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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

Claims Adjuster

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

Claims Processor

Baltimore, Maryland

•

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

Healthcare Claims Analyst- ONSITE

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

Functional Analyst – (Data Entry, Claims Processing)

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

Claims Representative - Liability W2 only

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

Claims Examiner - Workers Compensation W2 Only

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

Senior Business Analyst Claims module

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

Claims Examiner - Workers Compensation W2 Only

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

Claims Domain Test Manager - Remote with limited travel

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

Claims Business Consultant – Healthcare

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

Claims Specialist

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

Workers Compensation Claims Examiner - W2 Only

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

Healthcare Claims Integration Consultant (Dual Claims Aetna / Medicare / Medicaid)

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

Workers Comp, Lost Time Claims Subject Matter Expert (User Research) - AI SaaS

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

Claims Analyst

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

Healthcare Payer Business Analyst - Government Programs/Risk Adjustment

Remote

•

Today

Business Analyst (Healthcare Payer Government Programs/Risk Adjustment) Tentative duration - 06 Months with Possible extension REMOTE (EST candidates strongly preferred) Position Summary We are seeking an experienced Business Analyst to support strategic and operational initiatives for a health plan focused on government lines of business (Medicaid, Medicare, and ACA Exchange). This role will partner closely with clinical, operational, compliance, and technology teams to drive initiatives re

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Third Party, Contract

Principal Data ArchitectMicrosoft Fabric & Insurance Claims Modernization

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

Business Architect Expert - Telematics & Connected Claims - Remote

Remote or New York, New York

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3d ago

At Allstate, great things happen when our people work together to protect families and their belongings from life's uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers' evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. Job Description Business Architect Expert - Telematics & Connected Claims

Full-time

USD 110,000.00 - 181,025.00 per year

Technical Analyst(RCM and Claims)

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

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