Claims Examiner Jobs

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Claims Examiner - Workers Compensation

TAJ Technologies, Inc.

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Remote

Contract

Its a remote position. Mandatory: Work comp claims handling experience is needed; loss time. Minimum 6+years of relevant WC experience required. PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation
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Posted 5 days ago | Updated 5 days ago

Claims Examiner-Lost Time

Sunrise Systems, Inc.

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New Haven, Connecticut, USA

Contract

Job Title: Claims Examiner-Lost Time Location: 555 Long Wharf Drive, New Haven, CT06511-5941 Duration: 3 Months (Possible Extension or Conversion) Position Type: Hourly contract Position (W2 only) Note: Job Schedule- 5 days on-site Job hours-8:30am-5:00pm EST 3+ years of Workers Compensation Lost Time Claim Examiner or Commensurate Experience (Having experience in worker s compensation is not a requirement but a nice thing to have, as long as the skills they do have are transferable.) Duties
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Posted 48 days ago | Updated 14 hours ago

Claims Examiner - Workers Compensation(California)

MetaSense, Inc.

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Remote

Contract, Third Party

ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates an
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Posted 60+ days ago | Updated 21 days ago

Claims Processor - Onsite

VIVA USA INC

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Mason, Ohio, USA

Contract

Title: Claims Processor - Onsite Mandatory skills: claims processing, data entry, PCs, spreadsheet applications, claims system, Metastorm, Exclaim, website, software programs, Excel, Access, third party benefits, administration, customer service, manual claims, claims projects, claims adjudication, claims projects, processes standard claims, adjustments Description: GENERAL FUNCTION: Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through
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Posted 19 days ago | Updated 3 days ago

Sr. Claims Business Analyst - Local to MN and WI only

Smart Caliber Technology

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Minnesota, USA

Contract, Third Party

Position: Healthcare Business Analyst Duration 12 Months Location: Plymouth, MN or Madison WI (Hybrid- 3 days onsite) REQ: 8+ Years of exp We have client BA needs either claims platform, payer general ledger, or Enrollment & Eligibility Good Communication skill We need a claims BA that understands e2e Claims workflow and is comfortable mapping out operational future state process. They would be working with the claims operations and tech teams to map out how claims will work operationally so
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Posted 3 days ago | Updated 18 hours ago

Sr. Project Manager with Guidewire Claims Center and Billing Center - Remote

XFORIA Inc

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Remote

Contract

Sr. Project or Program Manager with Guidewire Claims Center and Billing Center Location - Warren, NJ 100 % Remote. Experience with Guidewire Claims Center and Billing Center is required. We are looking for a Guidewire Project / Program Manager to work for a leader in the commercial insurance industry. This strategic leadership role is responsible for the seamless implementation and integration of the Guidewire platform into downstream systems within a Commercial Property & Casualty (P&C) Insuran
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Posted 16 hours ago

Epic Resolute PB Claims Analyst

Talent Groups

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Remote

Full-time

Position: Epic Resolute PB Claims Analyst Location: Remote Job Type: Direct Hire Job Description:The Professional Billing Claims Analyst position will be housed under a subsidiary organization. To implement, maintain, support, and maximize the use of clinical, financial, and administrative portions of the software applications utilized by client in conducting daily operations under the direction of the Manager of Professional Billing and Claims.Responsibilities: Maintaining current clinical, f
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Posted 3 days ago

Epic Professional Billing Claims Analyst III

Community Care Cooperative (C3)

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Boston, Massachusetts, USA

Full-time

Title: Epic Professional Billing Claims Analyst Reports to: Manager of Professional Billing and Claims Classification: Individual Contributor Location: Boston (Hybrid) Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization fou
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Posted 3 days ago

EPIC Analyst(Billing & Claims and Remittance)

Zenox Global, LLC

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San Francisco, California, USA

Contract, Third Party

Job Title: Application Analyst - Epic Resolute Professional Billing & Claims and Remittance Role Description: We are seeking a skilled and experienced Application Analyst with expertise in Epic Resolute, and Claims and Remittance modules o join our dynamic team. This Epic Applications Analyst plays a critical role in the implementation and installation of Epic applications, module upgrades, new components, and modifications. This position is responsible for workflow configurations, go-live suppo
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Posted 18 days ago

Application Analyst - Epic Resolute Professional Billing & Claims and Remittance

AgreeYa Solutions

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San Francisco, California, USA

Contract, Third Party

Title: Application Analyst - Epic Resolute Professional Billing & Claims and Remittance Location: San Francisco/Sacramento CA or Alpharetta, GA Duration: 12 + Months Role Description: We are seeking a skilled and experienced Application Analyst with expertise in Epic Resolute, and Claims and Remittance modules o join our dynamic team. This Epic Applications Analyst plays a critical role in the implementation and installation of Epic applications, module upgrades, new components, and modificati
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Posted 19 days ago | Updated 12 hours ago

Application Analyst Epic Resolute Professional Billing, Claims & Remittance

Tranzeal, Inc.

