claims Jobs

1 - 20 of 719 Jobs

Supervisor Claims (Operational Support-Analytics)Job Title - Supervisor Claims (Operational Support-Analytics)

CalOptimaCompany Name - CalOptima

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Orange, California, USA

Full-time

Supervisor Claims (Operational Support-Analytics) CalOptima CalOptima Health is seeking a highly motivated an experienced Supervisor Claims to join our team. The Supervisor Claims (Operational Support-Analytics) will manage the day-to-day operations of the operational support staff, including the Analytics team. The incumbent will be responsible for managing projects for Claims Administration, User Acceptance Testing (UAT) and exception reporting. The incumbent will follow regulatory and interna

Claims Resolution Specialist (Customer Service)Job Title - Claims Resolution Specialist (Customer Service)

CalOptimaCompany Name - CalOptima

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Orange, California, USA

Full-time

Claims Resolution Specialist (Customer Service) CalOptima CalOptima Health is seeking a highly motivated an experienced Claims Resolution Specialist (Customer Service) to join our team. The Claims Resolution Specialist will be the first line of contact for CalOptima Health providers. The incumbent will assist providers with questions related to the payment of claims and resolution of claims payment issues. Position Information: Department: Claims Administration Salary Grade: 304 - $53,813 - $80,

Claims Certification Trainer (Guidewire)Job Title - Claims Certification Trainer (Guidewire)

Pyramid Consulting, Inc.Company Name - Pyramid Consulting, Inc.

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San Antonio, Texas, USA

Contract

Immediate need for a talented Claims Certification Trainer (Guidewire). This is a 12+ months contract opportunity with long-term potential and is located in San Antonio, TX / Plano, TX / Phoenix, AZ(Onsite). Please review the job description below and contact me ASAP if you are interested. Job ID: 25-69158 Pay Range: $60 - $70/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Re

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

Fraud & Claims Operations Consultant 2 - ContingentJob Title - Fraud & Claims Operations Consultant 2 - Contingent

PTR GlobalCompany Name - PTR Global

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Salt Lake City, Utah, USA

Full-time

Fraud & Claims Operations Consultant 2 Salt Lake City Utah 84116 Hybrid 3 days onsite Pay Rate: $28.00-$30.00 hourly W2 Job Description: In this contingent resource assignment, candidate may: Participate in low to moderately complex initiatives and identify opportunity for process improvements within Fraud and Claims Operations. Review and analyze basic or tactical Fraud and Claims Operations assignments or challenges that require research, evaluation, and selection of alternatives, related

Fraud & Claims Operations ConsultantJob Title - Fraud & Claims Operations Consultant

Motion Recruitment Partners, LLCCompany Name - Motion Recruitment Partners, LLC

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Salt Lake City, Utah, USA

Full-time

Outstanding long-term contract opportunity! A well-known Financial Services Company is looking for a Fraud & Claims Operations Consultant in Salt Lake City, UT (Hybrid). Work with the brightest minds at one of the largest financial institutions in the world. This is a long-term contract opportunity that includes a competitive benefit package! Our client has been around for over 150 years and is continuously innovating in today's digital age. If you want to work for a company that is not only a h

Java Developer with Healthcare Claims Processing - ONLY W2Job Title - Java Developer with Healthcare Claims Processing - ONLY W2

nTech SolutionsCompany Name - nTech Solutions

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Remote or Reston, Virginia, USA

Contract

ONLY W2ONLY W2ONLY W2 MUST HAVE experience with Healthcare Claims processing Title: Java Developer with Healthcare Claims Processing Location: Reston, VA (Hybrid) Duration: 6 Months Contract + Extension Job Description: Terms of Employment Contract, 6 Months This position is hybrid. Candidates should be comfortable working onsite in Reston, VA up to once per week. Overview & Responsibilities We are seeking a skilled Java Developer with strong experience in healthcare claims processing and mode

Claims Examiner - MJob Title - Claims Examiner - M

Next Step SystemsCompany Name - Next Step Systems

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Tucson, Arizona, USA

Full-time

Claims Examiner, Tucson, AZ The Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Claims Examiner

Medical Claims Examiner - MJob Title - Medical Claims Examiner - M

Next Step SystemsCompany Name - Next Step Systems

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Tucson, Arizona, USA

Full-time

Medical Claims Examiner, Tucson, AZ The Medical Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of

Medical Claims Coder - MJob Title - Medical Claims Coder - M

Next Step SystemsCompany Name - Next Step Systems

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Tucson, Arizona, USA

Full-time

Medical Claims Coder, Tucson, AZ The Medical Claims Coder needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medica

Healthcare EDI Claims Analyst with Pega Implementation expertiseJob Title - Healthcare EDI Claims Analyst with Pega Implementation expertise

Blink Technology PartnersCompany Name - Blink Technology Partners

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Pennsylvania, USA

Third Party, Contract

Position : Healthcare EDI Claims Analyst with Pega Implementation expertise Location: Remote Duration : Long Term Mode of Interview : Telephonic/Video Job Description: We are seeking a skilled EDI Analyst to join our team. The ideal candidate will have experience with PEGA implementation for claims processing and a strong understanding of APIs, including REST and SOAP. This role involves gathering requirements for request/response payloads and conducting API testing. Knowledge of PEGA claims w

Sr. Business Analyst ( Healthcare Claims Data / SQL)Job Title - Sr. Business Analyst ( Healthcare Claims Data / SQL)

IT Associates, Inc.Company Name - IT Associates, Inc.

