Job Search Results for clinical

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

Safety Pharmacovigilance BA

Seeking an experienced Business Systems Analyst to support the Safety Vigilance platform within a pharmaceutical R&D environment. This individual will partner with business stakeholders, operations... More teams, and vendors to support system operations, drive process improvements, and maintain inspection readiness.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 Platform Engineer (Nice CXone)

The Platform Engineer serves as a technical subject matter expert (SME) for enterprise contact center platforms, including NICE CXone and associated telephony, routing, and integration components.... More This role is responsible for resolving complex incidents, leading root cause analysis (RCA), and ensuring platform reliability across a 24/7 support environment. This position operates as the final escalation point following Tier 1 and Tier 2 triage, focusing on high-impact P0/P1 issues, platform engineering, and continuous improvement initiatives to improve system stability and reduce incident recurrence. This role is critical to supporting a large-scale CCaaS transformation enabling reliable, scalable, and integrated contact center services across the enterprise, directly impacting member access, clinical workflows, and customer experience 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

Remote Prior Authorization Specialist

Insight Global is seeking a fully remote Prior Authorization Specialist to support a Healthcare AI client. This is a fully remote, part-time opportunity working 10-20 hours/week where candidates will... More leverage their prior authorization expertise to evaluate and improve AI-driven authorization strategies. This role is highly analytical and requires a strong understanding of payer policies, documentation strategies, and real-world authorization workflows. Laptop and equipment will be provided.Shift Times: Flexible scheduling within Monday-Friday, 9am-8pm PST (can't work weekends)(must be available 10-20 hours/week from 9am-8pm PST // ideal for individuals seeking additional income)Duration: 3-month contract (potential to extend)Responsibilities:? Review pending authorization requests and evaluate AI-generated prior authorization recommendations and strategies? Assess the quality, logic, and effectiveness of AI recommendations across multiple payers and clinical policies? Identify gaps where AI recommendations differ from real-world prior authorization best practices and explain discrepancies? Provide detailed insights into payer-specific nuances, including portal workflows, policy requirements, and documentation phrasing strategies? Share operational knowledge with product teams to enhance AI-powered authorization processes? Partner with GTM teams to critique presentations and provide subject matter expertise on prior authorization workflowsWe 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

Provider Scheduler

Day-to-Day Responsibilities:? Oversee scheduling operations for a national team of ~50 providers, ensuring full coverage for telehealth visits? Build and release monthly schedules 30?60 days in... More advance, adjusting for demand, volume, and staffing gaps? Manage real-time schedule optimization, including overflow coverage, call-offs, and shift adjustments? Own payroll oversight, including timecard approvals, discrepancy resolution, and coordination with payroll teams? Analyze staffing and utilization data to improve efficiency, coverage, and cost management? Lead regular team meetings, check-ins, and performance conversations with direct reports? Partner with internal stakeholders (operations, HR, finance) to ensure smooth workforce operations? Develop and implement standardized processes around scheduling, payroll, and workforce planning? Maintain clear and consistent communication with team members regarding schedules, expectations, and updates? Support hiring, onboarding, and ongoing development of team membersOverview:The Provider Scheduler is responsible for overseeing the day-to-day workforce operations of a national telehealth provider team within a high-growth wellness organization. This role focuses on managing scheduling, payroll, and operational workflows to ensure seamless delivery of virtual services across multiple states.This individual will act as both a strategic leader and hands-on operator, driving efficiency across scheduling processes, ensuring accurate and timely payroll operations, and supporting a high-performing, distributed workforce. The Lead Practice Manager partners closely with cross-functional teams to optimize staffing models, improve utilization, and maintain operational excellence in a fast-paced environment.This is a non-clinical leadership role focused entirely on operational execution, team leadership, and process optimization within a telehealth setting.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

Quality Specialist

One of our large pharmaceutical clients is looking to hire a Sr Quality Specialist to join the EQ team. The individual will provide QA support for TAR-200 (including UPC) and TAR-210 projects,... More ensuring adherence to quality assurance processes and compliance with all company policies and procedures. They will perform assigned duties and collaborate with cross-functional teams to maintain regulatory standards, facilitate communication within the core team, and help to ensure that all quality-related activities project goals and deadlines are met. In particular, the specific tasks required on a daily basis by the position are:Support, review/pre-review, and/or approve the following --Batch record review -Quarantine shipment (Q-ship) activities-Release for Further Processing (RFFP) activities -EM Quality Events-EM CAPAs-EM Change Controls-EM Planned Deviations -EM Product Quality Complaints -EM Protocols-EM Risk Assessments-EM Electronic Batch Record (eBR) changes-EM Manufacturing Process Instruction (MPI) changes -EM equipment specific Master Validation Plan (MVP) changes-Sterilization-specific documentation -New equipment qualification documentation Own/support the following -Own Child records for Change Controls in TrackWise -Own/support internal Nonconformances (NC) in Comet-Own/support internal Investigations in Comet-Own/support internal Supplier Investigations in CometHelp maintain/manage/keep organized the following-Outstanding EM issues-Transfer of document to the EM-Status of Clinical Trial Material (CTM) lots/production schedule-Various workstreams (help build templates, flowcharts, etc.)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

