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Hybrid in The Bronx, New York

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Today

JOB PURPOSE: The Claims and Credentialing Analyst will be a pivotal role in analyzing and coordinating all activities of the Provider Data team by evaluating and refining processes, conducting comprehensive data analysis, and ensuring compliance with all applicable State, CMS, contractual guidelines and ensuring provider compliance with credentialing standards. JOB RESPONSIBILITIES: Coordinate provider credentialing process to increase efficiency and ensure that credentialing deadlines are met.

Full-time

$75,000 - $85,000

AR Claims Analyst

Remote

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28d ago

The RCM Associate supports daily revenue cycle work to help claims move correctly from start to finish. This role may work on insurance verification, claim submission, accounts receivable follow-up, or payment posting based on business needs. The associate is expected to follow written instructions, complete assigned tasks on time, and update records accurately. Work assignments may change as priorities change. Key Responsibilities: Work assigned insurance claims until they are paid, denied, or

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Full-time

$40,000 - $50,000

Business Intelligence Analyst (Property Claims)

New York, New York

•

Yesterday

The Property Claims Business Intelligence Analyst analyzes and recommends technical solutions for complex projects to meet the needs of Claims and other impacted business areas. Will be responsible for defining and delivering the BI Strategy and ensure the successful delivery of Business Intelligence Solutions and Executive / Operational dashboards. The BI analyst will be a motivated self-starter building strong relationships with the business, IT and BI teams. What will be my duties and respons

Full-time

Compensation information provided in the description

Epic Build Analyst – Professional Billing (PB) Claims & Remittance

Remote

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7d ago

Job Title: Epic Build Analyst Professional Billing (PB) Claims & Remittance Location - Remote Principal Duties Epic analyst certified in PB Claims and Remittance with extensive experience building payors and plans in Epic. The analyst will cover support duties including upgrades, testing, ticket resolution, and system maintenance. The role requires coordination with FTEs, operations teams, and other application teams. Minimum Qualifications Under varying levels of direction and expertise, the a

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Third Party, Contract

Depends on Experience

Rx Claim Data Analyst

Remote or Hybrid in Newark, New Jersey

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Today

JD Rx Claims Data AnalystJob Title: Rx Claims Data Analyst Job Summary:Looking for a Data Analyst with experience in Rx (Pharmacy) Claims and Healthcare/PBM domain to analyze pharmacy claims data, validate adjudication logic, and support reporting and data quality initiatives. Key Responsibilities: Analyze Rx claims adjudication processes including eligibility, formulary, pricing, and prior authorization. Write SQL queries to extract and analyze pharmacy claims data. Perform data validation and

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Contract

Depends on Experience

Intern - Tort Claims and Engineering Audit Support

New York, New York

•

Today

Company Description Job Description Note: Applicants must be enrolled in an accredited undergraduate degree program for the Fall 2026 semester. Please clearly indicate your expected graduation date on your resume. The New York City Comptroller's Office works to promote the financial health, integrity, and effectiveness of New York City government, in order to strengthen trust, secure a thriving future for all New Yorkers, and build a more just, equitable, and resilient city. Led by an indepen

Part-time

Casualty Lead Global Reinsurance Claims

New York, New York

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5d ago

Primary Details Time Type: Full time Worker Type: Employee Casualty Lead Global Reinsurance Claims Location: USA - New York Work Arrangement: Hybrid 8-12 day per month in-office The salary range for this role is: $156,000-234,000K The Opportunity This is a highly visible leadership role as the recognized technical expert for Casualty Reinsurance claims, with responsibility for guiding complex matters and shaping best-in-class claim outcomes. The role partners closely with Product, Pricing and

Full-time

Compensation information provided in the description

Claims Domain Test Lead

Remote

•

Today

Job: Claims Domain Test Lead Location: Remote(USA) Claims Domain Test Lead: Play the role of Claims Domain lead 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 cycle. Responsible to meet customer expectations, troublesho

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Third Party, Contract

$70 - $75

Project Manager - PBM - PMP - Claims Adjudication

Remote

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6d ago

PBM is a must. Pharmacy or Health PlansClient PortalsProvider Network Management and/or Clinical Programs. Claims Adjudication is always a plus.

