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Hybrid in Lake Mary, Florida

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Today

Job Description - Claims Center Business Analyst must be local to lake mary, FL What You Can Expect as a Business Analyst II: * Work with major functional areas of the business to understand and document change requests submitted to the IT organization * Demonstrate knowledge of integrations with internal and external applications; Research dependencies and collaborate with solution architects and developers on system design plans * Review and analyze how changes to business processes and/or bus

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Contract

$40 - $50

Claims Center BA

Lake Mary, Florida

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Today

RESPONSIBILITIES: Kforce has a client that is seeking a Claims Center Business Analyst in Lake Mary, FL. What You Can Expect as a Business Analyst II: * Work with major functional areas of the business to understand and document change requests submitted to the IT organization * Demonstrate knowledge of integrations with internal and external applications; Research dependencies and collaborate with solution architects and developers on system design plans * Review and analyze how changes to bus

Contract, Third Party

$50 - $70 hourly

Sr. Analyst - PBM - Claims / formulary adjudicator - Healthcare - Medicaid

Remote

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10d ago

PBM experience Agile Healthcare Government programs, compliance, or Medicare. NCPDP 4 year degree is required (must be achieved) claims adjudicator integration understanding with strong business and technical acumen

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Contract

$50+

SAP Consultant Warranty Claims

Remote

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27d ago

Job Description: We are looking for an experienced SAP Warranty Claims Consultant with 13+ years of SAP experience and a dedicated focus on Warranty Claims processing within SAP CS/SM/WTY for a leading global heavy equipment and construction manufacturing client. This is a warranty claims-focused role not a general service management or vendor management position. The ideal candidate must have deep, hands-on expertise in both Customer Claims (IC/OC) and Vendor Claims (OV/IV) processing, with a

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Third Party, Contract

Depends on Experience

Senior Claims Technical Specialist - Financial Lines

Remote

•

Today

Job Title: Senior Claims Technical Specialist - Financial Lines Location: This can be onsite (NYC, Chicago, or Plano, Texas) or remote, but there would be some travel expectations for mediations, settlement conferences, etc. Duration: 12+ Months Senior Claims Technical Specialistspecifically need staff familiar with Architects' and Engineers' Errors and Omissions claims. (This is must-have.) Job Summary:The purpose of this role is to oversee the examination, evaluation, and processing of comple

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Third Party, Contract

Depends on Experience

GW Claims Developer

Remote

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8d ago

Role : GW Claims Developer Location : Remote Type : Contract Software engineer who already understands Guidewire at a deeper levelspecifically, the underlying designs and how different integration patterns are applied. The ideal candidate should be comfortable working across both real-time and asynchronous integrations, Configuration understand the trade-offs of each approach, and be able to apply broader software development and integration best practices in a Guidewire context. Teks

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Contract, Third Party

Depends on Experience

EPIC Resolute Certified - Claims Applications Analyst - REMOTE

Remote

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27d ago

Bachelor's degree in health care information technology, computer science, or related area, and / or equivalent combination of experience / training. 5 7 years related clinical applications experience or equivalent combination of education, training and experience. Please verify any certificates and/or licenses required for the position: Epic Resolute HB or PB Claims and Remittance Admin certification. Job Function: Involves the design, building, testing, and implementation of clinical applicati

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Contract

$80 - $100

Claims Representative

Remote

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6d ago

Job Description: Looking for a motivated and detail-oriented Claims Representative to support our client in handling and processing insurance claims. This is a remote opportunity ideal for candidates with strong communication skills and a customer-focused mindset. Key Responsibilities: Review and process incoming insurance claims accurately and efficiently Communicate with customers, policyholders, and third parties to gather required information Verify claim details and ensure compliance with c

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Contract

Depends on Experience

Senior Majesco Configurator (Policy / Billing / Claims) (Remote)

