Financial Claims Examiner II Jobs in Boston, MA

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Epic Professional Billing Claims Analyst III

Community Care Cooperative (C3)

•

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 1 day ago

Enterprise Architect - P&C @ Boston, MA (hybrid); candidate should be either local or relocate from day-1

Vbeyond Corporation

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Boston, Massachusetts, USA

Full-time

Enterprise Architect - P&C Boston, MA (hybrid); candidate should be either local or relocate from day-1 Full Time Requirements: Education: Bachelor's degree in computer science, Engineering, or a related field. Advanced degrees (e.g., MBA, MSc) are a plus. Experience: 15+ years in technology and architecture roles, with at least 5 years in a senior leadership position. Proven experience in designing and implementing enterprise-scale systems and Insurance PAS or Claims systems Strong backgrou
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Posted 2 days ago | Updated 1 day ago

Guidewire UAT- Orange County CA but 100% remote

Tech Rakers

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Remote

Contract, Third Party

Job Title: Guidewire UAT Location: Orange County CA but 100% remote Duration: 18 months (Extensions) Top Skills' Details Bachelor s degree in Accounting/Finance preferred or relevant technical field. Progressive and relevant systems/applications, and/or accounting experience. At least 2 years of prior accounting systems testing experience. Prior insurance accounting or similar field is a plus. Prior experience with Guidewire or Tableau is a plus. Detail-oriented and appreciation for work accurac
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Posted 1 day 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 16 days ago | Updated 1 day ago

Senior Analyst, Network Relations

CVS Health

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Texas, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 26 days ago | Updated 1 hour ago

Technical Business Analyst (Claims/HRP)- W2

PamTen Inc

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Remote

Contract

Project Description: This position is responsible for understanding stakeholder needs and business issues to be addressed in the Enrollment Applications. Collaborate with the Product owner to assess configuration, EDI Eligibility transactions data mapping, Open Enrollment process, Exchange (Affordable Care Act) processes. Understand Eligibility and Premium billing functions. Assess requirements associated with new input and output Eligibility feeds, define UAT scope/testing needs and validate re
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Posted 16 days ago

VP, PBM

Vaco by Highspring

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Remote

Full-time

Hiring a VP of PBM for a startup healthcare client 100% remote in US only Duties/Responsibilities: Lead the development and launch of Companys in-house Pharmacy Benefit Manager (PBM), defining the vision, strategy, and roadmap to transition from external vendors to internal operations. Manage the strategic shift from outsourced PBM services, ensuring a seamless, cost-effective transition with minimal service disruption. Oversee core PBM functions: claims adjudication, pharmacy contracting,
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Posted 26 days ago

Epic Resolute PB Claims Analyst

Talent Groups

•

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 1 day ago

Data Analyst - Cloud (Remote)

S2Tech

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Remote

Full-time

Data Analyst - Cloud Location: Remote About Us: Known for Delighting the Client through performance, innovation, and an employee-centric culture, S2Tech is a fast-growing IT consulting company serving clients in over a quarter of the United States. We are widely recognized as a leading provider of both technical and business services in support of Health and Human Services-related projects. Feel free to learn more at s2tech.com. Why S2Tech?: Stable privately-owned company with a strong reputatio
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Posted 1 day ago | Updated 1 day ago

Senior Data Analyst

PARAKEET WORLD SOLUTIONS LLC

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Remote

Full-time

Job Title : Senior Data Analyst Location: Fort Worth, TX (100% Onsite)Type: Full-Time (W2 only)Duration: 5 Months This is a FTE req from an existing client, which is in software consulting company. They would hire the candidate on their payroll to work on the clients We are seeking an experienced Senior Data Analyst to join our client s Enterprise Data team. The ideal candidate will have 8+ years of hands-on experience, with a deep understanding of the P&C insurance domain, strong data modellin
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Posted 1 day ago | Updated 1 day ago

Finance Manager (Remote in US)

Gainwell Technologies LLC

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Remote or Columbus, Ohio, 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 dynamic Finance Manager to serve as a financial leader in building and implementing a high-performing financia
Posted 60+ days ago | Updated 9 hours ago

Data Analyst - Corporate Technology Data Engineering & Analytics

Mass Mutual Financial Group

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Remote or Boston, Massachusetts, USA

Full-time

The Opportunity Join our dynamic team as a Data Analyst - Corporate Technology Data Engineering & Analytics, where you'll play a pivotal role in driving the execution of our data strategy. This role is crucial in driving digital transformation and operational efficiency across financial systems that support Actuarial, FP&A, Reinsurance, Treasury, Accounting and Tax functions and requires a balance of technical expertise, business acumen, and leadership capabilities. You will work cross-function
Posted 52 days ago | Updated 1 hour ago

Data Science Engineer

Takeda pharmaceutical

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Lexington, Massachusetts, USA

Full-time

By clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application will be processed in line with Takeda's Privacy Notice and Terms of Use. I further attest that all information I submit in my employment application is true to the best of my knowledge. Job Description Pursuant to Section 20 C.F.R. 656.10, you are hereby notified that an application for Alien Employment Certification will be filed by
Posted 60+ days ago | Updated 1 hour ago

Senior Network Pricing Analyst - Hybrid in Las Vegas, NV

UnitedHealth Group

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Remote or Las Vegas, Nevada, USA

Full-time

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Why work for the leading organization in health care to help improve the lives of millions? You'll fin
Posted 7 days ago | Updated 1 hour ago

PBM Strategy and Implementation Consultant

TalTeam

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Remote

Contract

This role requires deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The successful candidate will be responsible for a new pharmacy supply chain implementation and PBM transition, including managing execution activities, aligning stakeholders, contract management, vendor relationship management, and driving business readiness. Project Leadership & Accountability Manage business execution team, ensuring alignment of team efforts with goals, o
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Posted 32 days ago | Updated 2 days ago

Data Analyst II Medical Economics

Centene Corporation

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Florida, USA

Full-time

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of v
Posted 15 days ago | Updated 1 hour ago

Data Analyst IV Medical Economics

Centene Corporation

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Missouri, USA

Full-time

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of v
Posted 13 days ago | Updated 1 hour ago

Lead Data Scientist - AI

CVS Health

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Remote or Wellesley, Massachusetts, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 60+ days ago | Updated 1 hour ago

Financial Health Care Executive for Pharmacy Benefits Program

Vega Consulting Solutions

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Remote or Baltimore, Maryland, USA

Contract

Vega Consulting is hiring! Financial Healthcare Executive for a Pharmacy Benefits Management Program implementation with our direct client. This is a contract to hire opportunity. Seeking candidates who are eligible for hire and able to travel to Maryland when required. The PBM Executive must have has the financial acumen and deep expertise in pharmacy supply chain financial management, PBM transitions, and pharmacy operations. The successful candidate will be responsible for a new pharmacy supp
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Posted 60+ days ago | Updated 19 days ago

Provider Service Analyst, Medicaid, Remote, USA

Gainwell Technologies LLC

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Remote or Denver, Colorado, 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 Provider Services Analyst - Medicaid who provides on-site and remote account analysis
Posted 3 days ago | Updated 9 hours ago