Job Search Results for clinical

EPIC Cogito Data Analyst

Job Description:This person will support Hospital and Enterprise Analytics by designing and developing analytical solutions and providing internal consultation and project management. Leads... More requirements gathering, applies business/clinical knowledge, and uses technical and analytical expertise to create reports, dashboards, and views from diverse data sources. Ensures data integrity, sustainability, and adaptability of solutions for strategic initiatives and hospital goals. Frequently takes formal or informal leadership on projects, driving continuous improvement in workflows and optimizing analytic solutions for executive leadership and key 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

PB System integration Analyst II

Job Description:Responsible for the preparation and review of analysis for various PB Coding leadership and external customers by creating a reporting dashboard (PB Coding and Charge Capture... More Dashboard). Work as an operational and technical analyst supporting the technology used by the PB Coding Department in the revenue cycle function. Partner with Revenue cycle, clinical leadership, and IT to identify and analyze root cause of user and system issuesSubmit and track system requests, submit system enhancements and new edits, and participate in system upgradesDevelop efficient workflows and claim scrubber edits Routine Epic maintenance for PB coding, including tasks like managing reports, work queues, revenue setup, and verifying IT configurationsManaging 2 shared inbox requestsDay to day: Request optimizations, innovation, create automation solutions to make the coders and medical reviewers life more efficientKey Responsibilities Include:Sitting in on meetings in new growth projects and ability to drive conversations and have a seat at the table with ITWe 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

Trainer

We are seeking an experienced Infor CloudSuite Workforce Management (WFM) and Multi-View Scheduling (MVS) Trainer to support a large-scale scheduling system implementation for a major healthcare... More organization. This role is responsible for delivering high-quality training to approximately 800 nurse schedulers as they transition to the new scheduling module. Training materials will be fully developed and provided?your primary responsibility is to lead engaging, effective training sessions and ensure end users feel confident adopting the new technology.This position is remote, with required onsite training days as scheduled.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 UM Physician Reviewer

Insight Global is hiring a fully remote Physician Reviewers for a leading health insurance company. The Physician Reviewer will review requests for care before, during, and after treatment to... More confirm they follow medical guidelines and company policies. This includes checking different types of services like hospital stays, rehab care, medical equipment, and outpatient treatments. They document their decisions clearly so members can easily understand them, and they use the right templates to keep everything consistent. Physician Reviewers also talk directly with doctors when needed to explain decisions or suggest alternative treatments based on medical evidence. They work quickly to meet deadlines, follow all laws and regulations, and handle other related tasks as needed. This is a remote position that requires strong attention to detail, clear communication, and the ability to make informed decisions quickly.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 BCBS 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

Financial Clearance Rep

City of Hope is looking for a Financial Clearance Representative to support their growing CAP team. This position supports the Authorizations Team responsible for obtaining service authorizations for... More patients seen at City of Hope clinics across multiple states and cities (3 clinics, possibly expanding to 4, in Arizona, 2 Clinics in Chicago, and 1 clinic in Atlanta). The current team size is 6 members, but looking to eventually expand to 12 team members. This person will be working with all types of insurance plans: HMOs, PPOs, Medi-Cal, Medicare, etc. across the given states. This person will need to quickly become familiar with the different plan types for the different locations. This practice uses Epic EMR system, and training will be provided. There will be City of Hope Training modules, once completed will participate in 1 on 1 training with the team lead, then transition to independent work once the team member feels comfortable. High volume of radiology and chemotherapy authorizations, as City of Hope specializes in oncology treatment and research. Key Responsibilities: - Process and submit authorizations for services ordered by providers after patient visits. - Verify insurance eligibility for all scheduled patients on a monthly basis. - Monitor and manage two primary work queues: Patient Queue ? Insurance verification and registration updates and Referral Queue ? Authorization and order submissions. - Look up registration errors, update insurance/registration errors and details, and complete data entry tasks. - Work through queues by appointment date or expected future date, ensuring all tasks are completed thoroughly before moving to the next patient.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 FHIR Business Analyst

Insight Global's healthcare client is hiring for a Lead FHIR Business Analyst. Candidates will start in a hands-on role focused on mapping healthcare transactions to FHIR standards. They will analyze... More incoming specs, create detailed mapping documents, and collaborate with engineering teams to validate transformations. They will also author CQL logic to support decision-making workflows and ensure compliance with interoperability regulations. Once the solution moves into production, they will transition into a technical lead role?owning program governance, standards, and release management while mentoring others on FHIR and CQL best practices.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 Cloud Data Engineer (Remote)

We are looking for a lead data engineer highly collaborative and comfortable with ambiguity and change in a fast-paced environment to partner closely with various teams to design, build and maintain... More data systems and applications. Must be a self-starter and highly organized with strong problem-solving and learning skills to work with various teams analyze and design data storage structures and build performant automated data pipelines that are reliable and scalable in a fast growing data ecosystem. Leverage strong understanding of data modeling principles and modern data platforms to properly design and implement data pipeline solutions. Experience using analytic SQL, working with traditional relational databases and/or distributed systems such as AWS S3, Hadoop / Hive, Redshift. Provide production support and adhering to the defined SLA(s). Strong technical skills and demonstrated ability to be detail-oriented. Good understanding of data security, compliance, and policies in healthcare services. Demonstrated ability to test and validate according to industry best practices and to communicate effectively with peers in technology teams. Strong interpersonal, written, and oral communication skills with ability to work with all levels of the organization. Prior experience in the healthcare industry is a plus.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

Mental Health Evaluation Lead - PsyD/PhD

We?re seeking a seasoned professional in mental health evaluations who is passionate about delivering high-quality solutions for diverse stakeholders. In this role, you?ll help strengthen our... More evaluation services by providing assessments and case management grounded in collaboration, clarity, and efficiency.Key Responsibilities- Conduct evaluations such as short-term disability and substance use assessments, along with related documentation (e.g., accommodation requests or return-to-work readiness following monitored referrals).- Offer case management support, including consulting on leave paperwork and guiding clients and partners through programs like fitness-for-duty assessments, substance use evaluations for regulated and non-regulated roles, and monitored referral processes.- Conduct comprehensive, virtual mental health evaluations and case management- Maintain a full caseload of evaluation appointments (28 potential bookable calendar spots)- Consult with a team of evaluators, case managers, and operations peers in regular 1:1s and group consultations- Provide ongoing case management support to clients, employers, vendors, and key stakeholders, including submitting paperwork, supporting treatment recommendations, answers questions, and connecting to appropriate resources This position is fully remote and is an independent contributor 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