26 results (4 new)
Baltimore, Maryland
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Today
The role involves researching claims data, running reports, validating and analyzing claims data as well as logging in data. Must have 2+ years of functional analysis. Must have 1-2 years of data entry experience Must have experience with healthcare claims processing. Must have advance level excel experience. Must know how to use Pivot tables as well as good word experience. If they have LuminX is a big plus.
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Contract
Depends on Experience
Hybrid in Baltimore, Maryland
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18d ago
Claims AdjusterIntroduction:Immediate position for a Claims Adjuster / Processor! The selected candidate will process claims AND investigate/perform adjustments of complex Healthcare (payor) claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines. The selected candidate will verify healthcare insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line
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Contract
22 - 25
Hybrid in Baltimore, Maryland
•
Today
Claims Adjustment experience FACETS G6 platform Medical Claims processing experience. Medical Claims Adjustment experience. Medical Terminology, Provider Refund. Subrogation, Workers Comp. Disbursements. Investigate and perform adjustment of claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines. Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizin
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Contract
Depends on Experience
Baltimore, Maryland
•
Today
Functional Analyst Baltimore, MD (Onsite Job) 6 Months+ CTH 100% Onsite in Downtown Baltimore, MD (Canton) Inperson Interview Required Must have: Data Entry, Claims Processing, MS Office, (Excel) PURPOSE: Provides Operations Support by obtaining facts; analyzing problems; designing solutions; developing testing methods; conducting and documenting tests; providing operating information to customers. ESSENTIAL FUNCTIONS: 50% Research and improve operations by examining and research
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Third Party, Contract
Depends on Experience
Baltimore, Maryland
•
Today
VEGA IS HIRING! Actively searching for Healthcare, Functional, Business Analysts for a 6 month + contract to hire opportunity with our direct client, located in Baltimore, MD. This is an onsite W2 based position based out of Baltimore, MD. Only candidates with current healthcare experience will be considered for this position. The Functional Business Analyst will provide Operations Support by obtaining facts; analyzing problems; designing solutions; developing testing methods; conducting and do
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Contract
Depends on Experience
Remote
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19d ago
Position: Claims Representative - Liability Duration: 02+ Months contract length. Contract extension and/or Conversion to direct employee is possible Location: 100% Remote ship Required. Manager Notes: Any specific skill/ certification/ experience: 3-4 years bodily injury claims low exposure up to 25KYears of experience: 3-4years Job Description: Duties: To process low level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards a
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Contract
20 - 25
Remote
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19d ago
Hiring for Senior Business Analyst Location - Remote Senior Business Analyst Claims module: Play the role of Claims Domain lead for MMIS health care projects. Drive the claims module and process, domain knowledge, performs analysis of business requirements, designs and develops documentation, ensures quality process, coordinates with customers. Works in team environment and provides guidance throughout the entire life cycle. Responsible to meet customer expectations, troubleshoot problems in th
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Full-time
$60,000 - $80,000
Remote
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19d ago
Position: Claims Examiner - Workers Compensation Duration: 03+ Months contract length. Contract extension and/or Conversion to direct employee is possible Location: Remote in California Pay Range: $52/hr to $56/hr on W2 without Benefits ship Required. Manager Notes: Experience - min 3 years of experience is needed. Public entity and County of Los Angeles Experience is a plus.SIP is mandatory.Shift timings: 8:00 4:30 Primary Purpose: To analyze complex or technically difficult workers'' compen
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Contract
52 - 56
Remote
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29d ago
Claims Domain Test Manager Location: Atlanta, GA or remote with limited travel during critical phases 6+ months contract to Hire Play the role of Claims Domain test manager for MMIS health care projects. Drive the test strategy and process, domain knowledge, performs analysis of business requirements, designs and develops test plans, ensures quality process, coordinates with customers on delivery and deployments. Works in team environment and provides testing guidance throughout the entire life
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Contract, Third Party
Depends on Experience
Remote
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6d ago
About VLink: Started in 2006 and headquartered in Connecticut, VLink is one of the fastest growing digital technology services and consulting companies. Since its inception, our innovative team members have been solving the most complex business, and IT challenges of our global clients. Job Title: Claims Business Consultant Healthcare Duration: 3 Months (Contract) Expected extension possible but not guaranteed. Required: 512+ years overall (Minimum 5 years of relevant experience in healthcare
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Contract
Depends on Experience
Remote
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8d ago
