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 1 day ago | Updated 1 day 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 44 days ago | Updated 17 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 17 days ago

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

Smart Caliber Technology

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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
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Posted 22 days ago | Updated 16 hours ago

EPIC Analyst(Billing & Claims and Remittance)

Zenox Global, LLC

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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
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Posted 14 days ago

Application Analyst - Epic Resolute Professional Billing & Claims and Remittance

AgreeYa Solutions

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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
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Posted 15 days ago | Updated 10 days 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 15 days ago | Updated 7 days 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 2 days 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 16 days ago | Updated 7 days ago

Prior Authorization Rep/Claims Data Entry - Hybrid

VIVA USA INC

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Mason, Ohio, USA

Contract

Title: Prior Authorization Rep/Claims Data Entry - Hybrid Mandatory skills: UM Support, Utilization Management, Data entry, MS Office, Excel, Facets, Filebound, Jira, prior authorization, UM prior authorization requests, Healthcare Administration, Claims Processing, Health Insurance, administrative support, calls, outbound calls, critical thinking, multitask, compliance, problem solving Description: GENERAL FUNCTION: The UM Support Analyst/Admin administrative and data entry work supporting UM
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Posted 13 hours 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 2 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 2 days ago | Updated 2 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 6 days ago | Updated 7 hours ago

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.
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Posted 1 day 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 41 days ago | Updated 9 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 10 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 9 days ago

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

My IT LLC

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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 under
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Posted 2 days ago | Updated 6 hours ago

Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLC

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Remote or Dallas, 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
Posted 48 days ago | Updated 7 hours ago

Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLC

•

Remote or Austin, 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
Posted 48 days ago | Updated 7 hours ago