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Naperville, Illinois

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Today

RESPONSIBILITIES: Kforce has a client in Naperville, IL that is seeking a Lead Product Manager - Claims. Responsibilities: * Define and execute a clear product vision for agent workflows across Claims platform, aligned to Customer Experience (CX), efficiency, and cost outcomes * Translate business goals into a prioritized, outcome-driven roadmap * Own customer and agent research for Claims experience and operate as the Voice of the Customer and the Agent * Identify and size customer, agent, and

Full-time

$100,000 - $120,000 annually

Sr. Analyst - PBM - claims adjudicator - Healthcare - Medicaid

Remote

•

Yesterday

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

Easy Apply

Contract

$50+

Claims Domain Test Lead

Remote

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22d ago

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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Contract, Third Party

$70 - $75

Senior Systems Analyst (Epic Resolute Billing, Claims & Remittance) | Open for remote for the consultants who are in PST time zone

Remote

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Today

Tranzeal is an industry leading global Business Transformation Service Provider offering specific consulting services as well as prepackaged, industry specific solutions and services to companies around the world. Our Consulting Services are dedicated to helping our clients maximize their investments in IT and the overall effectiveness and efficiency of the business. Tranzeal s deep industry experience makes us the partner of choice for a growing number of Fortune 1000 companies, midsize enterpr

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Contract, Third Party

Depends on Experience

Disability Case Manager / Disability Claims Specialist

Remote

•

Today

Job Title: Disability Case Manager / Disability Claims Specialist OverviewWe are seeking a detail-oriented and analytical Disability Case Manager to manage end-to-end disability claims, including adjudication, benefit determination, and case management. This role involves reviewing medical documentation, interpreting disability plans, and collaborating with clinical and vocational resources to support claimants and facilitate return-to-work outcomes. Key ResponsibilitiesManage disability claims

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Contract

Depends on Experience

Epic Resolute Professional Billing Claims Remittance

Remote

•

Today

Title- Senior Systems Analyst (Application Analyst - Epic Resolute Professional Billing & Claims and Remittance) Location- Oakland, CA/Hybrid/Remote Job Description: Job Title: Application Analyst - Epic Resolute Professional Billing & Claims and Remittance Role Description: We are seeking a skilled and experienced Application Analyst with expertise in Epic Resolute, and Claims and Remittance modules to join our dynamic team. This Epic Applications Analyst plays a critical role in the implementa

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Contract

Depends on Experience

EPIC Resolute Certified - Claims Applications Analyst - REMOTE

Remote

•

Today

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

Epic Build Analyst Professional Billing (PB) Claims & Remittance

Remote

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2d ago

Job Title: Epic Build Analyst Professional Billing (PB) Claims & Remittance Duration: 6 Months Location: Remote Epic Build Analyst Professional Billing (PB) Claims & Remittance Principal Duties: Epic analyst certified in PB Claims and Remittance, must have extensive experience building payor/plans in Epic. Analyst will be covering support duties, assisting with upgrades, testing, tickets, and maintenance. Coordination with FTE's and operations, along with coordination from other applications as

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Contract

Depends on Experience

Healthcare QA Analyst for Payment Integrity and Claims Repricing.

Remote

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2d ago

Our direct client is looking for QA Analyst Payment Integrity and Claims Repricing. Location: Remote, CTH after 6 months Please send me your rate, contact details and current location. Key Responsibilities Claims Repricing Validation Validate claim repricing based on:Provider contractsFee schedules (CPT/HCPCS based)DRG/APC logicPercentage of billed chargesMedicare-based pricingVerify allowed amount, patient responsibility, and payer liability calculations.Test in-network vs out-of-network pric

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Contract

Depends on Experience

Epic HB / PB Claims Applications Analyst ** Remote Acceptable **

Remote

•

Today

Overview: Our client, a Medical Center facility under the aegis of a California Public Ivy university and one of largest health delivery systems in California, seeks accomplished Epic HB / PB Claims Applications Analyst. Candidate must be authorized to work in USA without requiring sponsorship Location: San Francisco, CA (Remote Acceptable) Duration: 13 weeks contract w/ possibility of extension Notes: Candidate must work 8:00am 5:00pm Pacific Time business hours. Description: Involves the