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Chicago, Illinois, USA

Full-time

Sr. Business Analyst - Fulltime Position Location - Rosemont, IL (2 days a week onsite)Healthcare client Exp with Facets a plus Good experience with SQL is a must. Visa sponsorship is not available for this role. Locals to Chicago only. Our client that is looking to add a Senior Business Analyst leads the analysis and optimization of claims processes within the health insurance industry. The role involves defining business requirements and specifications including for Facets system configuration

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

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

EDI analyst - claims with Snip ValidationJob Title - EDI analyst - claims with Snip Validation

RiseIT SolutionsCompany Name - RiseIT Solutions

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Remote

Contract

Company: iTechUS, Inc. Job Title: EDI analyst- Claims & Eligibility Location : US Remote Job Responsibilities : Healthcare experience would be a BIG PLUS. Claims hands on Exp , with 834 Transactions, Claims and Eligibility. EDI with Claims & Eligibility (834, 837, 835, etc.). Required Skills : Need to have Snip Validation experience. Healthcare experience would be a BIG PLUS. Claims hands on Exp , with 834 Transactions, Claims and Eligibility. Must have EDI with Claims & Eligibility (834, 837,

Claims ExaminerJob Title - Claims Examiner

DTG Consulting Solutions Inc.Company Name - DTG Consulting Solutions Inc.

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Englewood, New Jersey, USA

Full-time

Spanish is Must Responsibilities: Review and process health care claims promptly and accuratelyVerify claim details using CPT and ICD codesAddress inquiries from providers, members, and insurers regarding claim statusEnsure compliance with internal policies and regulatory requirementsMaintain detailed and accurate documentation of claim processingCollaborate with team members to resolve any discrepanciesQualifications: Proven experience in processing health care claimsKnowledge of CPT, ICD codes

SEMS/Claims Analyst - Logistics Analyst IIIJob Title - SEMS/Claims Analyst - Logistics Analyst III

ATR International, Inc.Company Name - ATR International, Inc.

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Austin, Texas, USA

Full-time

Job Description: Logistics is offering a SEMS/Claims Analyst opportunity: The successful candidate will eliminate aging SEMS and process claims for AMR Logistics Work closely with the AMR Logistics teams and cross functionally to produce weekly, monthly, & quarterly data driven reports Interpret data, analyze results using statistical techniques and provide ongoing reports Develop and implement databases, data collection systems, data analytics and other strategies that optimize statistical eff

Mechanical Claims Analyst - Hybrid / Call CenterJob Title - Mechanical Claims Analyst - Hybrid / Call Center

TEKsystems c/o Allegis GroupCompany Name - TEKsystems c/o Allegis Group

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Deerfield Beach, Florida, USA

Full-time

Our client, a leading North American provider of auto-dealership services, is looking to add Mechanical Claims Analyst to their Deerfield Beach, FL team. Description Are you a skilled mechanic looking to shift gears in your career? We are seeking Mechanical Claims Analysts to join our expanding customer contact team. In this role, you'll transition from the physical demands of the shop floor to a comfortable office environment where you will leverage your automotive expertise and in-depth knowle

Epic Billing and Claims Sr. AnalystJob Title - Epic Billing and Claims Sr. Analyst

DeloitteCompany Name - Deloitte

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McLean, Virginia, USA

Full-time

Are you an experienced, passionate pioneer in technology who wants to work in a collaborative environment? As an experienced Epic Billing and Claims Senior Analyst you will have the ability to share new ideas and collaborate on projects as a consultant without the extensive demands of travel. If so, consider an opportunity with Deloitte under our Project Delivery Talent Model. Project Delivery Model (PDM) is a talent model that is tailored specifically for long-term, onsite client service delive

Epic Billing and Claims Sr. AnalystJob Title - Epic Billing and Claims Sr. Analyst

DeloitteCompany Name - Deloitte

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Richmond, Virginia, USA

Full-time

Epic Billing and Claims Sr. AnalystJob Title - Epic Billing and Claims Sr. Analyst

DeloitteCompany Name - Deloitte

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Seattle, Washington, USA

Full-time