17 Hipaa Compliance Jobs

The ideal candidate for this role should be ready to join immediately and can share their details via email for quick processing. Act fast for immediate attention! Roles and Responsibilities: Lead end-to-end Java-based solution design, development, and integration in a healthcare ecosystem. You will collaborate with product managers, business analysts, and architects to deliver high-quality solutions aligned with compliance standards such as HIPAA. Your role will involve guiding and mentoring development teams, enforcing coding standards, and ensuring adherence to design principles. Additionally, you will conduct technical reviews, identify risks, and suggest performance and scalability improvements. It will be your responsibility to drive DevOps practices, CI/CD pipelines, and cloud deployment strategies. Must-Have Skills: - 10+ years of experience in Java/J2EE development and solution design - Expertise in Spring Boot, Microservices, REST APIs, and SQL/NoSQL databases - Strong knowledge of healthcare standards like HL7, FHIR, EDI, or HIPAA compliance - Experience with cloud platforms (AWS/Azure/GCP) and containerization (Docker, Kubernetes) - Excellent leadership, communication, and stakeholder management skills Good-to-Have Skills: - Familiarity with Kafka, Elasticsearch, or CI/CD tools like Jenkins, GitHub Action - Knowledge of security frameworks (OAuth2, JWT) and healthcare data privacy policies - Certification in cloud or healthcare technologies is a plus Candidates with the above qualifications and skills are encouraged to apply by sending their details to nitin.patil@ust.com.,

The ideal candidate should be ready to join immediately and can share their details via email for quick processing at nitin.patil@ust.com. Act fast for immediate attention! Roles and Responsibilities: Lead end-to-end Java-based solution design, development, and integration in a healthcare ecosystem. Collaborate with product managers, business analysts, and architects to deliver high-quality solutions aligned with compliance standards (e.g., HIPAA). Guide and mentor development teams, enforce coding standards, and ensure adherence to design principles. Conduct technical reviews, identify risks, and suggest performance and scalability improvements. Drive DevOps practices, CI/CD pipelines, and cloud deployment strategies. Must Have Skills: - 10+ years of experience in Java/J2EE development and solution design. - Expertise in Spring Boot, Microservices, REST APIs, and SQL/NoSQL databases. - Strong knowledge of healthcare standards like HL7, FHIR, EDI, or HIPAA compliance. - Experience with cloud platforms (AWS/Azure/GCP) and containerization (Docker, Kubernetes). - Excellent leadership, communication, and stakeholder management skills. Good to Have Skills: - Familiarity with Kafka, Elasticsearch, or CI/CD tools like Jenkins, GitHub Actions. - Knowledge of security frameworks (OAuth2, JWT) and healthcare data privacy policies. - Certification in cloud or healthcare technologies is a plus.,

The System Support Associate will be responsible for implementing and modifying EDI file feeds, utilizing programming languages like C#, Java, Python, and SQL. You should have hands-on experience working within the US healthcare industry, understanding HIPAA compliance standards, and creating secure connections using SFTP (Secure File Transfer Protocol). As a member of the technical team, you will be responsible for integrating data feeds into our systems and ensuring compliance with industry standards and regulations. Key Responsibilities: - Implement and modify EDI (Electronic Data Interchange) file feeds for healthcare/benefits data integration. - Develop and maintain solutions using programming languages such as C#, Java, Python, and SQL. - Create, configure, troubleshoot, and maintain secure SFTP connections for transferring EDI files. - Gather specifications from clients, carriers & vendors and deliver solutions that meet the presented needs. - Ensure compliance with HIPAA regulations and US healthcare industry standards while managing sensitive patient data. - Effective communication and coordination with clients and carriers. Qualifications & Core Competencies: - Bachelor's degree in Computer Science or a related field (B. Tech preferred). - 2-5 years of proven expertise in the Implementation of EDI/carrier/Vendor file feeds. - Proficiency in C#, Java, Python, and SQL for developing and managing EDI integrations. - Experience in configuring and managing SFTP connections for secure file transfers. - Good understanding of US healthcare benefits like FSA, HSA, COBRA, 401k, 403b, Roth, HIPAA compliance, etc. The Company is committed to complying with all applicable laws providing equal employment opportunities. This commitment applies to all persons involved in the operations of the Company and prohibits unlawful discrimination by any employee of the Company, including supervisors and co-workers. PrismHR provides reasonable accommodation for qualified individuals with disabilities and disabled veterans in job application procedures. If you have any difficulty using the online system and need a reasonable accommodation due to a disability, you may contact taglobal@prismhr.com. PrismHR is dedicated to building a diverse, inclusive, and authentic workplace. If you are excited about the roles but your past experience does not align perfectly with every qualification in the job description, you are encouraged to apply anyway. PrismHR particularly encourages applicants from traditionally under-represented groups as they seek to increase the diversity of the workforce and provide fair opportunities for all.,