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Remote or San Francisco, California, USA

Contract

Application Analyst Epic Resolute Professional Billing, Claims & Remittance Job Summary: We re seeking an experienced Application Analyst with deep expertise in Epic Resolute Professional Billing, Claims, and Remittance modules. This role will be key in implementing, optimizing, and supporting Epic billing applications, enhancing revenue cycle workflows, and ensuring system integrity and performance. Key Responsibilities: Lead configuration and implementation of Epic Resolute and Claims/Remittan
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Posted 19 days ago | Updated 10 hours ago

Senior Claims Specialist

Crox Consulting Inc

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Chicago, Illinois, USA

Full-time

Position Description: The Senior Claims Specialist is responsible for the coverage analysis, investigation, negotiation and resolution of complex and excess casualty claims. Qualifications 3-7 years of claims experience handling excess and complex casualty claims. Experience in general liability claims including bodily injury, property damage, New York Labor Law, public sector and/or construction matters preferred. Experience with evaluating complex risk transfer issues. Experience handling high
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Posted 60+ days ago | Updated 4 hours ago

Remote QA Manager with Healthcare Payer and Claims exp

Infinite Computer Solutions (ICS)

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Remote

Full-time

Note : GCEAD, L2EAD, consultant can apply for this position who can work on W2. Job Summary: We are looking for an experienced QA Healthcare Manager to lead the quality assurance team in ensuring the reliability, security, and compliance of healthcare applications. The ideal candidate should have a strong background in healthcare software testing, regulatory compliance (HIPAA, CMS, FDA), test automation, and team leadership. Key Responsibilities: we need someone who understand healthacre paye
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Posted 20 days ago | Updated 11 days ago

Senior Data Scientist (100% Remote): Pharma & Claims Data Expert (Contract-to-Hire)

Rower

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Remote

Contract

Rower is hiring a Full-Time Data Scientist with deep experience in the pharmaceutical space and a proven track record working with healthcare claims data. This is a contract-to-hire role, ideal for someone who can hit the ground running and wants to grow into a long-term strategic position on high-impact projects. What We re Looking For: 8+ years of hands-on experience in data science, analytics, or statistical modeling Deep pharma domain knowledge including commercial analytics, market access,
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Posted 6 days ago

Enterprise Data Architect with Claims Adjudication Process

ProCorp Systems Inc.

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Remote

Contract, Third Party

Enterprise Data Architect with Strong Healthcare (Claims Adjudication Process) Location: Remote Duration: 12 months Requisition Job Description The Lead Data Architect is responsible for designing, building, and maintaining efficient and scalable Application architecture within an organization. They collaborate with various stakeholders to understand technical requirements, create robust solutions, and ensure the integrity, security, and performance of the application infrastructure. This includ
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Posted 6 days ago | Updated 6 days ago

Claims Systems Delivery Manager (Remote in US)

Gainwell Technologies LLC

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Remote or Milwaukee, Wisconsin, USA

Full-time

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. Summary As a Claims Systems Delivery Manager (Remote in US) at Gainwell, you can contribute your skills as we harness the power of tec
Posted 10 days ago | Updated 7 hours ago

Enterprise Data Architect with Claims Adjudication Process - Remote

ProCorp Systems Inc.

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Remote

Contract, Third Party

Enterprise Data Architect with Claims Adjudication Process Location: Remote Duration: 12 months Healthcare Background Mandatory Requisition Job Description The Lead Data Architect is responsible for designing, building, and maintaining efficient and scalable Application architecture within an organization. They collaborate with various stakeholders to understand technical requirements, create robust solutions, and ensure the integrity, security, and performance of the application infrastructure.
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Posted 5 days ago

Excellent Job Opportunity || Claims Assist - Solution Architect || Charlotte, NC

Sysmind, LLC

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Illinois, USA

Third Party, Contract

Dear Job Seeker My name is Leo and I work as a Sr. US IT Recruiter with SYSMIND. We have been serving fortune 500 clients in the industry to bridge their staffing gap since the past 25 years. I have an Excellent opportunity with one of our clients. Description: Role Name: Claims Assist - Solution Architect Location: Charlotte, NC Duration: 6+ months with possible extension Required Qualifications: Bachelor's Degree in Computer Science, or related technical discipline with proven experience
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Posted 45 days ago | Updated 10 hours ago

Senior Project/Program Manager - Claims Platform Migration

ConsultNet, LLC

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Minneapolis, Minnesota, USA

Full-time

Senior Project/Program Manager - Claims Platform Migration (Fully Insured) Overview We're seeking an experienced Senior Project/Program Manager to lead a high-impact initiative focused on migrating a commercial claims platform. The ideal candidate will bring deep expertise in managing complex technology and business transformation efforts specific to fully insured commercial health plans (small and large group). This individual will play a critical role in building and executing repeatable proce
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Posted 4 days ago | Updated 11 hours ago

Business Systems Analyst (Provider, Hospitals, Revenue Cycle, Claims)

Saama Technologies, LLC

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Remote

Contract, Third Party

We are seeking a Sr. Business Systems Analyst (BSA) to support the Revenue Cycle and Claims domain for a hospital (Provider) ecosystem. The ideal candidate will play a pivotal role in analyzing data flows, understanding business processes, and delivering technology solutions that enhance operational efficiency across Registration, Scheduling, Billing, and Accounting. Key Responsibilities: Collaborate with stakeholders to gather, define, and document both current and future business and data need
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Posted 13 days ago