Join a mission-driven healthcare organization dedicated to ensuring accurate claims processing and supporting equitable access to care. This role plays a key part in maintaining financial integrity by analyzing and correcting healthcare claim payments. Responsibilities: Research and analyze medical claims adjustment requests to determine payment accuracy Adjust and adjudicate claims using multiple systems and platforms Apply appropriate payment guidelines including CMS, Medicare, Medicaid, and internal policies Investigate incorrectly processed claims and determine corrective actions Communicate findings and coordinate with internal stakeholders as needed Respond to provider inquiries regarding claim payments and required documentation Process claim adjustments within established timelines Maintain up-to-date knowledge of claims processing and coding updates Ensure accurate documentation and recordkeeping of all claims activity Generate reports and assist with audits as required Work independently and exercise sound judgment in decision-making Qualifications: High School Diploma or equivalent required; Associate degree preferred Minimum 3 years of healthcare claims operations experience Strong understanding of claims adjudication processes Knowledge of medical terminology, CPT, ICD-10, and revenue codes Experience working with claims processing systems Familiarity with CRM systems such as Salesforce preferred Strong Excel and data analysis skills Excellent written and verbal communication skills Knowledge of HIPAA guidelines and protected health information Experience handling provider claim inquiries "Please note that the salary range and/or hourly rate range of $20.00 - $30.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply."
04/27/2026
Full time
Join a mission-driven healthcare organization dedicated to ensuring accurate claims processing and supporting equitable access to care. This role plays a key part in maintaining financial integrity by analyzing and correcting healthcare claim payments. Responsibilities: Research and analyze medical claims adjustment requests to determine payment accuracy Adjust and adjudicate claims using multiple systems and platforms Apply appropriate payment guidelines including CMS, Medicare, Medicaid, and internal policies Investigate incorrectly processed claims and determine corrective actions Communicate findings and coordinate with internal stakeholders as needed Respond to provider inquiries regarding claim payments and required documentation Process claim adjustments within established timelines Maintain up-to-date knowledge of claims processing and coding updates Ensure accurate documentation and recordkeeping of all claims activity Generate reports and assist with audits as required Work independently and exercise sound judgment in decision-making Qualifications: High School Diploma or equivalent required; Associate degree preferred Minimum 3 years of healthcare claims operations experience Strong understanding of claims adjudication processes Knowledge of medical terminology, CPT, ICD-10, and revenue codes Experience working with claims processing systems Familiarity with CRM systems such as Salesforce preferred Strong Excel and data analysis skills Excellent written and verbal communication skills Knowledge of HIPAA guidelines and protected health information Experience handling provider claim inquiries "Please note that the salary range and/or hourly rate range of $20.00 - $30.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply."
Join a healthcare organization committed to delivering high-quality service and operational excellence. This role is essential in supporting provider communications and ensuring accurate resolution of claims-related inquiries. Responsibilities: Serve as the primary liaison for written provider inquiries and issue resolution Respond to claim-related inquiries from physicians, clinical staff, and provider administrators Coordinate with internal departments including Claims, Utilization Management, Provider Relations, and Member Services Track, manage, and ensure timely follow-up and closure of all inquiries Prepare clear and accurate written responses to providers and maintain detailed records Perform data entry into internal systems such as IMAX Adjust claims to correct overpayments and underpayments Participate in special projects related to claims investigations Resolve member billing issues referred from Member Services Qualifications: Strong knowledge of claims processing and payment methodologies Understanding of health plan benefits and claims operations Experience with systems such as IMAX and TXEN preferred Customer service experience, preferably in healthcare Ability to handle escalated or challenging provider interactions professionally Excellent written and verbal communication skills Strong attention to detail and organizational skills Please note that the salary range and/or hourly rate range of $60.00 - 70.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
04/26/2026
Full time