The role requires a Java Developer to lead end-to-end Java-based solution design, development, and integration in a healthcare ecosystem. You will collaborate with product managers, business analysts, and architects to deliver high-quality solutions aligned with compliance standards such as HIPAA. Your responsibilities include guiding and mentoring development teams, enforcing coding standards, ensuring adherence to design principles, and conducting technical reviews to identify risks and suggest performance and scalability improvements. Additionally, you will drive DevOps practices, CI/CD pipelines, and cloud deployment strategies. You should possess 10+ years of experience in Java/J2EE development and solution design, expertise in Spring Boot, Microservices, REST APIs, and SQL/NoSQL databases, and a strong understanding of healthcare standards like HL7, FHIR, EDI, or HIPAA compliance. Experience with cloud platforms such as AWS/Azure/GCP and containerization tools like Docker and Kubernetes is essential. Excellent leadership, communication, and stakeholder management skills are required for this role. Preferred skills include familiarity with Kafka, Elasticsearch, or CI/CD tools like Jenkins and GitHub Actions, knowledge of security frameworks like OAuth2 and JWT, and healthcare data privacy policies. Experience in Agile methodologies and SAFe frameworks, as well as certifications in cloud or healthcare technologies, are considered advantageous. Candidates ready to join immediately are encouraged to share their details via email at nitin.patil@ust.com for quick processing. Act fast for immediate attention!,

You should have 6-8 years of experience in AI/ML development, with a strong emphasis on Generative AI and Prompt Engineering. Your proficiency in programming languages should include Python as primary, with knowledge of JavaScript, SQL, and NodeJS being beneficial. You must have a strong experience with AI/ML frameworks such as TensorFlow, PyTorch, Transformers, and understanding of Generative AI models including LLMs. Expertise in designing and implementing efficient prompts for Generative AI is necessary, focusing on improving model performance, Guardrails, RAG, Prompting attacks evasion, and user interaction. Experience in integrating AI models with APIs and application servers (Flask, Django, FastAPI) for scalable AI applications is required. You should also have previous experience in Generative AI application development, especially in designing prompts for LLMs. Knowledge of SQL and NoSQL databases like MongoDB for managing AI model inputs and outputs is essential. Experience in Vector Databases, Vector Similarity Search, and Embedding models and frameworks is also a must. It would be good to have experience with cloud platforms like AWS, Azure, and containerization technologies like Docker for deploying AI solutions. A solid understanding of software development best practices including version control (Git), code reviews, testing, and CI/CD pipelines is beneficial. Knowledge of front-end technologies (HTML, CSS, JavaScript) for developing intuitive user interfaces is an advantage. Exposure to Azure AI/ML stack and familiarity with healthcare-related projects or HIPAA compliance is advantageous. Experience in designing multi-lingual Generative AI applications is also an advantage. You should hold a Bachelor's degree in Computer Science, Artificial Intelligence, Machine Learning, or a related field. In addition to the required experience, skills in containerization technologies (Docker), AI/ML development, software development best practices, code, vector databases, PyTorch, prompt engineering, JavaScript, API integration (Flask, FastAPI, Django), Python, AIML, Generative AI models, cloud platforms (AWS, Azure), SQL, databases, HIPAA compliance, multi-lingual Generative AI applications, Transformers, Azure AI/ML stack, front-end technologies (HTML, CSS, JavaScript), NoSQL databases, and API/ML are necessary for this role.,

