Insurance guidelines jobs

Customer Service Representative (Medical)

TEKsystems · Posted Oct 26, 2026

Open

Plattsburgh, New York, United States
On-site
Contract · Entry
$18–$18 per hour

Customer Service Representative (Medical)

TEKsystems · Posted Oct 26, 2026

Open

Plattsburgh, New York, United States
On-site
Contract · Entry
$18–$18 per hour

Referral Specialist Lead

Northwest Human Services, Inc. · Posted Nov 6, 2026

Open

Salem, Oregon, United States
Full-time
2+ years

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Lead Referral Specialist who provides technical guidance, coaching, and support to the referral team, coordinates complex referrals, pre-authorizations, and improves workflows.

Responsibilities

Provide day‑to‑day technical guidance, coaching, and support to Referral Specialists
Serve as a subject matter expert for referral processes, pre‑authorizations, and department workflows
Assist with onboarding and training new Referral Specialists
Support team members with complex or escalated referral and authorization requests
Initiate and coordinate medical, mental health, and medication pre‑authorizations with insurance companies and other third‑party payers

Requirements

High school diploma or equivalent

Skills

Medical terminology Referral processes Pre‑authorizations Insurance guidelines ICD‑10 CPT coding

Sr Payer Policy Analyst

Labcorp · Posted Nov 5, 2026

Open

Remote, United States
Remote
Senior
$85K–$110K per year
5+ years

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Compensation

$85-110K

Responsibilities

Works directly with Segment Science and Marketing management teams to develop an understanding of existing and emerging technologies to provide education, appeals influence and insight pertaining to payer policy for Government and Commercial payers.
Provides support to include attending Payer meetings with Payor Solutions Account Executives to communicate specific policy concerns and denials trends.
Regularly monitors payer policy updates and changes such as NCD, LCD and other coverage policies impacting revenue.
Functions as a liaison between LabCorp Medical Directors and Government and Commercial Payer Medical Directors on issues pertaining to existing payer policies and proposed policy changes impacting reimbursement.
Assists the Manager with subject matter expertise for the development of comments on regulatory proposals, written testimony, policy position papers and regulations that affect the company.

Requirements

Bachelor's degree
Nice to have: Advanced degree
Nice to have: MBA
Nice to have: JD
Nice to have: M.A./M.S.

Skills

Microsoft Suite

Sr Payer Policy Analyst

Labcorp · Posted Nov 5, 2026

Open

Remote, United States
Remote
Full-time · Senior
$85K–$110K per year
5+ years

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The Senior Payer Policy Analyst is responsible for assisting the Manager of Payer Policy and Relations with policy and alliance development activities for the company, including assistance with development and implementation of policy strategies to support LabCorp and the laboratory industry at the state and federal levels.

Compensation

Pay Range: $85-110K

Responsibilities

Works directly with Segment Science and Marketing management teams to develop an understanding of existing and emerging technologies to provide education, appeals influence and insight pertaining to payer policy for Government and Commercial payers.
Provide support to include attending Payer meetings with Payor Solutions Account Executives to communicate specific policy concerns and denials trends.
Regularly monitors payer policy updates and changes such as NCD, LCD and other coverage policies impacting revenue.
Functions as a liaison between LabCorp Medical Directors and Government and Commercial Payer Medical Directors on issues pertaining to existing payer policies and proposed policy changes impacting reimbursement.
Will assist the Manager with subject matter expertise for the development of comments on regulatory proposals, written testimony, policy position papers and regulations that affect the company, analyzing public policy, legislative and regulatory proposals, and reporting internally as required.

Requirements

Bachelor’s degree

Benefits Specialist

United Medical Inc. · Posted Nov 4, 2026

Open

Virginia Beach, Virginia, United States
On-site
2+ years

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Administers and processes durable medical equipment supplies for patient orders, handling benefit inquiries, documentation, and cost communication.

Responsibilities

Ensure timely and accurate processing of patient orders
Respond to benefit inquiries for patients and physicians or therapists
Educate patients on financial responsibilities
Review and analyze medical documentation for billing accuracy
Schedule patients for appointments

Skills

DME/HME industry experience Intake documentation Billing Compliance Medical terminology Insurance guidelines Reimbursement practices Healthcare billing codes (CPT, ICD-10, HCPCS)Proficient computer skills

Social Worker - Inpatient (Per Diem)

Overlake Medical Center & Clinics · Posted Oct 9, 2026

Open

Bellevue, Washington, United States
On-site
Contract · Associate
$41–$67 per hour
1+ years

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Assessment and discharge planning for patients requiring post-acute services, such as skilled nursing facilities, home health, Hospice, and outpatient services and resources, supporting patients and families with transitions of care and new diagnoses, and collaborating with multidisciplinary team and community resources.

Compensation

Hourly $41.11 - $66.60

Responsibilities

assessment and discharge planning for patients requiring post-acute services
supporting skilled nursing facilities, home health, Hospice, and outpatient services and resources
supporting patients and families with transitions of care and new diagnoses
collaborating with multidisciplinary team and community resources

Requirements

Master's degree in Social Work or related field from an accredited university

Skills

assessment and care planning skills knowledge of community resources medical terminology hospital systems insurance guidelines

Social Worker - Emergency Department (1.0 FTE/Evenings)

Overlake Medical Center & Clinics · Posted Sep 23, 2026

Open

Bellevue, Washington, United States
Full-time
$41–$67 per hour
1+ years

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Social Worker in the Emergency Department providing assessments, interventions, and coordination of care for patients with mental health and substance use issues.

Compensation

$41.11 - $66.60

Responsibilities

Conduct assessments for mental health, substance use disorder, abuse and neglect, and other psychosocial issues
Provide interventions and coordinate appropriate dispositions such as voluntary and involuntary psychiatric hospitalizations
Provide resources based on patient needs
Document and participate in continual quality improvement processes

Requirements

Master's degree in Social Work
Related field from an accredited university
Nice to have: Master's degree in Social Work preferred
Nice to have: Related field from an accredited university preferred
Nice to have: Minimum one year of experience preferred

Skills

Assessment and care planning skills Broad knowledge of community resources Medical terminology Hospital systems