Position: Claims Examiner - Workers Compensation Duration: 03+ Months contract length. Contract extension and/or Conversion to direct employee is possible Location: 100% Remote in California Pay Range: $48/hr to $52/hr on W2 without Benefits ship Required. Manager Notes: Experience - min 3 years of experience is needed. Workers Compensation Experience.SIP is Preferred. Education & Licensing Bachelor''s degree from an accredited college or university preferred. Professional certification as app
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Contract
48 - 52
Remote
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13d ago
Job Description:To provide Absence case management and claim adjudications, based on medical documentation and the applicable Disability/FMLA/Paid Family Leave interpretation, including determining benefits due and making timely payments and adjustments.Review and analyze the claim nuances, eligibility review, and type of claims (intermittent or continuous)Review and analyze medical information (i.e. attending physician reports, medical records such as diagnostic tests, office notes, operative r
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Full-time
47,000 - 55000
Remote
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8d ago
Position: Claims Examiner - Workers Compensation Duration: 03+ Months contract length. Contract extension and/or Conversion to direct employee is possible Location: 100% Remote in California Pay Range: $50/hr to $54/hr on W2 without Benefits ship Required Manager Notes: Candidate with prior/current CA Indemnity and Litigated Workers Compensation experience is required.Self-Insured Plans (SIP) certification.Candidate Must Live in California: Prefer if someone could be in-office in either Rosevi
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Contract
50 - 54
Remote
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13d ago
Overview Engagement Type: Remote High-priority, immediate start Start Timeline: ASAP (Target onboarding: Early-July) We are seeking a highly experienced Healthcare Claims Integration Consultant to support a strategic healthcare initiative focused on dual claims processing, payer integration, and cost optimization in collaboration with Aetna and related healthcare programs. This role is critical to supporting a large-scale healthcare transformation involving Medicare and Medicaid coordination, du
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Contract
$150,000 - $160,000
Remote or New York, New York
•
Today
About Us: EvolutionIQ's mission is to deliver state of the art technology that helps insurance claims teams make claims handling more accurate, fair, and efficient, so that more people impacted by injury or illness can continue their lives with dignity and stability. We are currently experiencing massive growth and to accomplish our goals, we are hiring world-class talent who want to help build and scale internally, and transform the insurance space. Our team is our #1 priority, and we have been
Full-time
Baltimore, Maryland
•
Today
Company Description Lumen SolutionsGroupInc. is a technology consulting Services company based inFlorida. Weprovidea wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, and EnterpriseTransformation. Role: Claims Analyst Location: Baltimore, MD (Onsite) Job Type: Contract-To-Hire J
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Contract
Depends on Experience
Remote
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22d ago
Job SummaryWe are seeking an experienced Senior Epic Resolute Revenue Cycle Analyst/Administrator to support, optimize, and enhance Epic Hospital Billing (HB), Professional Billing (PB), and Single Billing Office (SBO) applications. The ideal candidate will possess extensive experience in Epic Revenue Cycle operations, system configuration, workflow optimization, claims management, and revenue integrity initiatives. This role will partner with revenue cycle leadership, finance teams, operational
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Contract, Third Party
60 - 65
Remote
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8d ago
Role: GW Business Analyst ClaimCenter Duration: 4 MonthsLocation: Remote role EST Job Description-:Responsibilities: 1. Business & Functional Analysis - Elicit, analyze, and clarify claims business requirements through workshops, interviews, and working sessions with Claims, Comm Auto, Corporate, and IT stakeholders. - Translate business needs into ClaimCenteraligned functional requirements, ensuring they map cleanly to configuration, rules, and integrations. - Identify and document business rul
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Contract
Depends on Experience
Remote
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20d ago
Role Technical Analyst(RCM and Claims) Location Remote Job Description: Note - We need technical people who can write/run SQL Queries. Role Overview: Develop Revenue Cycle Data product strategy in partnership with product directors, product managers, peers in Architecture and Delivery, and ADDG Leadership Team. Manages the strategy and lifecycle of products, features and/or enhancements from conceptualization through requirements gathering, product specification and roadmap, imp
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Third Party, Contract
Depends on Experience
Remote
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7d ago
Job Title: Principal Data Architect Microsoft Fabric & Insurance Claims ModernizationDuration: FTE/Contract Educational Qualification*Any Bachelor's DegreeExperience Range12 16 yearsTagline/Tech Stack Snapshot - Platform Architecture | Microsoft Fabric | AI-Accelerated Delivery | Insurance Claims ModernizationRole Summary - (To be filled by Practice /DO) We are looking for a seasoned Technical Architect to own end-to-end solution architecture for a specialty medical stop loss insurance enterpris
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Third Party, Contract
$0 - $0
