Top 388 Regulatory specialist Jobs in Nevada

Senior Claim Benefit Specialist - Remote
CVS Health —Nevada
- $18.50 - $42.35 an hour
- Full-time
- Remote
- Mid-level
- High school diploma or GED
- Mentoring
- Health insurance
- Dental insurance
Project Engineer
P&C Recruiting and HR —Elko, NV
- 5 years
- Databases
- Driver's License
Quick Apply
Mortgage Foreclosure Specialist
Village Capital & Investment —Henderson, NV
- Full-time
- Mid-level
- Office
- 1 year
- Health savings account
- Health insurance
Quick Apply
Escrow Officer Assistant (Mortgage Operations)
Village Capital & Investment —Henderson, NV
- Full-time
- Mid-level
- Office
- 3 years
- Health savings account
- Health insurance
Quick Apply
Speech Language Pathologist (Sign on Bonus) - Las Vegas, NV
FOX Rehabilitation —Las Vegas, NV
- $81,000 - $115,000 a year
- Part-time
- CPR Certification
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Nevada Licensed Nurse Practitioner - Per Diem
NutriDrip —Las Vegas, NV
- $55 - $100 an hour
- Full-time
- Nursing
- Sales
- Inventory management
Quick Apply
IT Workday Platform Manager
Golden Entertainment —Las Vegas, NV
- $90,000 - $120,000 a year
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Health savings account
- Health insurance
Quick Apply
Pediatric Audiologist (Au.D.)
Advanced Pediatric Therapies —Sparks, NV
- $100,000 - $120,000 a year
- Part-time
- Background check
- 18 years or older
- Doctoral degree
- Paid holidays
- Relocation assistance
Quick Apply
Occupational Therapist - Carson City, NV
FOX Rehabilitation —Carson City, NV
- $80,000 - $116,000 a year
- Part-time
- CPR Certification
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Phlebotomy Instructor/Director
Phlebotomy Training Specialists —Reno, NV
- $26 - $30 an hour
- Part-time
- Classroom
- Blood sampling
- Management
Quick Apply
Healthcare Credentialing & Provider Relations Specialist
Reno-Sparks Indian Colony —Reno, NV
- $30.36 - $37.34 an hour
- Full-time
- Mid-level
- 3 years
- High school diploma or GED
- Paid holidays
- 401(k)
Physician - Correctional Setting
Reliable Health Care Services of Southern Nevada, Inc —Carson City, NV
- Monday to Friday
- Medicine
- Acute care experience
- Senior level
- Continuing education credits
- Health insurance
Quick Apply
Pediatric Pharmacy Clinical Operations Manager
Sunrise Hospital and Medical Center —Las Vegas, NV
- $137,446.40 - $206,148.80 a year
- Full-time
- Bachelor of Science
- Pediatrics
- Senior level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Social Worker I
Reno-Sparks Indian Colony —Reno, NV
- $76,440.00 - $115,622.36 a year
- Full-time
- Microsoft Excel
- 21 years or older
- Children
- Health insurance
- Dental insurance
Nurse Practitioner
International SOS —Reno, NV
- $75 an hour
- Part-time
- Nursing
- English
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
12d
Physical Therapist PT OCS Resident
Banner Health —Fallon, NV
- Full-time
- Hospital
- BLS Certification
- Physical & Rehabilitation Medicine
- Wellness program
- Relocation assistance
Respiratory Therapist / Nurse
Lincare Inc. —Carson City, NV
- Weekends as needed
- RN License
- Computer literacy
- Mid-level
Quick Apply
5d
Regulatory Compliance Exam Specialist
Westlake Services, LLC —Las Vegas, NV
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Paid holidays
- Disability insurance
Quick Apply
10d
HEALTH/HUMAN SERVICES PROFESSIONAL TRAINEE - UNDERFILL
State of Nevada —Nevada
- Full-time
- Nursing
- Microsoft Excel
- Basic math
- Paid holidays
- Disability insurance
5d
SOCIAL SERVICES PROGRAM SPECIALIST 2
State of Nevada —Reno, NV
- Full-time
- Experience working with individuals with developmental disabilities
- Customer service
- Mid-level
- Paid holidays
- Disability insurance
5d

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regulatory specialist jobs near nevada

Senior Claim Benefit Specialist - Remote

CVS Health -
Nevada

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Job Details

Full-time
$18.50 - $42.35 an hour

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

High school diploma or GED
Health insurance knowledge

Full Job Description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established plan processing guidelines. Functions as a subject matter expert by providing coaching, and offering guidance on escalated or technically challenging issues. Supports customer service operations by addressing inquiries and resolving issues to ensure a positive member experience.

Additional Responsibilities

Reviews pre‑specified claims and those that exceed specialist adjudication authority or processing expertise.
Applies medical necessity guidelines, determines coverage, verifies eligibility, identifies discrepancies, and implements cost‑containment measures to support accurate claim adjudication.
Ensures compliance with all regulatory requirements and confirms that payments align with company policies and procedures.
Identifies and reports potential overpayments, underpayments, and other claim irregularities.
Performs claim rework calculations as needed.
Trains and mentors as needed to enhance team performance and technical proficiency.
Conducts outbound calls to obtain required information for claims or reconsideration requests.

Required Qualifications

Minimum of 18 months of medical claim processing experience with a health insurance payor or third‑party administrator.
Proven success working in a high‑volume, production‑driven environment.
Demonstrated ability to manage multiple assignments with accuracy, efficiency, and attention to detail.

Preferred Qualifications

Self-Funding experience
DG system knowledge

Education

High School Diploma required
Preferred Associates degree or equivalent work experience.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $42.35

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Apply Now

Refine Your Search

regulatory specialist jobs in nevada

Senior Claim Benefit Specialist - Remote

Project Engineer

Mortgage Foreclosure Specialist

Escrow Officer Assistant (Mortgage Operations)

Speech Language Pathologist (Sign on Bonus) - Las Vegas, NV

Nevada Licensed Nurse Practitioner - Per Diem

IT Workday Platform Manager

Pediatric Audiologist (Au.D.)

Occupational Therapist - Carson City, NV

Phlebotomy Instructor/Director

Healthcare Credentialing & Provider Relations Specialist

Physician - Correctional Setting

Pediatric Pharmacy Clinical Operations Manager

Social Worker I

Nurse Practitioner

Physical Therapist PT OCS Resident

Respiratory Therapist / Nurse

Regulatory Compliance Exam Specialist

HEALTH/HUMAN SERVICES PROFESSIONAL TRAINEE - UNDERFILL

SOCIAL SERVICES PROGRAM SPECIALIST 2

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