claims Jobs

21 - 40 of 622 Jobs

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

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

Claims and Mailroom Clerk - Madison, WI - On-siteJob Title - Claims and Mailroom Clerk - Madison, WI - On-site

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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Madison, Wisconsin, USA

Full-time

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work

Excellent Job Opportunity || Claims Assist - Solution Architect || Charlotte, NCJob Title - Excellent Job Opportunity || Claims Assist - Solution Architect || Charlotte, NC

Sysmind, LLCCompany Name - Sysmind, LLC

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Illinois, USA

Third Party, Contract

Dear Job Seeker My name is Leo and I work as a Sr. US IT Recruiter with SYSMIND. We have been serving fortune 500 clients in the industry to bridge their staffing gap since the past 25 years. I have an Excellent opportunity with one of our clients. Description: Role Name: Claims Assist - Solution Architect Location: Charlotte, NC Duration: 6+ months with possible extension Required Qualifications: Bachelor's Degree in Computer Science, or related technical discipline with proven experience

Claims Examiner-Lost TimeJob Title - Claims Examiner-Lost Time

Sunrise Systems, Inc.Company Name - 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

Technical Business Analyst (Claims/HRP)- W2Job Title - Technical Business Analyst (Claims/HRP)- W2

PamTen IncCompany Name - 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

Medical Claims Auditor I (Remote, USA)Job Title - Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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Remote or Dallas, Texas, 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 Medical Claims Auditor I who is responsible for processing all casualty or estate fu

Medical Claims Auditor I (Remote, USA)Job Title - Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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Remote or Austin, Texas, USA

Full-time

Medical Claims Auditor I (Remote, USA)Job Title - Medical Claims Auditor I (Remote, USA)

Gainwell Technologies LLCCompany Name - Gainwell Technologies LLC

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Remote or Houston, Texas, USA

Full-time

Data EngineerJob Title - Data Engineer

Uniglobe Technologies, IncCompany Name - Uniglobe Technologies, Inc

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Nashville, Tennessee, USA

Contract

Title: Software Engineering Advisor (Data Engineer) Location: Nashville, TN (Hybrid) Duration: 12+ Months Contract Job Description: Mandatory: Datawarehouse, Data Lake, Claims, Provider, Healthcare exp.Provides expert content/professional leadership on complex Engineering assignments/projects.Designs and develops a consolidated, conformed enterprise data warehouse and data lake which store all critical data across Customer, Provider, Claims, Client and Benefits data.Designs, develops and imple

Sr Claims Systems Data Analyst - QNXTJob Title - Sr Claims Systems Data Analyst - QNXT

Molina HealthcareCompany Name - Molina Healthcare

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Remote or Long Beach, California, USA

Full-time

Job Description JOB DESCRIPTION Job Summary Responsible for accurate and timely review of production support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains understanding of solution functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received on claims to identify billing issues that will impact claims processing and payment. Monitor ne

Guidewire cloud ArchitectJob Title - Guidewire cloud Architect

Nityo Infotech CorporationCompany Name - Nityo Infotech Corporation

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Hartford, Connecticut, USA

Full-time

Job Title: -Guidewire cloud Architect Duration: Full Time Role Location Hartford, CT, Raleigh, NC, Indianapolis, IN, Richardson, TX and Tempe, AZ(ONSITE) What Client is looking for? Required Qualifications: At least 11 years of experience with Information Technology.Bachelor s degree or foreign equivalent required from an accredited institution. Will also consider three years of progressive experience in the specialty in lieu of every year of education.Experience in leading and solutioning Guid

SQL Claims AnalystJob Title - SQL Claims Analyst

Apex SystemsCompany Name - Apex Systems

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Montgomery, Alabama, USA

Full-time

Job#: 2069329 Job Description: Position: SQL Claims Analyst - Medicaid Location: ONSITE - 501 Dexter Ave, Montgomery, AL 36104 Duration: 12-month Contract-to-Hire Pay Rate: $50 - $60/hr. Overview: AL EDS is the new Alabama Medicaid Data warehouse, This position will support the Agency in the rollout and usage Responsibilities: Support the Agency with their Analytic StaffProvide on-site help desk supportCreate Power BI reports at the request of the AgencyProvide data analysis at the request

QNXT Benefit ConfigurationJob Title - QNXT Benefit Configuration

EconosoftCompany Name - Econosoft

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Remote

Contract

We are actively seeking QNXT Benefit Configuration Subject Matter Experts (SMEs) with a strong background in both commercial and government benefit structures. The ideal candidate will have hands-on expertise in QNXT core modules and be proficient in benefit setup, configuration, claims validation, and data migration. This position plays a critical role in ensuring accurate benefit designs and seamless integration within QNXT environments. Key Responsibilities: Configure and manage QNXT benefits

(REMOTE) Epic Application Coordinator Resolute - Professional Billing Claims Admin Claims and RemittanceJob Title - (REMOTE) Epic Application Coordinator Resolute - Professional Billing Claims Admin Claims and Remittance

Trinity HealthCompany Name - Trinity Health

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Remote or Livonia, Michigan, USA

Full-time

Employment Type: Full timeShift: Description: Epic Resolute Certified Application CoordinatorREMOTE: position allows for work remote (90-95%) opportunityResolute Certified Application Coordinator experience highly preferred POSITION PURPOSE Responsible for providing primary support and contact for each application. Coordinates all issues that arise during the project for assigned application areas and provides subject matter expertise and comprehensive knowledgeable in Trinity Health's policie

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

Vbeyond CorporationCompany Name - 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

Engineering Manager (Claims Platform)Job Title - Engineering Manager (Claims Platform)

HeadwayCompany Name - 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

Project ManagerJob Title - Project Manager

Information Technology GroupCompany Name - Information Technology Group

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Jeffersonville, Indiana, USA

Contract

Description: This role is a supply chain and transportation role with a specific focus on freight investigations, claims, and data analytics. Experience processing transportation claims, especially parcel claims with UPS and FedEx, would be a plus. Experience is needed for parcel transportation (UPS and FedEx) with a focus on claims and freight investigations related to loss and theft. This role will support our other internal teams that are engaged with minimizing theft of material and recoupin

Ace Certified Guidewire Developer - Cloud, Configuration/Integration exp - US Physical Resident/Work Authorized - RemoteJob Title - Ace Certified Guidewire Developer - Cloud, Configuration/Integration exp - US Physical Resident/Work Authorized - Remote

Access Global Group LLCCompany Name - Access Global Group LLC

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Remote or US

Full-time, Contract

Company Overview Do you want to be part of a exciting environment, supporting the growth of cutting-edge technology in cloud computing? Access Global Group (AGG) employees are passionate about what they do. We're a diverse group of cloud technology professionals with the same goal: to make our clients' lives easier through technology and we have a good time while we're at it! As a Salesforce Cloud Alliance Partner, Our recognized ability to deliver outstanding value is the product of effectively

Production Support Claims - Sterling B2BJob Title - Production Support Claims - Sterling B2B

Vega Consulting SolutionsCompany Name - Vega Consulting Solutions

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Reston, Virginia, USA

Third Party, Contract

Onsite Interview required in Reston, VA. Vega Consulting is staffing a B2B Sterling engineer for a contract opportunity to provide Production and or Monitoring support for our direct Client. Candidates must be located in DC, VA, WVA, MD, PA or NC - Travel to Reston, VA is required - (minimum once a month). B2B Developer8-11 Years ExperienceExperience in B2B production support and infrastructure teams.Healthcare experience/Familiarity with HIPAA X12 transactions, e.g 837, 834, 270, 276EDI Technic