claims Jobs

1 - 20 of 1,002 Jobs

Epic Professional Billing Claims Analyst IIIJob Title - Epic Professional Billing Claims Analyst III

Community Care Cooperative (C3)Company Name - 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

EPIC Analyst(Billing & Claims and Remittance)Job Title - EPIC Analyst(Billing & Claims and Remittance)

Zenox Global, LLCCompany Name - Zenox Global, LLC

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San Francisco, California, USA

Contract, Third Party

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

Claims Examiner - Workers CompensationJob Title - Claims Examiner - Workers Compensation

TAJ Technologies, Inc.Company Name - 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

Claims Processor - OnsiteJob Title - Claims Processor - Onsite

VIVA USA INCCompany Name - VIVA USA INC

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Mason, Ohio, USA

Contract

Title: Claims Processor - Onsite Mandatory skills: claims processing, data entry, PCs, spreadsheet applications, claims system, Metastorm, Exclaim, website, software programs, Excel, Access, third party benefits, administration, customer service, manual claims, claims projects, claims adjudication, claims projects, processes standard claims, adjustments Description: GENERAL FUNCTION: Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through

Epic Resolute PB Claims AnalystJob Title - Epic Resolute PB Claims Analyst

Talent GroupsCompany Name - 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

Sr. Project Manager with Guidewire Claims Center and Billing Center - RemoteJob Title - Sr. Project Manager with Guidewire Claims Center and Billing Center - Remote

XFORIA IncCompany Name - 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

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

AgreeYa SolutionsCompany Name - 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

Application Analyst Epic Resolute Professional Billing, Claims & RemittanceJob Title - Application Analyst Epic Resolute Professional Billing, Claims & Remittance

Tranzeal, Inc.Company Name - 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

Senior Claims SpecialistJob Title - Senior Claims Specialist

Crox Consulting IncCompany Name - 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

Sr. Claims Business Analyst - Local to MN and WI onlyJob Title - Sr. Claims Business Analyst - Local to MN and WI only

Smart Caliber TechnologyCompany Name - Smart Caliber Technology

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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

Enterprise Data Architect with Claims Adjudication ProcessJob Title - Enterprise Data Architect with Claims Adjudication Process

ProCorp Systems Inc.Company Name - 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

Senior Data Scientist (100% Remote): Pharma & Claims Data Expert (Contract-to-Hire)Job Title - Senior Data Scientist (100% Remote): Pharma & Claims Data Expert (Contract-to-Hire)

RowerCompany Name - 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,

Claims Examiner - Workers Compensation(California)Job Title - Claims Examiner - Workers Compensation(California)

MetaSense, Inc.Company Name - 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

Remote QA Manager with Healthcare Payer and Claims expJob Title - Remote QA Manager with Healthcare Payer and Claims exp

Infinite Computer Solutions (ICS)Company Name - 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

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

Program Manager / Sr. Claims Risk ManagerJob Title - Program Manager / Sr. Claims Risk Manager

Horizontal TalentCompany Name - Horizontal Talent

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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

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

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

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

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.