(Claims OR Coverage) jobs

Remote

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2d ago

Job Title: Transactional Liability Claims Counsel Location: Remote The Transactional Liability Claims Professional is responsible for managing a portfolio of complex Transactional Liability claims, including Representations & Warranties (R&W) Insurance and Tax Liability. The role requires strong legal and analytical skills to evaluate coverage, investigate alleged breaches of transaction-related representations and warranties, assess exposure, establish reserves, and negotiate claim resolutions.

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Full-time

Depends on Experience

Medicaid Claims QA Analyst(Healthcare)

Remote

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24d ago

Job Description: Job Title: Senior QA Tester Location: Remote Type: Full Time/W2 with Infinite Computer Solutions Job Description: Role summary: Responsible for claims testing for MMIS health care projects. Drive the test strategy and process, domain knowledge, perform analysis of business requirements, designs and develops test plans, ensures quality process, coordinates with customers on delivery and deployments. Works in team environment and provides testing guidance throughout the entire lif

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Full-time

$85,000 - $95,000

California Workers Compensation Claims Examiner

Remote

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8d ago

Position: California Workers Compensation Claims Examiner Duration: 03 Months of contract with Possible extension or conversion Location: Remote Pay Range: $50/hr to $55/hr on W2 without benefits Required Skills: SIP is mandatory.3+ years of relevant and recent California Workers Compensation experience.Ed code experience preferred but not required.Indemnity claims experience. PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; t

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Contract

50 - 55

FACETS Architect (with Healthcare Claims)

Remote

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Today

Remote Job Contract to Hire Important Notes from HM: Proficiency in innovating ideas and solutions resulting in tangible and measurable business outcomes. Mastery in creating architecture solutions within the enterprise architecture future state for technological acceleration of value outcomes, and effectively present and persuade key decision makers to invest in this acceleration. Must have recent solution/domain architecture experience with Facets G6 real-time and batch claims processing,

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Contract

$80 - $90

Data Systems Analyst (Medical Claims or Pharmacy claims)

Remote

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Yesterday

Medical Claims or Pharmacy claims or membership information. SQL Server and SQL writing Some recent experience with Data modeling & Data Warehousing (Any platform is ok, does not have to be snowflake) EDI transaction experience API integration into Data Warehouse with EDI 834 and 837. This is not a BA role

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Contract

$50+

Senior Auto Claims Adjuster

Phoenix, Arizona

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Today

Job Title: Senior Auto Claims Adjuster Location: Phoenix, AZ Duration: 6 Months Pay Rate: $37/HR (W2 Only) Job/Role Description: Manage complex Auto Claims from initial investigation through resolution, maintaining independent ownership of an assigned claims inventory.Investigate and evaluate Auto Claims involving coverage disputes, disputed liability, comparative negligence, physical damage, total loss, and multi-vehicle accidents.Independently investigate and determine auto liability by revie

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Full-time, Contract

USD37 - USD37

Healthcare Claims Processor (Fully Insured)

Remote

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2d ago

Healthcare Claims Processor (Fully Insured)Introduction:Elite Technical Services is partnering with a major healthcare insurance provider to identify motivated, detail-oriented Medical Claims Processors to join their Fully Insured operational team. This specialized track is responsible for establishing the baseline adjudication and processing engine for core commercial health insurance plans. This is a fast-paced, high-volume production environment well-suited for professional processors who pos

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Contract

Epic Systems Professional Billing/Claims Analyst

Remote

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Today

Role: Epic Systems Professional Billing/Claims Analyst Location: Remote Duration: 12+ Months Mandatory areas: 7+ years of experience in Implementation experience. Must Have: EPICClaims ManagementProfessional BillingDomain: Healthcare must have.Must have Certifications: Epic Professional BillingEpic Certification and current CEE.Experience with Epic Reporting Workbench ReportsCommunication experience for strategic and tactical deploymentsExperience with Epic-integrated projects Responsibilities

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Third Party, Contract

Depends on Experience

Claims Support Rep III

Hybrid in Sun Prairie, Wisconsin

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2d ago

Job Title - Claims Support Rep Location Sun Prairie, WI Duration 12+ Months Processes orders, prepares correspondence, and fulfills customer needs to ensure customer satisfaction. Requires a high school diploma or equivalent and 0-3 years of experience in the field or in a related area. Has knowledge of commonly used concepts, practices, and procedures within a particular field. Relies on instructions and pre-established guidelines to perform the functions of the job. Works under immediate sup

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Contract

$20+

Insurance Claims Change Manager

Chicago, Illinois

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5d ago

ABSOLUTELY NO H1S OR 3RD PARTIES. THIS ROLE WILL BE HYBRID ONSITE IN CHICAGO. Claims Change Manager Change Orchestration, Process Analysis and Transformation Leading global specialty insurance company actively seeking a Claims Change Manager with extensive claims transformation, change orchestration and process analysis experience to join on a contracting basis. The selected individual will be responsible for driving the end-to-end delivery and adoption of internal Claims transformation initiat

