Claims Examiner Jobs

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Claims Examiner

DevCare Solutions

Irving, Texas, USA

Contract

Essential Job Functions Enters insurance claims received electronically or in written form. Answers incoming customer calls regarding claim processing. Documents claim and associated history. Evaluates available information to validate straightforward basic claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility. Sends claim form to claimant for updating, correction or completion. Identifies need for additional information; cont

Claims Examiner-Lost Time

Sunrise Systems, Inc.

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

Claims Examiner - Workers Compensation(California)

MetaSense, Inc.

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

Hiring for Legal Administrative Temp Claims Support :: Remote

Feuji Inc

Remote

Contract

Job Title: Legal Administrative Temp Claims Support Duration: 06 Months Contract * Location - Remote NC* JOB SUMMARY/OVERVIEW We are seeking a detail-oriented and organized Legal Administrative Temp to provide essential support to Client s Employment Practices Liability ( EPL ) Claims team. This role will assist with administrative tasks including pulling documents, processing check requests, setting up claim files, and handling other claims-related duties as assigned by the Manager, EPL Claims

Healthcare Business Analyst with Claims or Payor Experience - Local to MN and WI only

Smart Caliber Technology

Backus, Minnesota, USA

Contract, Third Party

Position: Healthcare Business Analyst Duration 12 Months Location: to Minnetonka ,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 Best Regards, Chetna -D -Fax Truth Lies in Heart

EPIC Analyst(Billing & Claims and Remittance)

Zenox Global, LLC

San Francisco, California, USA

Third Party, Contract

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

Application Analyst - Epic Resolute Professional Billing & Claims and Remittance

AgreeYa Solutions

San Francisco, California, USA

Third Party, Contract

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

Application Analyst Epic Resolute Professional Billing, Claims & Remittance

Tranzeal, Inc.

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

Senior Claims Specialist

Crox Consulting Inc

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

Remote QA Manager with Healthcare Payer and Claims exp

Infinite Computer Solutions (ICS)

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

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

Rower

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,

Enterprise Data Architect with Claims Adjudication Process

ProCorp Systems Inc.

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

Claims Systems Delivery Manager (Remote in US)

Gainwell Technologies LLC

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

Enterprise Data Architect with Claims Adjudication Process - Remote

ProCorp Systems Inc.

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.

Rx-Claims Test Analyst

RiseIT Solutions

Remote

Third Party, Contract

Company: iTech US, Inc. Job Title: Rx-Claims Test Analyst Location: Remote Job Responsibilities: Experience in Healthcare or a PBM desired..NET C# experience as SDETPrioritize, manage multiple assignments, and direct the work of others to meet deadlines.Excellent communication (Verbal and Written) and collaboration skills.Superior organization, project management, and prioritization skills.Courteous and professional demeaner with the desire and ability to work as a team.Ability to interact and

Legal Administrative Temp - Claims Support

Software Guidance & Assistance

Raleigh, North Carolina, USA

Contract

Software Guidance & Assistance, Inc., (SGA), is searching for a Legal Administrative Temp - Claims Support for a contract assignment with one of our premier Human Resources services clients in NC. This role will be remote. *MUST BE LOCAL TO NC/SC Responsibilities : We are seeking a detail-oriented and organized Legal Administrative Temp to provide essential support to the firm's Employment Practices Liability ( "EPL") Claims team. This role will assist with administrative tasks including pul

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

Sysmind, LLC

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

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

Saama Technologies, LLC

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

Sr Business Analyst Techno-Functional (P and C -PAS/Claims)

My IT LLC

Atlanta, Georgia, USA

Full-time

Job Title: Sr Business Analyst Techno-Functional (P&C - Client / Claims ) Location: Atlanta, GA Type: FTE Exp. Level: Senior / Lead Reports To: Product Owner / Delivery Manager Job Description Our client's customer success team in Atlanta, GA is seeking a Sr Business Analyst with a techno-functional profile, who has deep expertise in P&C insurance, especially in Policy Administration Systems (Client) and/or Claims management platforms. This individual will work closely with our clients to

Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLC

Remote or Houston, Texas, 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 We are seeking a talented individual for a Medical Claims Auditor I who is responsible for processing all casualty or estate fu