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Contract

$60+

Claims Platform Developer / Engineer

Remote

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6d ago

Key ResponsibilitiesConfigure and customize claims platform modules (Benefits, Claims, Pricing, Provider)Develop enhancements, business rules, and workflowsBuild integrations with downstream/upstream systemsSupport data migration and system upgradesTroubleshoot claims adjudication defects and performance issuesParticipate in SIT, UAT, and production deploymentsDevelop technical documentation and configuration guidesEnsure compliance with payer regulatory requirementsRequired Qualifications5+ yea

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Contract

50 - 60

SAP S/4 Service Warranty claims with Automobile expereince

Remote

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13d ago

Job Description An SAP S/4 Service Warranty Consultant is responsible for designing, configuring, and optimizing Warranty Management processes within the SAP S/4HANA Service (formerly CS/SM) module. The role involves implementing endtoend warranty workflows, integrating service processes with logistics and finance, and ensuring accurate warranty claims processing for both internal and external stakeholders. Key Responsibilities Must Skills: S/4 services Warranty claims with Automobile

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Contract, Third Party

Depends on Experience

Functional Lead(W2(Full Time) Only) - California Workers Compensation Claims Experience(Required)

Remote

•

Today

Role : Functional Lead(W2(Full Time) Only) California Workers Compensation Claims Experience(Required)Client : State of CaliforniaProject : California DIR Claims Duration : Long TermCompensation: Based on Experience eSystems Inc. is a fast-growing Systems Integrator based in Princeton, New Jersey. We provide strategic IT solutions and services with primary practice areas in Java and Microsoft centric e-Business solutions, ERP solutions, Enterprise Application Integration, Data Warehousing and Bu

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Full-time

Depends on Experience

Senior Claims Platform SME – Advisory & Strategy

Remote

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6d ago

Key ResponsibilitiesProvide strategic advisory on claims platform transformation and modernization initiativesLead platform assessments, gap analysis, and optimization roadmapsDrive end-to-end claims lifecycle improvements (Enrollment, Benefits, Claims, Provider, Payment)Define enterprise architecture and integration strategy across claims ecosystemGuide platform migrations and upgrades (Facets/QNXT/HealthEdge/Diamond/Xcelys/ika)Partner with business leadership to align IT capabilities with paye

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Contract

60 - 70

Medical Claims Auditor (Remote - Texas)

Remote or Dallas, Texas

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Today

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 The Medical Claims Auditor is responsible for reviewing and analyzing medical claims to ensure accuracy, compliance, and adhere

Full-time

USD 30,500.00 - 42,500.00 per year

Medical Claims Auditor (Remote - Texas)

Remote or Austin, Texas

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Today

Full-time

USD 30,500.00 - 42,500.00 per year

Medical Claims Auditor (Remote - Texas)

Remote or Houston, Texas

•

Today

Full-time

USD 30,500.00 - 42,500.00 per year

Salesforce Business Architect/Delivery Lead - Claims

Remote or Miami, Florida

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Today

Job Description We Are: Accenture's Salesforce practice, and we live to see what this platform can do. Since we were one of the first on the scene, we're the largest global Salesforce practice, not to mention one of the best. In fact, we are the industry-leader for building Salesforce solutions, and we are Master Certified in all 12 industries and clouds. We use tech like Lightning, Einstein, and Bolt to build stronger, better relationships with customers. And we are always learning. We're bui

Full-time

USD 132,500.00 - 302,400.00 per year

IT Project Manager (Claims Platform Implementation) - Remote (West Coast preference)

Remote

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Today

IT Project Manager (Claims Platform Implementation) Primary Location: Remote V-Soft Consulting is currently hiring IT Project Manager (Claims Platform Implementation) our premier client in Remote. Education and Experience 8+ years of IT Project or Program Management experience leading large-scale healthcare systems implementations. Deep expertise in implementing or upgrading core claims platforms (QNXT strongly preferred). This includes a strong understanding of claims adjudication systems/wo

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Contract

Depends on Experience

Lead Director - Software Engineering - Commercial Claims

Remote or Irving, Texas

•

Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary: The Lead Director of Software Engineer

Full-time

USD 144,200.00 - 288,400.00 per year

Senior Product Manager Claims Technology & AI Solutions

Remote

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21d ago

Title: Senior Product Manager Claims Technology & AI Solutions Location: Remote Duration: 6 Months+ can be extendable Domain/Industry: Preferably Insurance Type: Contract Key Responsibilities: Drive product vision, strategy, and execution for claims-focused technology solutions.Partner with engineering and business leadership to design scalable, AI-powered products.Simplify complex claims processes into user-friendly digital workflows.Define and manage product roadmaps, prioritize features, and

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Contract, Third Party

$75 - $80

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