Job Search Results for healthcare payer

REMOTE Java Developer with TypeScript!

We are seeking a Senior Java Developer with strong healthcare payer experience to design and support scalable, cloud-native applications supporting mission-critical payer systems.Responsibilities?... More Lead development of enterprise Java applications using Spring Boot and Spring Batch? Design and support batch and event-driven workflows for payer systems (care/case/disease management & population health)? Contribute Python scripting and TypeScript development as needed (their rules engine tool is built on TypeScript)? Deploy, maintain, and troubleshoot applications on OpenShift? Implement messaging and streaming solutions using Kafka? Participate in architecture decisions, code reviews, and Agile deliveryWe 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

Finance Oracle Solution Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.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

Supply Chain Oracle Fusion Solution Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.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

Payroll Oracle Fusion Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.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

HR Oracle Fushion Solution Architect

We are seeking a Solution Architect Lead with deep Oracle Fusion experience to support enterprise healthcare provider clients across Finance, Supply Chain, HR, and Payroll domains. This role is... More highly consultative and advisory in nature, partnering closely with clients to guide decision-making and shape best-practice solutions based on real-world healthcare operations experience.This position is ideal for a leader who has come up through healthcare provider operations, led complex Oracle Fusion implementations, and can translate that experience into confident, opinionated guidance?not just presenting options, but recommending the right approach.Note: Candidates must come from a healthcare provider environment. Insurance or payer-only backgrounds will not be considered.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

Follow Up Representative

Insight Global is looking for a Follow-Up Representative to support a large hospital system in the Maryland/DC area. This person will support the Denials Appeals & Performance (DAP) team, a... More centralized hospital denial group supporting 10 hospitals across the Maryland/DC region.This role focuses on post-appeal and post-submission insurance follow-up, helping offload administrative and payer-chasing work from RN teams. Follow-Up Reps will manage a mixed inpatient and outpatient inventory, working with primarily commercial payers and MCOs. This is not an appeal-writing role, though there is opportunity for growth and cross-training over time. The environment is fast-paced, documentation-driven, and collaborative, with a strong emphasis on accuracy, persistence, and accountability.Primary Responsibilities? Perform post-appeal insurance follow-up on hospital denial accounts? Productivity is quality-focused, not quota-driven? Looking for someone who has experience touching <40 accounts/day ? Check claim and appeal status via: ? Payer portals? Phone calls to insurance companies? Written payer correspondence? Work accounts originating from: ? Denials Appeals & Performance (DAP) RNs? Acute Case Management (ACM) RNs? Document all follow-up actions clearly in the appropriate system? Identify cases with insufficient or unclear documentation and escalate appropriately? Track payer responses, timelines, and next steps? Support rebilling or resubmission efforts when required? Navigate long hold times and high-touch payer follow-up while maintaining productivity? Collaborate with: ? RN reviewers? Other follow-up representatives? Leadership as needed? Participate in: ? Team huddles? Workflow updates? Ongoing training and cross-training initiatives? Adapt to evolving workflows as the DAP team continues to expand and absorb new workstreamsWe 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 Relations Specialist

A national healthcare organization is seeking a Provider Relations / Network Development Specialist to support the expansion and maintenance of its provider network across Southeast and Midwest... More markets. This role is centered on provider outreach, relationship management, contract negotiations, and onboarding, ensuring network adequacy and access standards rather than talent acquisition or employment recruiting.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

Revenue Cycle Project Manager

Insight Global is looking for a Project Manager for one of their healthcare clients in New Jersey. This Financial Project Manager will be responsible for assessing and stabilizing a significant... More collections backlog resulting from EPIC implementation challenges by analyzing aged A/R, stalled and denied claims, and clearinghouse rejections to identify root causes and recovery opportunities. Working closely with billing specialists, IT, Epic analysts, and external vendors, the PM will troubleshoot claim edits, payer rejections, eligibility and authorization issues, and interface errors, while prioritizing high-value accounts for resolution. The role involves overseeing daily collections activity, monitoring account balances and key revenue cycle metrics, and driving short-term backlog reduction plans while simultaneously implementing standardized workflows and process improvements to prevent recurrence. Reporting directly to the CFO, this individual will provide clear executive-level updates on cash recovery, risks, and performance trends, ensure compliance with payer contracts and healthcare regulations, and serve as the central point of coordination to restore revenue cycle efficiency and maximize reimbursement across the 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

Pre-Authorization Coordinator

Job DescriptionThe PAVE Coordinator is responsible for initiating Pre-Authorization request to the payer for the claims that require approval. This position require communication with payers,... More patients, physician offices and hospital clinical staff. This position is primarily responsible for pre-certifying procedures ordered by physicians. The PAVE Coordinator will also be responsible monitoring appropriateness and medical necessity and provides necessary information for authorization and continued visits. This individual will confirm pre-certifications that have been obtained or will obtain pre-certifications if needed in addition to conducting quality assurance.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Serve as primary resource for LH regarding insurance eligibility; prior authorization process and requirements; collects patient demographic information and coverage information. Advises patients of their financial obligation and collects payments in a courteous and professional manner.Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information;Updates systems with accurate information obtained; performs quality assurance audits and reports back to leadership opportunities for providing education to patient accessResponsible for communicating to service line partners of situations where rescheduling is necessary, due to lack of authorization or limited benefits and is approved by clinical personnel;Ensures that proper authorization is in place for inpatient, elective, outpatient, surgical, urgent/emergent services and held responsible for timely notification to payers of the patient?s visit to the facility to protect financial standing of the organization. Escalates non-authorized accounts/visits to management;Ensures all benefits (Copays, Deductibles, Co-Insurance, OOP, LTM), authorizations, pre-certifications, and financial obligations of patients, are documented on account, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts and denial prevention.;Maintains a close working relationship with clinical partners, and ancillary departments to ensure continual open communication between clinical, ancillary, and Patient Access & Patient Financial Services, Surgical Scheduling departments. Case Management, and Utilization Review to facilitate the sending of clinical information in support of the authorization to the payer, as assigned;Monitors team mailbox, e-mail inbox, faxes, and phone calls responding to all related PAVE account issues, within defined time frames; Adheres to the department accuracy and performance standards.Contact payer to obtain prior authorization. Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization;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