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Los Angeles, California

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Today

Title: Senior Manager, Claims Adjustments Location: Los Angeles, CA Employment Type: Full Time (Onsite) Compensation: Pay Range: $117,509-$152,762 Per Year Job Summary: Join our team in Los Angeles, CA, as a full-time Senior Manager overseeing claims adjustments. This role involves managing complex workflows, ensuring compliance, and leading a team to drive performance. Strong expertise in claims processes and regulatory standards is essential. Key Responsibilities: Manage operational wo

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Full-time, Third Party

$117509 - $152762

Manager, Claims Compliance

Los Angeles, California

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Today

Title: Manager, Claims Compliance Location: Los Angeles, CA Employment Type: Full Time (Onsite) Compensation: Pay Range: $117,509-$152,762 Per Year Job Summary: Join our team in Los Angeles as a full-time Manager responsible for ensuring compliance in claims operations. This role involves regulatory interpretation, compliance monitoring, and the development of operational training. Proficiency in general technology tools is essential. Key Responsibilities: Ensure compliance with regulato

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Full-time, Third Party

$117509 - $152762

Senior Business Analyst Claims module

Remote

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22d 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

Sr Business analyst with healthcare claims(SME) MMIS

Remote

•

Today

1. Role: Senior Business Analyst Medicaid/MMIS SME (D04) Key Responsibilities Act as a Medicaid/MMIS SME across claims, eligibility, enrollment, and provider modulesLead requirements gathering, business process analysis, and documentation (BRDs, FRDs, user stories)Translate complex business needs into clear functional and technical requirementsCollaborate with stakeholders, product owners, and development teamsEnsure compliance with CMS guidelines, HIPAA, and state Medicaid regulationsSupport

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Full-time

$60,000 - $100,000

Director, Claims Administration

Los Angeles, California

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Today

Title: Director, Claims Administration Location: Los Angeles, CA Employment Type: Full Time (Onsite) Compensation: Pay Range: $135,136-$175,676 Per Year Job Summary: This role in Los Angeles, CA is a full-time, onsite position responsible for managing the claims administration process. The position involves leading a team, ensuring compliance with regulations, and utilizing general office software for reporting and data analysis. Key Responsibilities: Lead and manage the claims administra

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Full-time, Third Party

$135136 - $175676

Claims Representative - Liability W2 only

Remote

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22d 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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22d 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

Claims Examiner - Workers Compensation W2 Only

Remote

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11d 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 Business Consultant – Healthcare

Remote

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8d 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

Workers Compensation Claims Examiner - W2 Only

Remote

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10d 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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16d 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

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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

Epic HB Claims Analyst

Remote

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25d 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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Third Party, Contract

60 - 65

Principal Data ArchitectMicrosoft Fabric & Insurance Claims Modernization

Remote

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10d 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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Contract, Third Party

$0 - $0

Business Architect Expert - Telematics & Connected Claims - Remote

Remote or New York, New York

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6d 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

Director of Architecture for Agentic AI Claims Automation - Remote

Remote or Tempe, Arizona

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Today

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together. The Director

Full-time

USD 134,600.00 - 230,800.00 per year

Technical Analyst(RCM and Claims)

Remote

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23d 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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Contract, Third Party

Depends on Experience

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

Remote

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30+d 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+

Medical Claims Auditor (Remote - Texas)

Remote or Austin, 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 adheren

Full-time

USD 50,000.00 - 55,000.00 per year

Medical Claims Auditor (Remote - Texas)

Remote or Dallas, Texas

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Today

Full-time

USD 50,000.00 - 55,000.00 per year

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