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Contract

85 - 95

Senior QA Tester with Healthcare Medicaid Medicare Claims domain

Remote

•

Today

Hi Greetings from Infinite Computer Solutions ! Hope you are well today! I'd like to discuss a job opportunity with you. Hope you would be interested. Position: Senior QA Tester with Healthcare Medicaid Medicare Claims domain Location:Dallas, TX, St Louis, Mo, Las Vegas, NV, Hybrid/Remote Term : Fulltime About Infinite: InfiniteisagloballeaderindigitalengineeringandITservices,withover20yearsofexperiencedrivingdigitaltransformation.WepartnerwithleadingFortune1000companiestodeliverinnovative,sca

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Full-time

70,000+

ETL Test Engineer-Healthcare (Medicaid Claims Processing)

Hybrid in East Hartford, Connecticut

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Today

Position : ETL Test Engineer-Healthcare (Medicaid Claims Processing) Location:Hartford, CT (Hybrid) Duration: 12+ Months Contract Job Description:We are seeking an experienced ETL Test Engineer with a strong background in Healthcare Payer systems, specifically supporting the Medicaid line of business and Claims Processing. The ideal candidate will possess deep expertise in ETL and Data Warehouse testing, data validation, and healthcare data flows, with the ability to ensure high-quality data int

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Third Party, Contract

Depends on Experience

Business Analyst/ Claims SME

Minneapolis, Minnesota

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Today

Key Responsibilities Business Analysis & Solution Design Elicit, analyze, and document complex business, operational, and system requirementsTranslate business problems into functional requirements, workflows, process models, and user storiesFacilitate requirements workshops with business and technology stakeholdersSupport end-to-end solution design and implementation activitiesValidate that delivered solutions meet business objectives and acceptance criteriaPayment Integrity & Healthcare Domain

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Contract

43 - 50

Claims Examiner

New Haven, Connecticut

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9d ago

Experience working in a customer focused, fast-paced, fluid environment - Experience utilizing strong communication and telephonic skills - Prior experience requiring a high level of organization, follow-up, and accountability - Prior workers compensation claim handling experience is a plus but not required - Familiarity with claim handling (healthcare, short-term / long-term disability, auto personal injury protection / medical injury, medical billing, or general liability) is a plus but not re

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Contract

Depends on Experience

Senior Business Analyst – Claims Module

Remote

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7d ago

Role : Senior Business Analyst Claims Module Location : Remote with travel Type : Contract to Hire Senior Business Analyst Claims module: Play the role of Claims Domain lead for MMIS health care projects. Drive the claims module and process, domain knowledge, performs analysis of business requirements, designs and develops documentation, ensures quality process, coordinates with customers. Works in team environment and provides guidance throughout the entire life cycle. Responsible to

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Contract

Depends on Experience

Senior SAS Business Analyst with Medicaid/Claims experience (Remote)

Remote

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9d ago

Job Title: Senior SAS Business Analyst with Medicaid/Claims experience Duration: 6 months 100% remote Citizenship requirement: live in the Continental US. DESCRIPTION and RESPONSIBILITIES SAS is seeking a full-time SAS Senior Business Analyst with strong Health Care domain experience to work with our Medicaid customers. The individual in this role will develop the Requirements Traceability Matrix, create technical documentation and assist with testing facilitation (QA and UAT) for healthca

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Contract, Third Party

$55 - $60

IT Senior Automation Test Lead (Required Exp Healthcare Claims Processing Testing)

Hybrid in Raleigh, North Carolina

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Yesterday

Our Client is seeking a Senior Automation Testing Lead to lead the effort in building Automation Testing to support the Managed Care Transition Project. This position is responsible for the following activities related to a critical system being developed in-house at the State: *Experience assessing the testability of requirements and developing test cases based on Business Requirements and Software Design Documents. * Experience in the execution of functional, integration and regression tests.

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Contract, Third Party

Depends on Experience

Lead : Python Backend Developer (Healthcare / Claims)

Remote

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2d ago

Lead Python Backend Developer AWS & AI (Healthcare / Claims) Position: Lead Python Backend Developer AWS & AI Experience: 12+ Years Employment Type: Full-Time Domain: Healthcare / Health Insurance / Claims Mandatory About the Opportunity We are looking for a strong hands-on Python Backend Development Lead with extensive experience in AWS Cloud, Microservices, Distributed Systems, and AI-Assisted Development. The ideal candidate must have deep expertise in Python backend engineering, experie

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Full-time

Depends on Experience

Lead : Python Backend Developer (Healthcare / Claims)

Remote

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Today

Easy Apply

Full-time

Depends on Experience

Product Owner, Claims Editing (RTM)

Remote

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7d ago

100% remote in US$120,000-135,000 + 10% yearly bonus REQUIRED: 4 or more years of experience in healthcare claims editing, payment integrity, medical coding, reimbursement, medical policy, or claims analytics. About the RoleThe Product Owner, Claims Editing identifies, designs, and supports the implementation of automated claim edits that drive incremental value, improve payment accuracy, and generate revenue across claims-editing programs. The role initially focuses on Routine Test Management (

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Full-time

Depends on Experience