation Improvement Programs in partnership with the clinical departments.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

Payroll Analyst

Insight Global is looking for a Payroll Analyst to support a large Canadian retailer with an Oracle Cloud implementation. This is an initial 6 month, fully remote contract opportunity. They will be... More an essential resource that will be responsible for the following:? Collaborate and work closely with payroll and other functional leads and project stakeholders ? Support all phases of payroll testing activities, including, end-to-end payroll processing (historical corrections, pay adjustment, T4 administration), process validation, payroll data analysis, and reporting? Create documentation, end user guide updates and other miscellaneous duties as required and requested? Validate functional specifications and payroll related configuration through testing and design document reviews? Maintain test scripts and document test findings including status of tests? Troubleshooting for issue resolution ? Participate in team meetings representing the interests and needs of Payroll and ensure requirements are met by system functionality? Support the payroll team with system discrepancies such as researching and resolving inbound and outbound data transfer issues (e.g. data upload to government or third-party vendor sites bank/routing transit # problems for individual transactions)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

Child Welfare Business Data Analyst

One of our customers is looking for a Business Data Analyst who specializes in Child Welfare and Social Services. The ideal candidate for this role will bridge the gap between a Business Analyst and... More a Data Analyst, with a focus on supporting Technical and non-technical Business teams that are working with Child Welfare data. This is a customer-facing role, and you'll contribute primarily to report development, working towards the objectives of the organization with multiple groups at a time. You will work closely with a State customer to help them understand what they can and can't do with their data, and how to best use the data they've been given to support their reporting requirements. In some cases, you will also be expected to work with agency requestors to define and develop new queries and provide training and technical support to developers. You will create and implement data solutions, develop and present training classes for end user developers to help learn how to use the data warehouse platform most effectively and the business intelligence tools available to them to support their own data needs where possible. The client uses BI Query and SQL heavily in this environment, and it will be helpful if the person stepping into this role has data cleansing and ETL skills. It is also critical the person coming into this role has a strong understanding of child welfare programs at the state, local government, or federal level because you'll be directly involved in working with technical and non-technical business teams one on one as the primary point of contact for program needs and reporting. Having experience working in and with a CCWIS (Comprehensive Child Welfare Information System) will be necessary to the success of this role.?Strong communication skills will be required for this role, and this is intended to be an ongoing, multi-year contract - so we are looking for a long-term match! Please apply if interested!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