1mo
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Payer Quality Consultant, Director
Boston or Indianapolis or Raleigh or Charlotte or Jacksonville or Chicago or Cincinnati or Cleveland or Columbia or Kansas City or Columbus or Dallas or Las Vegas or Los Angeles or Baltimore or Birmingham or St. Louis or Salt Lake City or San Diego or San Francisco or San Jose or Seattle or Stamford or Tampa or Toledo or Austin or Washington or Melville or Miami or Denver or Des Moines or Nashville or Detroit or New Orleans or New York or Florham Park or Oklahoma City or Philadelphia or Phoenix or Pittsburgh or Houston
$155k-$410k/yr OnsiteFull Time
10+ YOEBachelor's degree and at least 10 years' experience; leadership and operations consulting experience; knowledge of Medicare Advantage and Medicaid preferred; strong communication, analytical, and client relationship skills.
2mo
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Healthcare Payer Relations Credentialing and Contract Support Specialist
Miramar, Florida, United States
HybridFull Time
Coordinate credentialing and contracting tasks; maintain credentialing data; liaise with internal/external stakeholders; ensure deadlines; on-site in Miramar, FL; Mon-Fri 8am-5pm; hybrid work.
3w
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Healthcare Payer AI Decision Science Consultant
New York City or Milwaukee or Dallas or Columbus or Cincinnati or Cleveland or Oklahoma City or Austin or Albany or Chicago or St. Petersburg or Hartford or Pittsburgh or St. Louis or Miami or Sacramento or Raleigh or Minneapolis or Scottsdale or Morristown or San Francisco or Boston or Denver or Philadelphia or Des Moines or Overland Park or Los Angeles or Walnut Creek or Charlotte or Seattle or Carmel or Houston or Arlington or Atlanta or Bentonville or Nashville or San Diego
$54k-$206k/yr FieldFull Time
3+ YOEBachelor's in a quantitative field, 3+ years in data science/ML/AI, payer domain knowledge, experience with frontier AI tools (e.g., Claude), strong communication and consulting skills.
Claude, Python, R, SQL, TensorFlow, PyTorch, scikit-learn, Open AI, Anthropic, AWS, Azure, Google Cloud, Hadoop, Spark, Tableau, Power BI
2w
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Lead Software Engineer Healthcare Payer SME — CapAdmin Platform
Miami, Florida, United States
HybridFull Time
7+ YOE7+ years payer/TPA domain experience, 8+ years software engineering, proficiency with C#/.NET or Java, relational databases, REST APIs, AWS/Redshift/QuickSight familiarity, strong communication and mentoring skills.
C#, .NET, Java, SQL Server, PostgreSQL, REST, AWS, Redshift, Amazon QuickSight
3d
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Credentialing Specialist
Coral Gables, Florida, United States
$22-$25/hr OnsiteFull Time
5+ YOE5+ years physician credentialing and provider enrollment experience; familiarity with Medicare/Medicaid/commercial payers, hospital privileging, payer enrollment, and revenue cycle impacts.
CredentialStream, Waystar, CAQH ProView, PECOS, NPPES, Medicare portals, Florida Medicaid portal, Commercial payer portals, Microsoft Excel, eClinicalWorks, Availity, Change Healthcare
1w
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Appeal Writer - Hospital Billing, Denials
Delray Beach, Florida, United States
$20-$26/hr RemoteFull Time
Analyze denied claims, draft and submit appeals, research payer and clinical documentation, and communicate with payers and stakeholders. High school diploma and strong analytical and written communication skills required.
Electronic Medical Records (EMR), Epic
1w
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Contract Implementation Administrator
Coral Springs, Florida, United States
$64k-$96k/yr OnsiteFull Time
2+ YOE2+ years in payer contracting, contract management, or healthcare revenue cycle for DME; associate's or bachelor's preferred; strong US DME payer rules knowledge; stakeholder management; ability to travel ~10%; Brightree experience preferred.
