claims manager Jobs

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Contract & Claims Manager

FlatironDragados

•

Norfolk, Virginia, USA

Full-time

Overview : Are you a detail-oriented leader with a knack for navigating complex contractual landscapes? As a Contracts and Claims Manager , you will oversee our project controls program and activities regarding contract and change management for a d ivision . Your expertise in interpreting contract language will ensure our project teams operate smoothly and efficiently within the parameters of contract specifications. The Hampton Roads Connector Partners JV (HRCP) consisting of Flatiron, Dragado
Posted 60+ days ago | Updated 12 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 days ago | Updated 9 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 5 days ago | Updated 1 day ago

Engineering Manager (Claims Platform)

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
Posted 60+ days ago | Updated 9 hours ago

Software Engineering Manager - Claims Platform (Hybrid Work Model)

Sentry Insurance

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Stevens Point, Wisconsin, USA

Full-time

At Sentry, we're more than just insurance-and we can offer you more than just a job. We want you to enjoy a career with us, where you're in the driver's seat of your career path with access to resources to help you succeed personally and professionally. As a Software Engineering Manager, you will lead and inspire a multidisciplinary team of software engineers, product analysts and quality analysts to build and enhance our claims platform. You will combine strong technical expertise with a strat
Posted 2 days ago | Updated 11 hours ago

Program Manager / Sr. Claims Risk Manager

Horizontal Talent

•

US

Contract

Join our dynamic team as a Project/Program Manager , where you'll lead and direct projects with creativity and expertise. Utilize your extensive experience to drive success and innovation in a fast-paced environment. Responsibilities Coordinate and oversee the completion of projects and programs, ensuring all aspects align with goals. Set deadlines, assign tasks, and monitor progress to ensure timely delivery. Prepare detailed reports for management on project status and outcomes. Lead and direc
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Posted 6 days ago | Updated 5 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 5 days 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 6 days 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 9 days ago | Updated 2 days ago

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 11 days ago | Updated 11 days ago

Senior Lead Data Architect With FHIR & HL7 with claims exp

ProCorp Systems Inc.

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Remote

Contract, Third Party

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 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 9 days ago

HIT - PB Claims w/ SBO

Randstad Digital

•

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 23 days ago | Updated moments ago

Application Analyst - Epic Resolute Professional Billing & Claims and Remittance

AgreeYa Solutions

•

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 25 days ago | Updated 6 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 4 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 25 days ago | Updated 6 days ago

Enterprise Data Architect with Strong Healthcare (Claims Adjudication Process, FHIR, HL7) - Remote

ProCorp Systems Inc.

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Remote

Third Party, Contract

Data Architect with Strong Healthcare (Claims Adjudication Process, 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 includ
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Posted 3 days ago

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
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Posted 26 days ago | Updated 17 days ago

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
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Posted 60+ days ago | Updated 1 hour ago

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
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Posted 60+ days ago | Updated 27 days ago