(claims or claims) jobs

Phoenix, Arizona

•

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

Easy Apply

Full-time, Contract

USD37 - USD37

Claims Support Rep III

Hybrid in Sun Prairie, Wisconsin

•

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

Easy Apply

Contract

$20+

Data Systems Analyst (Medical Claims or Pharmacy claims)

Remote

•

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

Easy Apply

Contract

$50+

Test Lead Healthcare Payer

Seattle, Washington

•

Yesterday

Test Lead Healthcare Payer Location: Seattle, WA Work Arrangement: Onsite 4 days per week Experience: 10+ years in Quality Engineering and Testing Key Responsibilities Lead end-to-end testing across multiple applications, interfaces, and healthcare business domains.Define test strategy, scope, coverage, estimates, schedules, and release readiness criteria.Manage SIT, E2E(end to end), regression, and UAT testing activities.Oversee test execution, defect triage, root cause analysis, risk mitigatio

Easy Apply

Contract, Third Party

Depends on Experience

Transactional Liability Claims Counsel

Remote

•

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.

Easy Apply

Full-time

Depends on Experience

FACETS Consultant

Durham, North Carolina

•

Today

Position: FACETS Consultant Location: Durham, NC Hybrid / Any Infosys office in USA Duration: 12 Months Job Details: Must Have Skills SQL Facets FACETS configuration, data analysis, troubleshooting, and database querying to support business and operational requirements. Nice to have skills FACETS Developer with hands-on experience in Claims Processing, Enrollment, and SQL Skilled in healthcare payer systems, FACETS configuration, data analysis, troubleshooting, and database querying to suppor

Easy Apply

Contract, Third Party

$60+

FACETS Developer

Durham, North Carolina

•

Yesterday

Job Title: FACETS Developer Location: Durham, NC 27707 Onsite Duration:12+Months Must Have Skills SQL Facets FACETS configuration, data analysis, troubleshooting, and database querying to support business and operational requirements. Detailed Job Description FACETS Developer with hands-on experience in Claims Processing, Enrolment, and SQL. Skilled in healthcare payer systems, FACETS configuration, data analysis, troubleshooting, and database querying to support business and operational require

Easy Apply

Contract

Depends on Experience

Healthcare Data Analyst

Hybrid in Edina, Minnesota

•

Yesterday

Title: Healthcare Data Analyst Location: Edina, MN (Hybrid, 3 days/week) Duration: Long Term Contract Job Description: Must have 3 years of experience with each of the following: 1) Working with large-scale healthcare data systems, including CMS Qualified Entity (QE) claims data, ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT/HCPCS diagnosis and procedure codes, healthcare claims data, insurance adjudication processes, and clinical data management. 2) Developing and maintaining healthcare data warehouses

Easy Apply

Contract

Depends on Experience

Automation Test Lead - Testing EDI (HIPAA X12) Applications

Raleigh, North Carolina

•

Yesterday

Experience in the execution of functional, integration and regression tests.Demonstrated Experience in Testing EDI Applications.Hands on experience to develop and execute test scripts for HIPAA X12 EDI Transactions such as 837I, 837P and NCPDP D.0Experience developing SQL queries.Experience in scripting automated Test Suites.Experience in the review, analysis and reporting of test results.Experience with Test and Defect Management Tools. HP ALM, JIRA preferred.Experience on testing web applicati

Easy Apply

Contract

Depends on Experience

Insurance Product Manager with Insurance Domain must

Union Beach, New Jersey

•

Yesterday

Job Title : Senior Product Owner Insurance TechnologyLocation: Union Beach, NJ (Onsite)Full Time Position OverviewDrive the vision and delivery of digital products that improve the experience and effectiveness of employees, clients, and business partners within the insurance environment.This role combines strategic product management with hands-on product ownership, translating complex insurance workflows and business needs into actionable requirements for cross-functional technology teams.The s

Easy Apply

Full-time

$120,000 - $160,000

Healthcare Data Analyst ICD

Edina, Minnesota

•

Today

Healthcare Data Analyst Edina, MN(Hybrid, 3 days/week) Must have 3 years of experience with each of the following: 1) Working with large-scale healthcare data systems, including CMS Qualified Entity (QE) claims data, ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT/HCPCS diagnosis and procedure codes, healthcare claims data, insurance adjudication processes, and clinical data management. 2) Developing and maintaining healthcare data warehouses and master datasets using the following: SQL Server, relatio

Easy Apply

Third Party, Contract

Insurance Claims Change Manager

Chicago, Illinois

•

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

Easy Apply

Contract

85 - 95

Senior EDI Developer (Healthcare Payer - Facets Ecosystem)

Seattle, Washington

•

Today

Role: Senior EDI Developer: Healthcare Payer (Facets Ecosystem) Location: Seattle, WA (Onsite from Day 1) Job Type: Contract Experience: 8+ years in IT, 5+ years in healthcare payer and EDI, 3+ years with Edifecs or TriZetto HIPAA Gateway Need candidates with Facets - Claims experience Role Overview: We are looking for a Senior EDI Developer with strong healthcare payer experience to design, develop, and optimize HIPAA X12 integrations within a Facets-based ecosystem. The role requires hands

Easy Apply

Contract, Third Party

Business Analyst

Quincy, Massachusetts

•

Today

Position: Business Analyst Primary work location: Quincy, MA Duration: 10+ month Position Summary We are seeking an experienced Business Analyst to support a healthcare technology team responsible for claims processing, provider reimbursement, and member-focused initiatives within a large-scale Medicaid Management Information System (MMIS) environment. This individual will participate in all phases of the system development lifecycle, including requirements gathering, analysis, testing, imple

Easy Apply

Full-time, Contract

$DOE

FACETS Architect (with Healthcare Claims)

Remote

•

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,

Easy Apply

Contract

$80 - $90

Lead : Python Backend Developer (Healthcare / Claims)

Remote

•

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

Easy Apply

Full-time

Depends on Experience

Healthcare Claims Processor (Fully Insured)

Remote

•

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

Easy Apply

Contract

California Workers Compensation Claims Examiner

Remote

•

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

Easy Apply

Contract

50 - 55

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

Easy Apply

Full-time

70,000+

Test Program Manager / QE Transformation Lead with Healthcare Payer (Facets) exp

Seattle, Washington

•

Today

Role: Test Program Manager / QE Transformation Lead Location: Seattle, WA (4 days a week on-site is required) Job Type: Contract Required Experience: 12+ years of experience in Quality Engineering and Testing. 5+ years of experience leading large testing programs. Proven experience in discovery, due diligence, transition, and managed services engagements. Experience building or managing a Testing Center of Excellence (TCoE). Strong experience in workforce planning, hiring, and vendor management

Easy Apply

Contract, Third Party