About Evernorth: Evernorth Health Services, a division of The Cigna Group (NYSE: CI), creates pharmacy, care, and benefits solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention, and treatment of illness and disease more accessible to millions of people. Integration Services Agile Product Owner Lead Analyst Position Overview: As the Integration Services Agile Product Owner Lead Analyst, you will serve as the voice of the customer within the Scrum team of the US Medical Front Office Technology Integration Services team. Your role will involve leveraging your solid business and technical expertise to manage the team's work intake efficiently. Additionally, you will be responsible for prioritizing deliveries to maximize the business value provided by your Scrum team. Collaboration within a larger technology organization to analyze and deliver innovative solutions to the marketplace will also be a key aspect of your responsibilities. Responsibilities: - Understanding the key business objectives and strategy of the products you support - Working closely with system teams and business owners to ensure their engagement and alignment with the team's direction - Collaborating with requesters to ensure their priorities are reflected in the team's backlog - Managing and refining the inflow of work into the team's product backlog - Providing analysis, architecture, and design support to scrum team(s) - Setting and communicating the team's scope for the current iteration Qualifications Required Experience / Qualifications: - Demonstrated ability to acquire in-depth knowledge of the industry and business, and leverage this knowledge proactively to achieve meaningful results - Proficiency in facilitating collaboration across various functions, departments, and organizational levels - 5-8 years of experience as a product owner/product manager - Experience in incorporating HIPAA compliance throughout the product design, development, and deployment processes - Capability to establish productive working relationships with both technical and non-technical partners - Understanding of key provider data business objectives and strategy - Creation of user stories and acceptance criteria that incorporate HIPAA requirements to ensure protection of Protected Health Information (PHI) Equal Opportunity Statement: Evernorth is an Equal Opportunity Employer that actively promotes and supports staff involvement in diversity, equity, and inclusion efforts. Our goal is to educate, inform, and advance internal practices and external work with diverse client populations.,

Job Description_ Senior Executive - AR Analyst _ Denial management Job Name: Senior Executive Position Title: Senior Executive - AR Analyst Band: A2 LOB: Denial Management - AR Analyst - RCM Reporting to: Assistant Manager Location/Site: EXL India, Chennai Overview: Review, Analyze and Manage assigned outstanding receivables portfolio by ensuring outstanding/denied claims are resolved, follow up effectively for additional information as needed with insurance companies for claims resolution, follow up with the insurance company on the outstanding/denied claims and resolve them within the timelines and defined Service Level Agreements (SLA's), website checking and working on non-callable denials. Qualifications: Graduation in any stream Experience: BPO Experience : 2-4 years US Healthcare AR experience preferred Communication Skill: Excellent written (documentation) and oral communication skills Working Hours: 40 hours per week as Full-time employee Shift time: Mid Shift Weekends Off Telecommuter/Internet requirements, if applicable: High Speed internet connection at home, must be broadband Must understand and adhere with telecommuter policy Skills and abilities: Working on website related claims and action based on coding team responses. All non-callable denials, demographic and eligibility denials need to be worked Ensure Daily Productivity targets are met at the required quality level on the assigned inventory, Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket, Review claims that have not been paid by insurance companies, Check insurance information provided by patient if it is insufficient or unclear, Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance, Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information, Post cash and write off the contractual adjustments accordingly while working on the accounts, Meeting daily/weekly and monthly targets set for an individual.

Sr. Executive- AR caller: Overview: Review, Call, Analyze and Manage assigned outstanding receivables portfolio by ensuring outstanding/denied claims are resolved, follow up effectively for additional information as needed with insurance companies for claims resolution, follow up with the insurance company on the outstanding/denied claims and resolve them within the timelines and defined Service Level Agreements (SLA's), Qualifications: Graduation in any stream Experience: BPO Experience - 2-5 years US Healthcare AR experience preferred Communication Skill: Excellent oral and written communication skills Working Hours: 40 hours per week as Full-time employee Shift time: 7:30 PM IST - 4:30 AM IST Weekends Off Telecommuter/Internet requirements, if applicable: High Speed internet connection at home, must be broadband Must understand and adhere with telecommuter policy Skills and abilities: Interact and probe the insurance representative to get the required status update and have the claim resolved, Ensure Daily Productivity targets are met at the required quality level on the assigned inventory, Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket, Review claims that have not been paid by insurance companies, Check insurance information provided by patient if it is insufficient or unclear, Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance, Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information, Post cash and write off the contractual adjustments accordingly while working on the accounts, Meeting daily/weekly and monthly targets set for an individual.