Brightree
2mo
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Quest Health Solutions LLC - RCM Insurance Specialist
Coral Springs or West Plains
OnsiteFull Time
Healthcare revenue cycle, DME, insurance verification, payer configuration, Brightree, and claims processing experience.
Brightree, E-claim, Insurance verification, Payer configuration
3d
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Patient Account Collection Rep-CBO-FT-BHC-Days
Fort Lauderdale, Florida, United States
OnsiteFull Time
Performs patient accounting and collections for payer sources in compliance with regulations; high school diploma/GED required.
2w
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Collections Manager - Onsite
Boca Raton, Florida, United States
OnsiteFull Time
Experience overseeing medical billing and payer collections, reducing AR aging, leading teams, and ensuring HIPAA/CMS compliance.
4d
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Revenue Cycle Specialist (68439)
Doral, Florida, United States
OnsiteFull Time
3+ YOE3 years healthcare billing experience, bachelor’s degree, knowledge of payer requirements, attention to detail, Excel and practice management/EMR experience.
Electronic Health Record, Microsoft Excel
2mo
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RCM Contracts Manager
Miramar, Florida, United States
OnsiteFull Time
5+ YOEOversee payer contract management for home health and DME; supervise Contracts Specialist; ensure pricing, fee schedules, and system configurations; ensure compliance.
1d
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Medical Records
Deerfield Beach, Florida, United States
OnsiteFull Time
2+ YOEMaintain and release client health records, process record requests, support payer appeals, ensure HIPAA/AHCA/DCF/CARF compliance, and use EHR systems.
EHR, BestNotes, Microsoft Office
2d
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Director, Credentialing & Enrollment
Plantation, Florida, United States
RemoteFull Time
7+ YOE3+ Mgmt7+ years progressive provider credentialing and payer enrollment experience, 3+ years supervisory experience; knowledge of NCQA/CMS standards, Medicaid/CHIP, and regulatory compliance.
CAQH, PECOS, Credential Stream, MD-Staff
1mo
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Revenue Cycle Analyst - Remote (Tri-County Area)
Medley or Florida
RemoteFull Time
2+ YOEBachelor's degree in a relevant field, minimum 2 years relevant experience, strong communication, technical proficiency with office software, and ability to analyze and reconcile billing and payer data.
1w
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Health Services Coordinator - ABA Intake & Authorizations
Miami, Florida, United States
$23-$26/hr HybridFull Time
Experience with healthcare intake, insurance verification and authorizations, strong phone and customer service skills, attention to detail, and ability to manage multiple cases using spreadsheets and payer portals.
2mo
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Billing Specialist
Doral, Florida, United States
OnsiteFull Time
1+ YOEHigh school diploma or GED; minimum 1 year medical billing experience; knowledge of CPT/ICD-10-CM/HCPCS; familiarity with payer guidelines and billing regulations.
CPT, ICD-10-CM, HCPCS, Billing software
1mo
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Business Office Manager
Lauderdale Lakes, Florida, United States
OnsiteFull Time
5+ YOE5+ MgmtBachelor's in healthcare administration or business, 5+ years supervisory experience in a medical setting, proficiency with accounting systems, knowledge of payer types (PPO, Medicare/Medicaid), and strong professionalism.
1mo
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Account Manager, Client Success (Healthcare)
Pompano Beach, Florida, United States
OnsiteFull Time
Experience in healthcare account or project management, familiarity with spreadsheets and PM tools (Excel, SmartSheet), detail-oriented, strong communication, and experience with health plan payers in risk adjustment or quality.
Microsoft Excel, SmartSheet
4d
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Specialty Account Executive - BioPlus Specialty Pharmacy
Lake Mary or Nashville or Indianapolis or Miami or Mason or Durham or Atlanta
HybridFull Time
3+ YOEAssociate degree and 3 years specialty or retail pharmacy (2 years pay program) experience or equivalent; BA/BS preferred; experience with payer credentialing and client account management.
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