Join a healthcare organization committed to delivering high-quality service and operational excellence. This role is essential in supporting provider communications and ensuring accurate resolution of claims-related inquiries. Responsibilities: Serve as the primary liaison for written provider inquiries and issue resolution Respond to claim-related inquiries from physicians, clinical staff, and provider administrators Coordinate with internal departments including Claims, Utilization Management, Provider Relations, and Member Services Track, manage, and ensure timely follow-up and closure of all inquiries Prepare clear and accurate written responses to providers and maintain detailed records Perform data entry into internal systems such as IMAX Adjust claims to correct overpayments and underpayments Participate in special projects related to claims investigations Resolve member billing issues referred from Member Services Qualifications: Strong knowledge of claims processing and payment methodologies Understanding of health plan benefits and claims operations Experience with systems such as IMAX and TXEN preferred Customer service experience, preferably in healthcare Ability to handle escalated or challenging provider interactions professionally Excellent written and verbal communication skills Strong attention to detail and organizational skills Please note that the salary range and/or hourly rate range of $60.00 - 70.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
Join a healthcare organization dedicated to operational excellence and accurate claims processing. This role is essential in ensuring timely and precise adjudication of provider claims while maintaining compliance with healthcare guidelines and policies. Responsibilities: Process medical and surgical claims, ensuring complete and accurate member and provider information Adjudicate claims within established guidelines and authorize final claim disposition Apply administrative policies and claims processing procedures as needed Review claims for accuracy, validity of charges, and potential errors Evaluate pended claims related to contractual or payment discrepancies Generate correspondence to providers requesting additional information when necessary Maintain productivity and quality standards established by the department Update reference materials and participate in training sessions Track individual production metrics and performance goals Perform additional duties and support functions as assigned Qualifications: Associate degree or equivalent combination of education and experience Minimum 2 years of experience in the healthcare insurance industry Knowledge of integrated claims processing systems Strong data entry skills with high attention to detail Knowledge of medical terminology, CPT, ICD codes, and revenue codes Ability to work efficiently in a fast-paced environment Strong organizational and communication skills Please note that the salary range and/or hourly rate range of $25.00 - $30.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
04/26/2026
Full time
Join a healthcare organization dedicated to operational excellence and accurate claims processing. This role is essential in ensuring timely and precise adjudication of provider claims while maintaining compliance with healthcare guidelines and policies. Responsibilities: Process medical and surgical claims, ensuring complete and accurate member and provider information Adjudicate claims within established guidelines and authorize final claim disposition Apply administrative policies and claims processing procedures as needed Review claims for accuracy, validity of charges, and potential errors Evaluate pended claims related to contractual or payment discrepancies Generate correspondence to providers requesting additional information when necessary Maintain productivity and quality standards established by the department Update reference materials and participate in training sessions Track individual production metrics and performance goals Perform additional duties and support functions as assigned Qualifications: Associate degree or equivalent combination of education and experience Minimum 2 years of experience in the healthcare insurance industry Knowledge of integrated claims processing systems Strong data entry skills with high attention to detail Knowledge of medical terminology, CPT, ICD codes, and revenue codes Ability to work efficiently in a fast-paced environment Strong organizational and communication skills Please note that the salary range and/or hourly rate range of $25.00 - $30.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
Join a healthcare organization undergoing critical system enhancements to improve claims processing and operational efficiency. This role is essential in ensuring system readiness and accuracy by validating that business and technical requirements are met prior to production deployment. Responsibilities: Serve as the primary subject matter expert for Claims Operations systems during UAT cycles Lead and coordinate User Acceptance Testing (UAT) activities to validate system functionality Develop and manage UAT test plans, test cases, and test scripts Execute positive and negative testing scenarios to identify defects Track, document, and manage defects through resolution Collaborate with IT, Claims, and cross-functional teams to ensure requirements are met Participate in requirement reviews, data analysis, and solution design discussions Monitor risks, issues, and mitigation plans related to UAT activities Provide test status reporting and ensure timely completion of testing cycles Support additional quality assurance and testing initiatives as needed Qualifications: Bachelor's degree or 8+ years of related experience 5+ years of IT quality assurance and systems/application testing experience Strong experience with User Acceptance Testing (UAT) methodologies Ability to create test plans, test cases, and test scripts Experience with multiple testing types including unit, integration, and system testing Experience working with business analysts and translating requirements into test scenarios Knowledge of healthcare systems, claims operations, and managed care environments Strong analytical, organizational, and multitasking abilities Excellent written and verbal communication skills Proficiency with Microsoft Office tools Project management experience or certification is a plus Please note that the salary range and/or hourly rate range of $70.00 - $78.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