Data Engineer

The Data Engineer is responsible for the development, maintenance, and operational support of enterprise data pipelines, ETL processes, and data platform components within the Data & Analytics... More Managed Services. The Data Engineer is accountable for the reliability, performance, and evolution of enterprise data pipelines, ensuring the organization transitions from foundational stabilization toward a modern, cloud-native data platform. This individual sets the technical direction, drives delivery excellence, and represents the data engineering function at the leadership level. Working across a complex environment of stored procedures, scheduled and streaming jobs, and a recently AWS-migrated data platform, this role ensures reliable, high-quality data flows that power enterprise reporting, analytics, and decision-making across clinical, operational, financial, and health plan domains.Key Responsibilities?Develop, maintain, and optimize SQL-based ETL processes, stored procedures, and data transformations across DB2, SQL Server, Datastage, Collibra and AWS?Define the enterprise data engineering architecture and technology standards across DB2, SQL Server, IBM DataStage, IBM Workload Scheduler, Oracle GoldenGate, Collibra and AWS?Develop and maintain data integration workflows from source systems to analytics platforms, including validation and reconciliation logic?Build and maintain data pipelines using IBM DataStage and UNIX scripting for enterprise data integration workflows?Govern platform health including capacity planning, performance benchmarks, upgrade management, and disaster recovery compliance with BCP/DR standards?Lead workload rationalization ? identifying pipelines, stored procedures, and jobs for consolidation, retirement, or re-architecture?Evaluate and drive adoption of modern data engineering capabilities (Apache Airflow, dbt, AWS Glue, Spark) aligned to Project Catalyst objectives?Monitor pipeline health proactively, detect anomalies, and resolve data quality and availability issues within defined SLAs?Support Dev/QA/Prod environment management including release coordination and production readiness validation?Assist with AWS stabilization activities for analytics data layers post migration from on-premises infrastructure?Track and manage all work through ServiceNow, ensuring accurate classification, status updates, and SLA compliance?Collaborate with Tableau, SAS and BusinessObjects developers to ensure data availability and pipeline reliability for reporting?Participate in L1/L2 triage for pipeline incidents, data quality failures, and integration issues?Contribute to runbook documentation and standard operating procedures for supported pipelines and jobs?Collaborate with cross-functional teams, including data engineers, data scientists, and business analysts, to deliver end-to-end solutions across client domains?Own SLA and KPI adherence across all data engineering queues ? incidents, service requests, small-ticket enhancements, and larger backlog-driven work?Lead root cause analysis (RCA) for critical data incidents and drive permanent fixes to prevent recurrence?Maintain full backlog visibility in ServiceNow ? classification, aging, capacity tracking, and executive-level reporting?Define and oversee data quality monitoring frameworks, escalation procedures, and continuous improvement programs?Own CSAT measurement and improvement for the data engineering domain, proactively addressing data trust and availability concerns?Deliver weekly operational and monthly executive reporting on pipeline health, throughput, SLA performance, and platform KPIs?Identify and implement automation opportunities to reduce manual pipeline interventions, dataset refreshes, and extract requests?Lead knowledge management across the engineering team ? runbooks, architecture diagrams, onboarding playbooks, and continuity documentation?Oversee end-to-end delivery of managed data analytics services to clients, ensuring projects meet business requirements, timelines, and quality standards?Manage client escalations and ensure timely resolution of issues.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

Business Analyst (Remote)

**This position can be fully remote but must work PST hours**-Partner with business stakeholders to elicit, document, and validate business and functional requirements for health plan initiatives.... More -Analyze and document current state and future state workflows related to claims processing, enrollment, eligibility, benefits configuration, care management, and provider data. -Translate business requirements into functional specifications, user stories, and acceptance criteria for technical teams. -Support system enhancements, implementations, and optimizations across core health plan platforms (e.g., claims, enrollment, provider, clinical, or reporting systems). -Facilitate stakeholder meetings, working sessions, and JAD sessions to ensure alignment and clarity. -Ensure solutions align with regulatory and compliance requirements (e.g., CMS, HIPAA, state mandates). -Create and maintain documentation including process flows, data mappings, and business rules. -Provide ongoing support post implementation, including issue analysis and process improvement recommendations.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

Financial Analyst

A client of Insight Global is looking for a financial analyst. The financial analyst will work to to maintain financial models, analyze claim-related data, and help the organization understand where... More savings opportunities exist. The ideal candidate has a strong grasp of financial concepts, is comfortable working with data, and can translate numbers into meaningful insights?even without deep healthcare experience.Key ResponsibilitiesMaintain and update financial models related to clinical edit savings.Perform variance analysis to explain changes, trends, and anomalies in financial performance.Partner closely with a data engineer to interpret data outputs and understand what the data is telling the team about claim processing.Use Power BI and native EPIC tools to analyze and visualize data (no SQL required). (they also don't need to be super familiar with EPIC and power BI because they can teach this, but ideally have experience w it)Identify patterns, root causes, and opportunities for improved claim accuracy and cost savings.Exact compensation may vary based on several factors, including skills, experience, and education but will vary anywhere from $24-$28. Benefit packages while on contract 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