Role & responsibilities MRD Technician Preparing patient charts and gathering information and documents from patients Ensuring that the medical records are organized, accurate and complete Filing the paperwork and reports of inpatients quickly and accurately Safeguarding patient records and ensuring that everyone complies with the HIPAA standards Transferring data into the facilitys main system database Processing the records for admitting and discharging patients

Job Title: Pega Developer (SSA) Smart Claims Engine (SCE) Experience: 6+ Years Department: IT & Information Security Role Category: Programming & Design Employment Type: Full-Time Job Summary: We are looking for an experienced Pega Developer (SSA) with a strong background in Smart Claims Engine (SCE) integration and healthcare claims processing . The ideal candidate will work closely with cross-functional teams to design, develop, and enhance Pega-based applications and workflows that improve operational efficiency in claims management systems. Key Responsibilities: Design, configure, and customize Pega applications aligned with claims processing needs and business objective. Integrate Pega applications with Smart Claims Engine (SCE) and third-party healthcare systems Develop decision rules, user interfaces, and business logic within the Pega platform Troubleshoot application issues and perform root cause analysis for effective resolution Participate in Agile ceremonies including sprint planning, stand-ups, and retrospectives Collaborate with business analysts, testers, and architects for smooth project delivery Ensure adherence to coding standards, contribute to code reviews, and reusable components Maintain technical documentation including workflows, user stories, and test cases Required Skills & Experience: Minimum 6 years of hands-on experience in Pega development , preferably on Pega 8.x or later Strong exposure to Smart Claims Engine (SCE) or similar healthcare claims systems Experience with Pega REST API, SOAP services , and third-party system integrations Familiarity with healthcare standards (e.g., HL7, FHIR ) and regulations like HIPAA Good understanding of SQL and relational databases (e.g., Oracle, MySQL) Strong communication, problem-solving, and collaboration skills Pega Certified Senior System Architect (SSA) certification is highly preferred Knowledge of Agile methodologies like Scrum or Kanban

Responsibilities Develop key features and enhance the platforms performance, scalability, and security Design and implement secure, efficient APIs to support communication and data flow Optimize database performance and adhere to data standards Collaborate with team members to align on technical and business requirements Contribute to the maintenance of CI/CD processes and proactive monitoring Stay updated on advancements in PHP, Laravel, AWS, and healthcare technology Requirements Experience with PHP frameworks, particularly Laravel, and a good understanding of modern development practices Knowledge of optimizing database performance, including query optimization and indexing Experience in designing and implementing RESTful APIs with authentication standards such as OAuth 2.0 Understanding of software architecture patterns, including MVC and microservices, to ensure maintainable and scalable code CI/CD and Monitoring Skills Familiarity with CI/CD processes and tools, with experience in automating testing and deployment Knowledge of monitoring tools for system health and performance Core Infrastructure Skills Practical experience in deploying, managing, and scaling applications using AWS services like EC2, RDS, and S3 Basic experience managing cloud-based architectures, including EC2 instances and load balancing Familiarity with containerization technologies such as Docker for application deployment Nice to have Experience with front-end development Basic knowledge of front-end technologies (HTML, CSS, JavaScript) for collaborative development Integration Skills Experience integrating third-party APIs, such as EMR systems or communication tools like Twilio Regulatory Awareness Understanding of regulatory standards impacting healthcare technology, such as HIPAA compliance Communication and Problem-Solving Strong communication skills to work effectively with team members and stakeholders Ability to analyze and troubleshoot technical issues to improve application performance

Description We are seeking an experienced AR Caller with expertise in Hospital Billing/Physician Billing to join our team. The ideal candidate will play a crucial role in managing our accounts receivable, ensuring timely follow-ups on outstanding payments, and maintaining accurate billing records. Responsibilities Contact healthcare providers, patients, and insurance companies to follow up on outstanding accounts receivable. Review and analyze billing statements and payment trends to identify discrepancies. Resolve billing issues and provide solutions to ensure timely payment. Maintain accurate records of communications and payments received in the billing system. Collaborate with the billing team to streamline processes and improve collection rates. Assist in preparing reports related to accounts receivable status and collection performance. Skills and Qualifications Bachelor's degree in Finance, Accounting, or a related field is preferred. 1-6 years of experience in hospital billing or physician billing is required. Strong understanding of medical billing processes, insurance claims, and payment posting. Excellent communication and interpersonal skills to effectively interact with patients and providers. Proficiency in billing software and Microsoft Office Suite, especially Excel. Attention to detail and strong analytical skills to identify issues in billing and payments. Ability to work independently and manage multiple tasks in a fast-paced environment.