Remote

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15d ago

Job Role: Senior Majesco Configurator (Policy / Billing / Claims) Location: Canada/USA- Remote Exp. Start date: 1st Week of May Duration: 6+ Months Year of Experience: 8-12 Years Role Summary Looking for a hands-on Majesco Configurator with deep expertise in configuring Policy, Billing, or Claims modules. Key Responsibilities Configure Majesco modules based on business requirements Work closely with business and BA teams for requirement analysis Perform product configuration, rule setup

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Contract, Third Party

$75 - $80

Project Manager - PBM - PMP - Claims / Medicare - Medicaid

Remote

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10d 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 Data Entry

Remote or Pierre, South Dakota

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Today

Data Entry, Processing, Review & Verification and Associated Tasks Location: Pierre, South Dakota Contract Duration: Key Responsibilities Perform data entry and processing of claims and related records Review and validate documentation for accuracy and completeness Utilize systems such as: Mainframe systems Datacap Provider Enrollment Portal File Director Verify data against multiple sources (manual and system-based validation) Work with claims documents including: CMS-1500 UB-04 (CMS-1450

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Contract, Third Party

Associate Business Process Services-Mailroom & Claims Team, Nevada / Remote

Remote or Las Vegas, Nevada

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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 As Associate Business Process Services-Mailroom & Claims Team, Nevada / Remote, you can contribute your skills as we harness th

Full-time

USD 35,000.00 - 58,500.00 per year

Claims Analyst (Enrollment & EDI)

Remote

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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 (Enrollment & EDI) Location:Baltimore, MD (Remote) Type:Contrac

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Contract

Depends on Experience

Senior Majesco Configurator (Policy / Billing / Claims) - SMC 26-04318

Remote

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Today

Job Title: Senior Majesco Configurator (Policy / Billing / Claims)Location: USA / Canada (Remote) Experience: 8 12 Years Role Summary We are seeking a skilled Senior Majesco Configurator with strong hands-on experience in configuring insurance platform modules such as Policy, Billing, or Claims. The ideal candidate will have deep domain knowledge and the ability to translate business requirements into effective system configurations. Key ResponsibilitiesConfigure Majesco modules based on busines

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Contract, Third Party

Depends on Experience

Life Insurance Claims Specialist

Remote

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8d ago

Our client, a major Life Insurance carrier is seeking a Life Insurance Claims Specialist for a long term (2 year minimum) contract position. This job can be worked remotely. The Life Insurance Claims Specialist will review contestable death claims, life insurance policy reinstatement requests, and evaluate Medical Information Bureau (MIB) inquiries for an existing book of business. Life Insurance Claims Specialist responsibilities include the following: Contestable claims review will require an

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Contract

$40 - $45

IFS Warranty/ Claims Consultant

Remote or Hybrid in Albany, New York

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Today

Vega Consulting is hiring! IFS Warranty/ Claims Consultant for a contract to hire job opportunity with our direct client located in Albany, N.Y. Travel to client site once a month to Albany, N.Y. Prefer Candidates that will convert to Full time employment. IFS Sales/Claims and Warranty Consultant will support implementation and optimization of IFS Applications across sales and warranty modules. This role involves aligning business requirements with IFS and CPQ capabilities, performing system con

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Contract

Depends on Experience

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

SAP Warranty Claims Consultant (S/4HANA | CS | SD | PM)

Remote

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Today

We are looking for an experienced SAP Warranty Claims Consultant with strong expertise in SAP S/4HANA and deep functional knowledge across Customer Service (CS), Sales & Distribution (SD), and Plant Maintenance (PM). The ideal candidate should have hands-on experience in SAP Warranty Claims Management, including end-to-end claims processing, entitlement checks, and settlement processes. Key ResponsibilitiesConfigure and support SAP Warranty Claims ManagementManage the complete warranty claim li

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Contract

Depends on Experience

Lead Data Scientist - Clinical Informatics (Claims Specialization)

Remote or New York

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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 CVS Health's Analytics & Behavior Chan

Full-time

USD 130,295.00 - 260,590.00 per year

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 50,000.00 - 55,000.00 per year

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