Claims Examiner Jobs

21 - 40 of 40 Jobs

Enterprise Data Architect with Claims Adjudication Process - RemoteJob Title - Enterprise Data Architect with Claims Adjudication Process - Remote

ProCorp Systems Inc.Company Name - 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.

Claims Correspondence AssociateJob Title - Claims Correspondence Associate

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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Roseville, California, 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 Correspondence Specialist is responsible for but is not limited to, researching, and analyzing incoming Member Complaints,

Legal Administrative Temp - Claims SupportJob Title - Legal Administrative Temp - Claims Support

Software Guidance & AssistanceCompany Name - Software Guidance & Assistance

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

Sysmind, LLCCompany Name - 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

Senior Project/Program Manager - Claims Platform MigrationJob Title - Senior Project/Program Manager - Claims Platform Migration

ConsultNet, LLCCompany Name - 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

Business Systems Analyst (Provider, Hospitals, Revenue Cycle, Claims)Job Title - Business Systems Analyst (Provider, Hospitals, Revenue Cycle, Claims)

Saama Technologies, LLCCompany Name - 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

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

My IT LLCCompany Name - 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

Health Claims Adjudicator (Licensed New York)Job Title - Health Claims Adjudicator (Licensed New York)

Sureminds SolutionsCompany Name - Sureminds Solutions

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Remote

Full-time

Inviting applications for the role of Management Trainee, Health Claims Adjudicator New York Licensed In this role, you will review, evaluate, and process medical claims submitted by healthcare providers or policyholders to ensure accuracy and compliance with insurance policies and for New York policies, adherence to State regulations. Responsibilities Claim & Appeals processing according to standard work & SOP Validation of information entered by indexer Verify coverage; evaluate eligibility

Medical Claims Auditor I (Remote, USA)Job Title - Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLCCompany Name - 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

Medical Claims Auditor I (Remote, USA)Job Title - Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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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

Medical Claims Auditor I (Remote, USA)Job Title - Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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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

Epic Resolute Professional Billing & Claims and RemittanceJob Title - Epic Resolute Professional Billing & Claims and Remittance

Tranzeal, Inc.Company Name - Tranzeal, Inc.

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Remote

Contract

Title- Senior Systems Analyst Location- Oakland, CA Job Information Job Description: 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 m

Senior Epic Analyst - Hospital Billing Claims & Remittance/Professional BillingJob Title - Senior Epic Analyst - Hospital Billing Claims & Remittance/Professional Billing

Golden Resources. Inc.Company Name - Golden Resources. Inc.

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Ohio, USA

Full-time

Our client is looking for a Senior Epic Analyst to join their Team! The Senior Epic Analyst will be responsible for Service Now requests and hospital billing claims & remittance. This position designs configures, tests, and implements changes of assigned Epic system applications. In addition, this role will lead operational work groups and teams to gather and analyze requirements for new requests. The Senior Epic Analyst consults with Epic representatives, leadership, and subject matter experts

Pharmacy Sr Business Analyst - Claims & Configuration SMEJob Title - Pharmacy Sr Business Analyst - Claims & Configuration SME

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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Kansas City, Missouri, 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 Pharmacy Sr Business Analyst - Claims & Configuration SME at Gainwell, you can contribute your skills as we harness the po

Epic Dorothy Home Care Billing & Claims Application Analyst I, II, III-(Open to experienced remote in ID, NE, MO, OK, TX)Job Title - Epic Dorothy Home Care Billing & Claims Application Analyst I, II, III-(Open to experienced remote in ID, NE, MO, OK, TX)

PIH HealthCompany Name - PIH Health

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Remote or Whittier, California, USA

Full-time

Determination for the Epic Application Analyst (I, II or ), Dorothy Home Care Billing & Claims roles will be based on experience and qualifications. PIH Health internal applicants or Altera employees (working at PIH Health as of May 2025), Epic certification in the required application/module must be obtained within 120 days of hire or transfer into the position. Failure to obtain certification within this timeframe may result in removal from the position; however, the employee will be eligible

Director, Information Technology (Claims, Membership, Benefits, Provider and Contact Center) (Director IV)Job Title - Director, Information Technology (Claims, Membership, Benefits, Provider and Contact Center) (Director IV)

CalOptimaCompany Name - CalOptima

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Orange, California, USA

Full-time

Director, Information Technology (Claims, Membership, Benefits, Provider and Contact Center) (Director IV) CalOptima CalOptima Health is seeking a highly motivated Director, Information Technology (Claims, Membership, Benefits, Provider and Contact Center) (Director IV) to join our team. The Director will be accountable for the Information Technology (IT) strategy and execution for Claims, Membership, Benefits, Provider and Contact Center applications. This position will work closely with busine

Epic HB/HB Claims Analyst - CertifiedJob Title - Epic HB/HB Claims Analyst - Certified

InterSources Inc.Company Name - InterSources Inc.

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San Mateo, California, USA

Full-time, Contract

Title: Epic HB/HB Claims Analyst - Certified Location: San Mateo, California What We're Looking For: Epic Certification: Required: Active Epic Hospital Billing (HB) Certification Required: Active Epic Hospital Billing Claims (HB Claims) Certification Epic Experience (2+ years): Proven experience in Epic design, build, and implementation within a healthcare setting. Strong preference for Epic Patient Billing experience. Proficiency with Epic "assisted application " modules. Education: Bachelor's

SQL Claims AnalystJob Title - SQL Claims Analyst

Apex SystemsCompany Name - Apex Systems

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Montgomery, Alabama, USA

Full-time

Job#: 2069329 Job Description: Position: SQL Claims Analyst - Medicaid Location: ONSITE - 501 Dexter Ave, Montgomery, AL 36104 Duration: 12-month Contract-to-Hire Pay Rate: $50 - $60/hr. Overview: AL EDS is the new Alabama Medicaid Data warehouse, This position will support the Agency in the rollout and usage Responsibilities: Support the Agency with their Analytic StaffProvide on-site help desk supportCreate Power BI reports at the request of the AgencyProvide data analysis at the request

Claims Processing Specialist - Oklahoma City, OK (Hybrid)Job Title - Claims Processing Specialist - Oklahoma City, OK (Hybrid)

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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Oklahoma City, Oklahoma, 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 Processing Specialist - Oklahoma City, OK (Hybrid) at Gainwell, you can contribute your skills as we harness the po

Engineering Manager (Claims Platform)Job Title - Engineering Manager (Claims Platform)

HeadwayCompany Name - Headway

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Remote or New York, New York, USA

Full-time

Headway's mission is a big one - to build a new mental health care system everyone can access. We've built technology that helps people find great therapists with the first software-enabled national network of providers accepting insurance. 1 in 4 people in the US have a treatable mental health condition, but the majority of providers don't accept insurance, making therapy too expensive for most people. Headway is building a new mental healthcare system that everyone can access by making it easy