Telehealth Coordinator Roles and Responsibilities: Manage and coordinate telehealth services. Ensure patients receive remote healthcare services efficiently and effectively. Troubleshoot technical issues related to telehealth services. Train healthcare providers on telehealth technology. Monitor and evaluate the effectiveness of telehealth services. Required Skills: Knowledge of telehealth technology Strong organizational skills Excellent communication skills Ability to troubleshoot technical issues Understanding of healthcare regulations

Health Information Technician Roles and Responsibilities: Manage and organize health information data. Ensure the accuracy, accessibility, and security of patient records. Maintain patient confidentiality and comply with healthcare regulations. Assist in the implementation and management of health information systems. Collaborate with healthcare providers to ensure proper documentation. Required Skills: Knowledge of medical terminology Proficiency in health information systems Attention to detail Strong organizational skills Ability to maintain confidentiality

Experience Required: 1 to 4 years (AR Calling) Key Responsibilities: Call insurance companies (US payers) to follow up on outstanding claims Analyze denied or unpaid claims and resolve issues Work on reducing AR days and improving collection rates Required Candidate profile -Immediate Joiners required -Comfortable to Work in rotational shifts as required Perks and Benefits -Voice Skill Bonus -Two way cab -One time meal

Position Reports To : Medical Team Lead Department : Operations Position Summary : - The role will be to review and verify large volumes of patient's full medical records with precision, perform clinical reviews as defined by the specific review methodologies and prepare a detailed report that includes chronologies and timelines, summaries, mass tort matrix and medical opinions on case validity and valuation. Job Responsibilities : - Analyzing and summarizing medical records for pre and post settlement projects. Interpreting clinical data in terms of medical terminology and diagnosis. o Adhering to company policies/ARCHER principles and hence taking good care of Archer culture. Adhere to Health Insurance Portability and Accountability Act (HIPPA) all the time. Daily reporting to Medical team lead for productivity & quality Knowledge, Skills And Abilities : - Technical Skills: Knowledge of basic level of health care data analysis and clinical review. o Sound knowledge of medical terminology, assessments, patient evaluation, and clinical medicine. Ability to work proficiently with Microsoft Word, Adobe, and Excel. Interpersonal Skills: Ability to perform well in a team environment, with staff at all levels, to achieve business goals. Ability to function under pressure and with deadline-oriented project demands as well as manage multiple initiatives. Team player and motivated self-starter. o Detail-oriented, organized, able to multi-task. Effective communication skills. Educational Qualification And Experience Required : - MBBS graduate (No experience required) BHMS/BAMS graduate (Minimum 2 years of experience with Claims Processing in the Insurance sector). Additional Skills : - HIPPA, Critical thinking, Basic understanding of US culture, Basic understanding of organization culture and behavior. Career Path : - Medical Officer Medical Team Lead

Job Description: We are looking for highly motivated Doctor of Pharmacy freshers who are passionate about starting their careers in healthcare operations. The selected candidates will play a vital role in supporting pharmacy and clinical processes for our U.S.-based healthcare clients. Roles and Responsibilities: Provide customer service support by handling clinical clarifications and assisting with outbound calls related to medication availability. Assist in processing clinical clarifications based on interventions from healthcare professionals and ensure accurate communication between departments. Handle data entry tasks, including entering and reviewing orders, ensuring accuracy in patient and medication information. Support pharmacy operations by processing prescriptions and ensuring compliance with quality standards and regulations. Assist with general clerical tasks as needed to support daily operations. Maintain awareness of compliance standards, particularly in relation to HIPAA and privacy regulations. Collaborate with internal teams to ensure the timely resolution of any operational issues. Demonstrate excellent customer service, communication, and organizational skills in all tasks. Experience/qualifications: Knowledge of Drug classification and Drug-Drug Interactions Doctor of Pharmacy graduates (2023/2024/2025 pass-outs) Knowledge of sig codes Knowledge of MS Outlook, MS Word, MS Excel & Internet Explorer Excellent communication skills both verbal and written Comfortable working in night shifts (U.S. shift timings) Excellent customer service & telephone skills Ensure compliance with HIPAA regulations and requirements. Shift Timings: Night Shift (U.S. Timings) Working Days: 5 Days a Week Job Location: Hyderabad Office-based only How to Apply: Interested candidates can apply directly through Naukri or send their updated resume to career@staffingly.com.