04/25/2026
Full time
Join a healthcare organization undergoing critical system enhancements to improve claims processing and operational efficiency. This role is essential in ensuring system readiness and accuracy by validating that business and technical requirements are met prior to production deployment. Responsibilities: Serve as the primary subject matter expert for Claims Operations systems during UAT cycles Lead and coordinate User Acceptance Testing (UAT) activities to validate system functionality Develop and manage UAT test plans, test cases, and test scripts Execute positive and negative testing scenarios to identify defects Track, document, and manage defects through resolution Collaborate with IT, Claims, and cross-functional teams to ensure requirements are met Participate in requirement reviews, data analysis, and solution design discussions Monitor risks, issues, and mitigation plans related to UAT activities Provide test status reporting and ensure timely completion of testing cycles Support additional quality assurance and testing initiatives as needed Qualifications: Bachelor's degree or 8+ years of related experience 5+ years of IT quality assurance and systems/application testing experience Strong experience with User Acceptance Testing (UAT) methodologies Ability to create test plans, test cases, and test scripts Experience with multiple testing types including unit, integration, and system testing Experience working with business analysts and translating requirements into test scenarios Knowledge of healthcare systems, claims operations, and managed care environments Strong analytical, organizational, and multitasking abilities Excellent written and verbal communication skills Proficiency with Microsoft Office tools Project management experience or certification is a plus Please note that the salary range and/or hourly rate range of $70.00 - $78.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
Join a large public healthcare organization supporting critical administrative operations at a senior leadership level. This role plays a key part in ensuring smooth executive functions, communication flow, and organizational efficiency. Responsibilities: Provide high-level administrative support to senior leadership Create, edit, format, and manage documents using Microsoft Word and Excel Develop presentations using PowerPoint and manage databases in Access Coordinate calendars, meetings, and executive schedules Prepare agendas, take meeting minutes, and distribute documentation Manage correspondence, including drafting and editing communications Oversee digital and physical filing systems Coordinate meeting logistics, including room scheduling and virtual setup Handle confidential and sensitive information with discretion Support procurement processes and vendor invoice tracking Ensure compliance with data privacy and security standards Assist in creating board-ready presentations and data visualizations Maintain relationships across departments and stakeholders Qualifications: Bachelor's Degree required Minimum 1 year of relevant administrative experience Strong proficiency in Microsoft Word, Excel, PowerPoint, and Access Experience with Google Workspace tools Familiarity with Outlook and Microsoft Teams Experience in data management and reporting Strong organizational and multitasking skills Ability to handle confidential information with professionalism Excellent written and verbal communication skills in English "Please note that the salary range and/or hourly rate range of $35.00 - $45.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply."
04/24/2026
Full time
Join a large public healthcare organization supporting critical administrative operations at a senior leadership level. This role plays a key part in ensuring smooth executive functions, communication flow, and organizational efficiency. Responsibilities: Provide high-level administrative support to senior leadership Create, edit, format, and manage documents using Microsoft Word and Excel Develop presentations using PowerPoint and manage databases in Access Coordinate calendars, meetings, and executive schedules Prepare agendas, take meeting minutes, and distribute documentation Manage correspondence, including drafting and editing communications Oversee digital and physical filing systems Coordinate meeting logistics, including room scheduling and virtual setup Handle confidential and sensitive information with discretion Support procurement processes and vendor invoice tracking Ensure compliance with data privacy and security standards Assist in creating board-ready presentations and data visualizations Maintain relationships across departments and stakeholders Qualifications: Bachelor's Degree required Minimum 1 year of relevant administrative experience Strong proficiency in Microsoft Word, Excel, PowerPoint, and Access Experience with Google Workspace tools Familiarity with Outlook and Microsoft Teams Experience in data management and reporting Strong organizational and multitasking skills Ability to handle confidential information with professionalism Excellent written and verbal communication skills in English "Please note that the salary range and/or hourly rate range of $35.00 - $45.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply."
