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Home Based Nasco Healthcare Jobs (NOW HIRING)

NASCO claims Specialist

Newark, NJ · On-site

$110K - $115K/yr

Mentor junior and mid level testers and analysts on healthcare claims concepts. * Review test ... Extensive experience in US Healthcare Insurance - NASCO Claims Processing. * Strong understanding ...

Home Based Services

$15 - $19/hr

Hillview Home Based Serves is currently searching for compassionate team members for Non-Medical In ... Caregivers serve a key role in the healthcare industry. Here are some basic caregiver job ...

Flexible Spending Accounts (FSA) for health and dependent care expenses * 401(k) Retirement Plan ... join us as our next Home Based Visitor. Together, we'll help every child reach their fullest ...

Home Based Visitor

New York, NY · On-site +1

$50K - $57K/yr

Flexible Spending Accounts (FSA) for health and dependent care expenses * 401(k) Retirement Plan ... join us as our next Home Based Visitor. Together, we'll help every child reach their fullest ...

Home Healthcare Aide

Oxford, MI

$13 - $17/hr

The home health aide is a paraprofessional member of the home care team who works under the supervision of a registered nurse or therapist and performs various personal care services as necessary to ...

Home Healthcare Aide

Oxford, MI

$13 - $17/hr

The home health aide is a paraprofessional member of the home care team who works under the supervision of a registered nurse or therapist and performs various personal care services as necessary to ...

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Home Based Nasco Healthcare information

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Infographic showing various Home Based Nasco Healthcare job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 15% Part Time, and 7% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution.

NASCO claims Specialist

Newark, NJ • On-site

$110K - $115K/yr

Full-time

Posted 29 days ago


Job description

Job Description
Key Responsibilities
 
• Serve as primary SME for end to end NASCO claims processing across professional, institutional, and pharmacy claims.
• Provide strategic direction and domain leadership for claims testing initiatives.
• Interpret and guide implementation of complex payer rules, benefit configurations, and provider contracts.
• Review and validate regulatory compliance with CMS, HIPAA, Medicare, Medicaid, and commercial plan requirements.
• Proactively identify domain risks, gaps, and improvement opportunities in claims workflows.
________________________________________
Testing Strategy & Governance
• Define overall NASCO claims testing strategy, scope, and coverage for releases.
• Review and approve test plans, scenarios, and test data from a domain correctness perspective.
• Ensure comprehensive validation of: 
o Claims adjudication logic
o Pricing and repricing
o Accumulators (deductibles, MOOP)
o COB and subrogation
o Authorizations, edits, and exceptions
• Lead UAT planning and execution, including business readiness and sign off.
• Own defect triage decisions, prioritization, and root cause analysis.
________________________________________
Stakeholder & Onsite Engagement
• Act as single point of contact for claims domain queries at client location.
• Partner closely with: 
o Product Owners
o Business Users
o Operations teams
o Development and QA leads
• Facilitate workshops, walkthroughs, and requirement clarification sessions.
• Influence decision making by translating business needs into system impacts.
________________________________________
Team Leadership & Mentorship
• Mentor junior and mid level testers and analysts on healthcare claims concepts.
• Review test artefacts and guide offshore UAT teams to ensure domain accuracy.
• Promote best practices in domain driven testing and knowledge sharing.
________________________________________
Required Skills & Qualifications
Mandatory Domain Expertise
• Extensive experience in US Healthcare Insurance – NASCO Claims Processing.
• Strong understanding of: 
o Claims lifecycle and adjudication engines
o EDI (837, 835, 270/271)
o Coding standards: ICD 10, CPT, HCPCS, DRG
o Commercial, Medicare, and Medicaid plans
• Hands on experience supporting core payer platforms.
________________________________________
Testing & Process Excellence
• Strong manual testing background with senior level oversight experience.
• Expertise in: 
o Test strategy definition
o UAT leadership
o Defect governance
• Familiarity with Agile, SAFe, or hybrid delivery models.
• Experience with test management and defect tracking tools (Jira, ALM, qTest).