claims Jobs

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Care Management Support CoordinatorJob Title - Care Management Support Coordinator

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

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Remote

Contract

Immediate need for a talented Care Management Support Coordinator. This is a 03+ Months Contract opportunity with long-term potential and is located in U.S.(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID:25-80418 Pay Range: $17 - $18/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 Responsibilities: Performs administrative c

Advance Planning Manager / Project CoordinatorJob Title - Advance Planning Manager / Project Coordinator

Stellar IT SolutionCompany Name - Stellar IT Solution

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Remote or North Carolina, USA

Contract, Third Party

APD Manager/Contracts Liaison Location NC Medicaid/DHB Remote Duration: 12 Months Job Description: This is not a new role, rather a new req for an increase in pay due to new responsibilities. Advanced Planning Manager and Advanced Planning Contract Liaison, this is a dual role. Complete Description: This position is a managerial position responsible for the strategic planning, daily operations, and management oversight of the Advanced Planning Writing Team within the Advanced Planning Office (

Health Data Scientist LeadJob Title - Health Data Scientist Lead

Accenture LLPCompany Name - Accenture LLP

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Washington, District of Columbia, USA

Full-time

At Accenture Federal Services, nothing matters more than helping the US federal government make the nation stronger and safer and life better for people. Our 13,000+ people are united in a shared purpose to pursue the limitless potential of technology and ingenuity for clients across defense, national security, public safety, civilian, and military health organizations. Join Accenture Federal Services, a technology company and part of global Accenture, to do work that matters in a collaborative

Data Scientist with GenAI & Palantir Experience (Insurance Domain)/ NY/NJ (Onsite)Job Title - Data Scientist with GenAI & Palantir Experience (Insurance Domain)/ NY/NJ (Onsite)

Marici SolutionsCompany Name - Marici Solutions

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New York, New York, USA

Contract

Position: Data Scientist GenAi+Palantir Location: NY/NJ Duration: Long Term Client: EXL Please share resume with complete Education Details, Linkedin profile, current location and visa Must Haves:- Palantir Foundry, Gen-AI, Insurance Domain Background (Underwriting/Claims) Job Description: An engineer who has worked on data workflows in Palantir Foundry independently. Should have Palantir typescript experience for react-based applications, custom dashboards, and plugins. Fundamental understandin

Analyst II - Product System ConfigurationJob Title - Analyst II - Product System Configuration

Inland Empire Health Plan (IEHP)Company Name - Inland Empire Health Plan (IEHP)

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Rancho Cucamonga, California, USA

Full-time

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the direction of the Supervisor of Product System Configuration, the Analyst II Product System Configuration is responsible for managing the more complex system configurations within the Business System. The primary functions of this position include but are not limited to, accurate interpretation

Member Care Coordinator | Santa Fe/Taos, NM | Contract to HireJob Title - Member Care Coordinator | Santa Fe/Taos, NM | Contract to Hire

Walker HealthforceCompany Name - Walker Healthforce

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Contract

Member Care Coordinator| 3+ Years of Experience | Remote/Fieldwork in Santa Fe/Taos, NM | Contract to Hire Walker Healthforce is seeking aMember Care Coordinator with 3+ Years of Experience to support a Healthcare Payor Client based in Santa Fe/Taos, NM. This is a 6 month contract to hire opportunity. MUST BE LOCAL TO: Santa Fe/Taos, NM START DATE: ASAP HOURS/SCHEDULE:M-F 8am-5pm WORKER TYPE:W-2 CORE REQUIREMENTS: Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in man

Remote Contract EPIC Revenue AnalystJob Title - Remote Contract EPIC Revenue Analyst

Seine LLCCompany Name - Seine LLC

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Remote

Contract

TITLE: Remote Contract EPIC Revenue Analyst There is one position and the need is immediate. This could possibly be an Option to Hire after one year. No Immigrations allowance with this customer; so all candidates to be considered must be anwho can join the end client without and conversion or sponsorship dollars, be a or Permanent Resident, or a . Must Haves: 3+ years of Professional EPIC Revenue Cycle experience Industry is: Hospital, Medical Job Description: The Epic Analyst is responsib