Join a mission-driven healthcare organization dedicated to improving access and quality of care for diverse communities. This role plays a critical part in supporting system transformation initiatives and enhancing provider network operations. Responsibilities: Support migration to a new core claims system (Health Rules Payer - HRP) for Provider Network Operations Participate in project meetings across all phases including preparation, testing, and post-go-live activities Maintain issue tracking logs and support resolution of provider-related system issues Assist in updating process documentation, policies, and procedures Prepare executive summaries and communication materials regarding system updates Represent leadership in operational and project meetings as needed Support provider data quality assurance across multiple platforms including CACTUS, PowerStepp, HRP, and Salesforce Monitor and triage provider complaints related to system migration Perform data collection, extraction, analysis, and reporting related to migration efforts Act as liaison between Credentialing, Provider Maintenance, and Customer Service teams Assist with additional projects and operational initiatives as assigned Qualifications: Bachelor's degree or equivalent combination of education and experience 3 to 5 years of experience within a health plan environment; Medicaid experience preferred Understanding of provider network management and healthcare system structures Familiarity with provider contracts, Medicare fee schedules, and CPT/HCPCS coding General knowledge of claims adjudication processes; Health Edge/HRP experience preferred Experience with Salesforce; healthcare setting preferred Strong analytical, organizational, and problem-solving skills Ability to manage workload independently and meet deadlines in a fast-paced environment Proficiency in Microsoft Office Suite including Excel, PowerPoint, and SharePoint Strong communication skills with the ability to present findings and recommendations "Please note that the salary range and/or hourly rate range of $60.00 - 70.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
04/24/2026
Full time
Join a mission-driven healthcare organization dedicated to improving access and quality of care for diverse communities. This role plays a critical part in supporting system transformation initiatives and enhancing provider network operations. Responsibilities: Support migration to a new core claims system (Health Rules Payer - HRP) for Provider Network Operations Participate in project meetings across all phases including preparation, testing, and post-go-live activities Maintain issue tracking logs and support resolution of provider-related system issues Assist in updating process documentation, policies, and procedures Prepare executive summaries and communication materials regarding system updates Represent leadership in operational and project meetings as needed Support provider data quality assurance across multiple platforms including CACTUS, PowerStepp, HRP, and Salesforce Monitor and triage provider complaints related to system migration Perform data collection, extraction, analysis, and reporting related to migration efforts Act as liaison between Credentialing, Provider Maintenance, and Customer Service teams Assist with additional projects and operational initiatives as assigned Qualifications: Bachelor's degree or equivalent combination of education and experience 3 to 5 years of experience within a health plan environment; Medicaid experience preferred Understanding of provider network management and healthcare system structures Familiarity with provider contracts, Medicare fee schedules, and CPT/HCPCS coding General knowledge of claims adjudication processes; Health Edge/HRP experience preferred Experience with Salesforce; healthcare setting preferred Strong analytical, organizational, and problem-solving skills Ability to manage workload independently and meet deadlines in a fast-paced environment Proficiency in Microsoft Office Suite including Excel, PowerPoint, and SharePoint Strong communication skills with the ability to present findings and recommendations "Please note that the salary range and/or hourly rate range of $60.00 - 70.00 is a good faith determination of potential base compensation offered to applicants at the time of this job advertisement and may be subject to modification in the future. When determining a team member's base salary and/or hourly rate, various factors may be taken into account as applicable (such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity). For consideration to this and/or other roles suitable for your background, please submit your most up-to-date resume to join our talent pool. At ATRIA Consulting, LLC, we are a woman-owned business fully committed to promoting, cultivating, and maintaining a culture of diversity, equity, and inclusion. We embrace and celebrate differences across all demographics and backgrounds. We encourage everyone to apply.
