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Caresource Jobs in Springfield, OH (NOW HIRING)

CareSource

Claims Management Analyst III

Dayton, OH · On-site +1

$72K - $115K/yr

CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-RW1

CareSource

SIU Investigator I

Dayton, OH · On-site

Review of all Incident Management System (IMS) documents and other tips received through CareSource fraud reporting mechanisms to determine if the allegation requires further review. Responsible for ...

System One

Enrollment Specialist

Dayton, OH · Remote

... CareSource experience or equivalent managed care experience servicing Medicaid and Medicare preferred • Proficiency with Microsoft Word and Excel • Excellent verbal and written communication ...

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Caresource information

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$24.8K

$50.5K

$73.9K

How much do caresource jobs pay per year?

As of Jul 6, 2026, the average yearly pay for caresource in Springfield, OH is $50,510.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,500.00 and $58,500.00 per year, depending on experience, location, and employer.

What is a Caresource job?

A CareSource job typically refers to a position at CareSource, a nonprofit managed care company that provides health insurance plans, including Medicaid and Medicare Advantage. Employees work in various roles, such as customer service, healthcare coordination, case management, and IT, to support members and improve healthcare outcomes. CareSource offers opportunities in healthcare administration, policy, and direct patient support, depending on the job function.

What are the key skills and qualifications needed to thrive in the Caresource position, and why are they important?

To thrive at CareSource, especially in common roles such as Case Manager or Customer Care Representative, candidates need a solid understanding of healthcare systems, insurance processes, and familiarity with Medicaid and Medicare regulations. Proficiency with healthcare management software, claims processing systems, and industry certifications like Certified Case Manager (CCM) are often required. Strong communication, problem-solving, and organizational skills are vital for effectively assisting members and collaborating with multidisciplinary teams. These skills and qualifications are critical to ensuring efficient service delivery and improving health outcomes for members within a managed care environment.

What are the typical challenges faced by employees working at CareSource, and how do they overcome them?

Employees at CareSource often navigate complex healthcare regulations and work with diverse member populations who have varying needs and backgrounds. One common challenge is balancing administrative tasks with providing empathetic, high-quality support to members. Team collaboration, ongoing training, and access to supportive management help staff overcome these hurdles. By leveraging strong problem-solving skills and staying updated on healthcare policy changes, CareSource employees are equipped to deliver exceptional service while maintaining compliance in a dynamic industry.

What cities near Springfield, OH are hiring for Caresource jobs? Cities near Springfield, OH with the most Caresource job openings:
Caresource jobs near you
Infographic showing various Caresource job openings in Springfield, OH as of June 2026, with employment types broken down into 80% Full Time, and 20% Contract. Highlights an 100% In-person job distribution, with an average salary of $50,510 per year, or $24.3 per hour.
Claims Management Analyst III

Claims Management Analyst III

CareSource

Dayton, OH • On-site, Remote

$72K - $115K/yr

Full-time

Posted 24 days ago

CareSource rating

7.7

Company rating: 7.7 out of 10

Based on 28 frontline employees who took The Breakroom Quiz

180th of 277 rated insurance

Job description

Job Summary:
The Claims Management Analyst III is responsible for leading eBusiness initiatives and coordination of activities across multiple functional areas.
Essential Functions:
  • Manage the EDI (Electronic Data Interchange) trading partners and network of clearinghouses to ensure accurate and timely exchange of information
  • Works closely with Vendor Management to improve and maintain the trading partner agreement with the trading partners. This includes cost reduction and adding services
  • Develop and maintain a partnership with the trading partner account representatives
  • Manage trading partner performance, establish and monitor service level agreements, regulatory requirements, and contractual metrics
  • Provide Subject Matter Expertise (SME) to all departments regarding eBusiness specific EDI transactions
  • Build, sustain and leverage relationships to constantly allow for continuous improvement of the EDI business process
  • Responsible for eBusiness EDI requirements that support regulatory, compliance, and business needs And eBusiness EDI regulatory reporting
  • Provide critical reporting and analysis of functional performance, and make recommendations for enhancements, cost savings initiatives and process improvements
  • Review and analyze the effectiveness and efficiency of existing processes and systems, and participate in development of solutions to improve or further leverage these functions
  • Participate in the process of estimating initiative budgets as well as developing business cases and tracking the benefits
  • Understand business strategy, define and lead eBusiness initiatives such as working with IT and others internal departments to automate functions
  • Understand the process to receive claims, claims rejections and denial processes, claims payment methodologies, adjudication processing, and Encounters to enable synergies among It and business groups
  • Contribute to and/or develop user stories or provide user story guidance for sprint planning
  • Develop, document and perform testing and validation as needed
  • Develop and maintain an in-depth knowledge of the company's business and regulatory environments
  • Identify issues, risks, and mitigation opportunities
  • Perform any other job duties as requested

Education and Experience:
  • Bachelor's degree or equivalent years of relevant work experience is required
  • Minimum of five (5) years of health care operations experience in insurance, managed care, or related industry is required

Competencies, Knowledge and Skills:
  • Advanced knowledge of healthcare EDI files (837, 277CA, 999, 270/271, 276/277, etc.)
  • Advanced computer skills
  • Demonstrated exceptional communication (verbal and written) and high level of professionalism
  • Data analysis and trending skills to include query writing Knowledge of Claims IT processes and systems
  • Working knowledge of managed care and health claims processing
  • Ability to effectively interact with all levels of management within the organization and across multiple organizational layers
  • Demonstrates excellent analysis, collaboration skills, facilitation and presentation skills
  • Strong interpersonal, leadership and relationship building skills
  • Decision making and problem solving skills
  • Ability to work independently and within a team environment
  • Time management skills; capable of multi-tasking and prioritizing work
  • Attention to detail
  • Effective decision making / problem solving skills
  • Critical thinking and listening skills

Licensure and Certification:
  • None

Working Conditions:
  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:
$72,200.00 - $115,500.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
#LI-RW1

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