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Contract

Depends on Experience

Claims Examiner - Workers Compensation - W2 Only

Remote

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5d ago

Position: Claims Examiner - Workers Compensation - W2 Only Location: Remote in California Pay Range: $48/hr to $53/hr on W2. Required Skills: SIP is mandatory5+ years of relevant California Workers Compensation experience Primary Purpose: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best p

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Contract

$48 - $53

Senior Systems Analyst (Application Analyst - Epic Resolute Professional Billing & Claims

Remote

•

Today

Title- Senior Systems Analyst (Application Analyst - Epic Resolute Professional Billing & Claims and Remittance) Location - Oakland, CA Highly Preferred Candidates working Remotely must be from the PST Timezone. Role Description: We are seeking a skilled and experienced Application Analyst with expertise in Epic Resolute, and Claims and Remittance modules to join our dynamic team. This Epic Applications Analyst plays a critical role in the implementation and installation of Epic applications, m

Easy Apply

Contract

$80 - $90

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.

Easy Apply

Contract

$60+

Epic Tapestry UM Application Support Engineer - 6068187

Remote or Chicago, Illinois

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Today

Accenture Flex offers you the flexibility of local fixed-duration project-based work powered by Accenture, a leading global professional services company. Accenture is consistently recognized on FORTUNE's 100 Best Companies to Work For and Diversity Inc's Top 50 Companies For Diversity lists. As an Accenture Flex employee, you will apply your skills and experience to help drive business transformation for leading organizations and communities. In addition to delivering innovative solutions for

Full-time

USD 47.85 - 57.85 per hour

Lead AI & Machine Learning Engineer - IntelliScript (Remote)

Remote or Brookfield, Wisconsin

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Today

What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging from actuarial science to information technology to clinical practice. Together, we develop and deploy category-defining, data-driven, software-as-a-service (SaaS) products for a broad spectrum of insurance, health IT and life sciences clients. We are a business unit within Milliman, Inc., a respected consultancy with offices around the world. Candidates who have their pick of jobs are drawn to IntelliScript'

Full-time

USD 147,400.00 - 279,680.00 per year

Senior AI & Machine Learning Engineer - IntelliScript (Remote)

Remote or Brookfield, Wisconsin

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Today

Full-time

USD 117,500.00 - 222,985.00 per year

Manager, Product Research - IntelliScript (Remote)

Remote or Brookfield, Wisconsin

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Today

What We Do Milliman IntelliScript is a group of a few hundred experts in fields ranging from actuarial science to information technology to clinical practice. Together, we develop and deploy category-defining, data-driven, software-as-a-service (SaaS) products for a broad spectrum of insurance clients. We're a business unit within Milliman, Inc., a respected consultancy with offices around the world. Candidates who have their pick of jobs are drawn to IntelliScript's entrepreneurial and collabor

Full-time

USD 93,700.00 - 177,675.00 per year

Claims Examiner

Park Ridge, Illinois

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Today

Job Description: Established nearly two centuries ago, FM is a leading mutual insurance company whose capital, scientific research capability and engineering expertise are solely dedicated to property risk management and the resilience of its policyholder-owners. These owners, who share the belief that the majority of property loss is preventable, represent many of the world?s largest organizations, including one of every four Fortune 500 companies. They work with FM to better understand the haz

Full-time

Claims Examiner

Park Ridge, Illinois

•

Today

Full-time

Regional Safety Supervisor

Skokie, Illinois

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Today

Midland Manufacturing, part of OPW, a Dover Company is a leader in the rail tank car valves and fittings industry. Our innovative rail products are manufactured and engineered for the safe and efficient loading, transporting,andunloading of hazardous and non-hazardous bulk products. For over 125 years, OPW has led the way in designing and manufacturing world-class retail fueling, fluid handling and car wash system solutions for the safe and efficient handling and distribution of fuels and criti

Full-time

Compensation information provided in the description

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