.Net Solution ArchitectureJob Title - .Net Solution Architecture

Octigo Solutions IncCompany Name - Octigo Solutions Inc

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Warren, New Jersey, USA

Full-time

Position- Solution Architecture Location- Warren, NJ- Hybrid Duration- Long term contract Job description: - Design and implement robust, scalable, and secure solutions tailored to insurance/reinsurance workflows such as underwriting, claims processing, policy administration, and risk modeling.Define architecture blueprints and ensure alignment with enterprise architecture standards and regulatory frameworks (e.g., NAIC, GDPR, Solvency II).Leverage microservices and event-driven architecture to

Member Care Coordinator | Field/Remote | Albuquerque, NM | Contract to HireJob Title - Member Care Coordinator | Field/Remote | Albuquerque, NM | Contract to Hire

Walker HealthforceCompany Name - Walker Healthforce

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Contract

Member Care Coordinator| 3+ Years of Experience | Field/Remote | Albuquerque,NM|Contract to Hire Walker Healthforce is seeking aMember Care Coordinator with 3+ Years of Experience to support a Healthcare Payor Client remotely. This is a 12 month contract to hire opportunity. START DATE: ASAP HOURS/SCHEDULE:M-F 8am-5pm WORKER TYPE:W-2 CORE REQUIREMENTS: Must be willing to travel to member homes Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR

QNXT Configuration Specialist :: 100% RemoteJob Title - QNXT Configuration Specialist :: 100% Remote

DMS Vision Inc.Company Name - DMS Vision Inc.

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Arkansas, USA

Contract, Third Party

Hi, Hope all is well, Please find the job description given below and let me know your interest. Position: QNXT Configuration Specialist Location: 100% Remote Contract: 6+ Months Contract Job Description: Configure and optimize QNXT modules to support real-time eligibility (270/271) transactions. Collaborate with API developers and business analysts to align eligibility rules with CareOregon business policies. Define, build, and test eligibility service parameters, payer response logic, and m

Powerbuilder DeveloperJob Title - Powerbuilder Developer

GreyCell Labs, IncCompany Name - GreyCell Labs, Inc

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Menands, New York, USA

Contract, Third Party

24 months experience developing jurisdictional data reporting requirements using the IAIABC EDI Claims Release 3 standard and designing the associated software modules necessary to integrate the IAIABC Claims Release 3 dataset into a Claims management system used by a regulatory agency. 84 months experience as a technical lead supporting Claim Management computer system(s) in a regulatory environment. This includes leading design sessions with users, writing design documents and writing technica

Sr. Business Analyst / Project ManagerJob Title - Sr. Business Analyst / Project Manager

AaditusCompany Name - Aaditus

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Third Party, Contract

Key Skills Required: Strong experience as a Sr. BA / PM in the Insurance industry Hands-on experience with Fineos or Majesco (must-have) Deep knowledge of Benefits / Claims processes Good to have experience with ADP or Workday Strong experience working in Agile environments using Jira Excellent communication and stakeholder management skills

Project ManagerJob Title - Project Manager

TriosysIT Inc.Company Name - TriosysIT Inc.

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Richmond, Virginia, USA

Contract, Third Party

Exp with Agile and Waterfall software development conceptsRequired10YearsExp with sr level Project Management practices and principles; Project Management Life Cycle (PMLC)Required10YearsExp with Systems Development Life Cycle (SDLC)Required10YearsExperience with successfully leading project teams through implementations, including at least one successfully led project of $1M or higher.Required10YearsProject Management Professional (PMP) certificationRequired MITA ArchitectureDesired Vendor ma

Remote Agile Coach with Healthcare DomainJob Title - Remote Agile Coach with Healthcare Domain

Infinite Computer Solutions (ICS)Company Name - Infinite Computer Solutions (ICS)

