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 7 days ago | Updated 7 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 50 days ago | Updated 9 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 23 days ago

Epic Resolute Professional Billing & Claims and Remittance Analyst

Tranzeal, Inc.

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Remote or Oakland, California, USA

Contract

Role- Epic Resolute Professional Billing & Claims and Remittance Analyst Location- Oakland, CA (Remote) Required certifications: Epic Resolute Role Description: We are seeking a skilled and experienced Application Analyst with expertise in Epic Resolute, and Claims and Remittance modules to 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 res
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Posted 1 day ago

Legal Administrative Assistant (Claims Support) - Onsite

VIVA USA INC

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Raleigh, North Carolina, USA

Contract

Title: Legal Administrative Assistant (Claims Support) - Onsite Mandatory skills: administrative support, Employment Practices Liability, EPL, administrative tasks, pulling documents, processing check requests, setting up claim files, claims related documents, claims related duties, Create claim files, maintain claim files, Retrieve legal documents, organize legal documents, Prepare check requests, process check requests Description: Job summary / overview: We are seeking a detail-oriented and
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Posted 21 days ago | Updated 1 day ago

Sr. Claims Business Analyst - 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: 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 5 days ago | Updated 9 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 2 days ago

Senior Lead Data Architect With FHIR & HL7 with claims exp

ProCorp Systems Inc.

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Remote

Third Party, Contract

Position: Data Architect With FHIR HL7 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 includes having the strong ability to look aro
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Posted 1 day 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 5 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 5 days ago

HIT - PB Claims w/ SBO

Randstad Digital

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Dallas, Texas, USA

Contract

job summary: We are looking for a candidate local to Dallas for one of our top highly decorated healthcare clients. We need an experienced Senior Epic Business Analyst who will assist the Revenue Cycle department with projects. This individual must be poficient in change router, claims, resolute, PB/HB and any knowledge of the MOVEit file transer application is a plus. location: Dallas, Texas job type: Contract salary: $60 - 80 per hour work hours: 8am to 5pm education: Bachelors responsib
Posted 19 days ago | Updated 1 hour 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 20 days ago | Updated 2 days ago

PBM / RX Claims Test Analyst - Remote - Contract

Ztek Consulting

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Remote

Contract

Title: PBM / RX Claims Test Analyst Location: Remote Duration: Contract Top 3 skills required for this role? 1.PBM 2.Rxclaims 3.Manual Testing Job Description/ Responsibilities/ Years of experience- 4-5 years experience in Healthcare or a PBM desired. .NET C# experience as SDET Prioritize, 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 prioritiz
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Posted 7 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 20 days ago | Updated 2 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 1 day 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 22 days ago | Updated 12 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 8 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 8 days ago | Updated 17 hours ago

Senior Claims Risk Manager

Kforce Technology Staffing

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Bellevue, Washington, USA

Contract

RESPONSIBILITIES: Kforce has an enterprise client in Bellevue, WA that is seeking a Senior Claims Risk Manager who will own the WW execution for growth of the company. This role requires comfort in ambiguous situations and maintaining a high bar in a dynamic, fast-moving environment. Strong business judgment, ability to influence cross-functional and remotely located teams, a customer-centric and creative mindset and strong analytical skills are also essential. Responsibilities: * The Senior Cl
Posted 1 day ago | Updated 2 hours 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 11 days ago | Updated 9 hours ago