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Claims Examiner - Workers Compensation - W2 Only

Apidel Technologies

Remote • 17d ago

Easy Apply

Contract

52 - 56

Claims Examiner - Workers Compensation W2 Only

Apidel Technologies

Remote • 17d ago

Easy Apply

Contract

48 - 52

Workers Compensation Claims Examiner - W2 Only

Apidel Technologies

Remote • 17d ago

Easy Apply

Contract

50 - 54

Claims Examiner :: Auto - W2 only

Apidel Technologies

Irving, Texas • 17d ago

Easy Apply

Contract

Case Manager (LTD/IDI Claims)

BOTG LLC

Remote • 23d ago

Easy Apply

Contract

$45 - $50

Technical Claims Specialist

SANS

Hybrid in New York, New York • 17d ago

Easy Apply

Contract

$60 - $80

Claims Technical Specialist

SANS

Remote • Today

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Contract

Depends on Experience

Claims Tester

Spar Information Systems

Remote • Today

Easy Apply

Contract

Physician ED Claims (Remote)

Pacific Consultancy Services

Remote • 10d ago

Easy Apply

Third Party, Contract

Depends on Experience

Snowflake Data Architect - Healthcare Claims, Remote - 69687

PRIMUS Global Services Inc.

Remote • Today

Easy Apply

Contract

$65.00 - 70.00

Annuity Claims Specialist

SynergisticIT

Remote • 8d ago

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Contract

$40 - $45

Technical Project Manager - Healthcare (Claims, Benefits & Membership)

CIS Technologies Inc.

Remote • 3d ago

Easy Apply

Contract

Depends on Experience

Claims Adjuster - General Liability

Apidel Technologies

Remote • 10d ago

Easy Apply

Contract

40 - 44

Business Systems Analyst Healthcare Benefits & Claims

K-Tek Resourcing LLC

Remote • 2d ago

Easy Apply

Contract

45 - 47

Business Analyst — CMdS Claims, Member & Finance Implementation (MES)

Group Nine

Remote • 4d ago

Easy Apply

Third Party, Contract

Depends on Experience

Business Analyst - Medicaid and Claims -Remote with Travel

The Dignify Solutions, LLC

Remote • Today

Easy Apply

Third Party, Contract

Depends on Experience

Epic Tapestry Consultant - Claims Connect

Codeforce 360

Remote • Today

Easy Apply

Third Party, Contract

$75 - $78

Business Systems Analyst With Healthcare Claims

Talent Groups

Minneapolis, Minnesota • 7d ago

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Contract

Depends on Experience

Healthcare Claims Analyst- ONSITE

Vega Consulting Solutions

Baltimore, Maryland • Today

Easy Apply

Contract

Depends on Experience

*Senior Contracts & Claims Manager*

Kellton

Portsmouth, New Hampshire • 4d ago

Easy Apply

Contract

Depends on Experience

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

EvolutionIQ

Remote or New York, New York • Today

Full-time

Sr Epic Resolute (Billing & Claims) Certified Analyst

UNC Health Care

Morrisville, North Carolina • Today

Full-time

Compensation information provided in the description

Sr Epic Resolute (Billing & Claims) Certified Analyst

UNC Health Care

Morrisville, North Carolina • Today

Full-time

Compensation information provided in the description

Quality Engineer (medical claims) - C2H

Javen Technologies, Inc

Eagan, Minnesota • Yesterday

Easy Apply

Contract

Depends on Experience

Healthcare Project Manager - (FACETS Claims Systems)

System One

Hybrid in Baltimore, Maryland • 21d ago

Easy Apply

Contract

$55

VP, Claims Transformation Initiative Lead

Chubb

New York, New York • Yesterday

Full-time

USD 220,000.00 - 260,000.00 per year

Claims AI Business Analyst IV

CareSource

Remote or Dayton, Ohio • Today

Full-time

USD 94,100.00 - 164,800.00 per year

Authorizations and Claims Analytics Solutions and Data Analyst III

LA Care Health Plan

Los Angeles, California • Today

Full-time

USD 102,183.00 per year

Staff Product Manager, Claims Experience

Coalition, Inc.

New York, New York • Yesterday

Full-time

USD 155,000.00 per year

Claims Transformation Domain Lead

Chubb

Hoboken, New Jersey • Yesterday

Full-time

USD 180,000.00 - 275,000.00 per year

Job Details

Skills

Claims Management
Insurance
Litigation
Workers Compensation
claims
Injury
Payments
Negotiations
Medicare
Customer Relationship Management (CRM)

Summary

Position: Claims Examiner - Workers Compensation - W2 Only

Duration: 03 Months of Contract with possible extension or conversion

Pay Range: $52/hr to $56/hr on W2 (without Benefits)

Requirements:

Only Ex-Sedgwick candidates
Any specific skill/ certification/ license: CA adjuster certification
Years of experience: 3+ years of relevant 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 practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

Essential Functions and Responsibilities:

Analyzes and processes complex or technically difficult workers'' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
Ensures claim files are properly documented and claims coding is correct.
Refers cases as appropriate to supervisor and management.

Additional Functions and Responsibilities

Performs other duties as assigned.
Supports the organization''s quality program(s).
Travels as required.

Education & Licensing

Bachelor''s degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.

Experience:

Five (5) years of claims management experience or equivalent combination of education and experience required.

Skills & Knowledge

Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 10509960
Position Id: SED9722
Posted 29 days ago

Fitment

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Sohel Contractor

Talent Acquisition Specialist @ Apidel Technologies

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Remote

•

17d 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

Easy Apply

Contract

48 - 52

Workers Compensation Claims Examiner - W2 Only

Remote

•

17d 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

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

Billing Specialist w/ VACCN Experience

Remote

•

2d ago

Billing Specialist w/ VACCN Experience (Remote, Contract) Our client, a premier healthcare services provider, is seeking an experienced Billing Specialist on a part-time basis with direct knowledge of Optum Veterans Affairs Community Care Network (VACCN) billing. The successful applicant must understand the VA Community Care claims process and be capable of investigating, correcting and recovering unpaid or denied behavioral healthcare claims. Type: Contract, Remote Start: August 2026 Positio

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Contract

Up to 27