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Remote

Full-time

Title : Agile Coach with Healthcare Domain Location : Remote Term :Long Term Contract/Fulltime/Permanent Note : GCEAD, L2EAD, consultant can apply for this position who can work on W2. Job Descriptions : Job Summary We are seeking a seasoned Agile Coach to lead and guide our teams in the successful adoption, implementation, and evolution of Agile frameworks and best practices. The ideal candidate will have a deep understanding of Agile principles (Scrum, Kanban, SAFe, etc.), strong facilitat

Product OwnerJob Title - Product Owner

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

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Bedford Park, Illinois, USA

Full-time

Our client is seeking a strategic and collaborative Product Owner to support and guide two Agile development teams focused on the underwriting blacklog, utilizing the InsuranceNow tech suite. This role will take end-to-end ownership of the platform, aligning delivery efforts with business goals and driving value across underwriting, policy, billing, and claims operations. You'll work closely with stakeholders across both technology and business units to define and deliver high-impact features, p

Project ManagerJob Title - Project Manager

Georgia ITCompany Name - Georgia IT

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Richmond, Virginia, USA

Contract

Title: Project Manager Duration: One-year engagement expected, hybrid on-site/telework (3 days in the office) Location: Richmond, VA Rate: DOE ABOUT THE ROLE The Project Manager will report directly to the Project Management Office (PMO) Director and lead multiple, complex IT initiatives within the modular Medicaid Enterprise System (MES).The Project Manager will initiate, plan, execute, monitor/control, and close projects as assigned and by state/federal regulations and industry best practices.

Business AnalystJob Title - Business Analyst

GreyCell Labs, IncCompany Name - GreyCell Labs, Inc

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Albany, New York, USA

Third Party, Contract

84 months experience eliciting business requirements from business customers or system artifacts and maintaining such requirements. 84 Months experience developing business requirements and process documentation such as use cases, process flows, screen mock-ups, and data dictionaries. 84 months of QA experience including the following: Create Test Plans, Test Cases, and Test scripts Execute functional and system tests including regression tests using manual testing tools and record results using

Lead Analyst QNXTJob Title - Lead Analyst QNXT

RyantechCompany Name - Ryantech

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Remote

Full-time

Job Title: Lead Analyst Configuration OversightLocation: Remote | Domain: Healthcare No 3rd aprty or bench sales . Job Summary:One of our Healthcare Parner is seeking a Lead Analyst Configuration Oversight to ensure accuracy and compliance in Medicaid Coordination of Benefits (COB) claim pricing and processing. This role supports Payment Integrity and Claims Operations, with a strong focus on identifying over/underpayments, validating configuration rules, and ensuring regulatory alignment. Ke

Transportation Coodinator (HYBRID)Job Title - Transportation Coodinator (HYBRID)

NetSource, Inc.Company Name - NetSource, Inc.

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New Brunswick, New Jersey, USA

Contract

Please note that this is a 3-month contract position. Top Three Skills: Transportation knowledge MS Office Ability to multi-task 3-5 years experience Bachelors degree required Transportation Analyst, Regional Transportation Organization, serves as liaison between RTO and supported Operating Company(s) as required.Manages OPCO s transportation network to ensure optimal service to both shipper and receiver including tactical issues on an exception basis.Also provides input and analysis for strate

IT Academic Applications Director (HEO) - Department of Instructional Computing and Information Technology (ICIT)Job Title - IT Academic Applications Director (HEO) - Department of Instructional Computing and Information Technology (ICIT)

Hunter CollegeCompany Name - Hunter College

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New York, New York, USA

Full-time

IT Academic Applications Director (HEO) -Department of Instructional Computing and Information Technology (ICIT) Job ID: 30543 Location: Hunter College Full/Part Time: Full-Time Regular/Temporary: Regular The Instructional Computing and Information Technology (ICIT) Academic Applications Development Director reports directly to the Deputy CIO. ICIT is a service-oriented organization In support of the college s Academic Mission and Curriculum, the Director will manage a diverse portfolio which in