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Remote

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2d 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

Easy Apply

Contract

50 - 60

Healthcare Data Engineer with Enrollment & Claims Exp - 100% Remote (or )

Remote

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8d ago

Position: Healthcare Data Engineer with Enrollment & Claims Exp Location: Remote but candidate must be located and can work only from below states Approved states: Alabama Alaska Arizona Arkansas Florida Georgia Idaho Indiana Iowa Kansas Kentucky Louisiana Maine Michigan Minnesota Mississippi Missouri Nebraska New Mexico North Carolina North Dakota Ohio Oklahoma Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia West Virginia Wisconsin Wyoming

Easy Apply

Contract, Third Party

Depends on Experience

Senior Claims Platform SME – Advisory & Strategy

Remote

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2d 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

Easy Apply

Contract

60 - 70

Sr. Batch Developer (UNIX/LINIX/C/Pharmacy Claims)

Bridgeport, Connecticut

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Today

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have

Full-time

USD 100,000.00 - 120,000.00 per year

Claims Specialist - Hybrid

Hybrid in Phoenix, Arizona

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2d ago

Title: Claims Specialist - Hybrid Mandatory skills: claim processing, unclaimed property claims, program rules, regulations, policies, procedures, follow-up claimant interviews, investigations, notarized affidavits, powers of attorney, wills, trusts, contracts, court documents, corporate resolutions, minutes, Research records, reports, Approve payment of claims Description: This position performs unclaimed property work of considerable difficulty in the area of claim processing. The role is that

Easy Apply

Contract

16 - 18

Business Analyst - Medicaid Claims Processing

Springfield, Illinois

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8d ago

Business Analyst Medicaid Claims Processing Location: Springfield, IL About Us: Known for Delighting the Client through performance, innovation, and an employee-centric culture, S2Tech is a fast-growing IT consulting company serving clients in over a quarter of the United States. We are widely recognized as a leading provider of both technical and business services in support of Health and Human Services-related projects. Why S2Tech?: Stable, privately-owned company with a strong reputation for

Easy Apply

Full-time

Depends on Experience

Claims Domain Test Lead

Remote

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4d 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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Third Party, Contract

$70 - $75

Claims Tester

Remote

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3d ago

Job: Claims Tester Location: Remote(USA) Claims Tester: Responsible for claims testing for MMIS health care projects. Drive the test strategy and process, domain knowledge, perform 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, troubleshoot problems in the applica

Easy Apply

Contract, Third Party

$60 - $65

IT Healthcare Delivery Lead (Payer & Claims experience is must)

Detroit, Michigan

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9d ago

OpTech is seeking for strong IT Delivery Lead for their Direct Healthcare Client. Location - Detroit, MI (onsite) Candidates should reside within 1 hour of Metro Detroit Duration - 1 year. QUALIFICATIONS: Top Three Skills/Experience Manage project execution and IT delivery of healthcare payer projects, providing day-to-day project leadershipManage multiple work streams of IT project delivery including financial management via close coordination/cooperation with Business Leads and IT Technical L

Easy Apply

Contract

Depends on Experience

Senior Risk & Claims Manager - Onsite

York, Pennsylvania

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14d ago

Maxonic maintains a close and long-term relationship with our direct client. In support of their needs, we are looking for a Senior Risk & Claims Manager Job Description: Job Title: Senior Risk & Claims Manager Job Location: York, Pennsylvania Work Schedule: Onsite Pay Rate: $100/hr, Based on experience. Job Description: General Summary Provides risk management services to System entities. Evaluates the risk of financial or property losses and arranges for appropriate insurance coverage for su

Easy Apply

Contract

Depends on Experience

AR Claims Analyst

Remote

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24d 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

Easy Apply

Full-time

$40,000 - $50,000

Project Manager - PBM - PMP - Claims Adjudication

Remote

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2d 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 Build Analyst – Professional Billing (PB) Claims & Remittance

Remote

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3d 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

Easy Apply

Third Party, Contract

Depends on Experience

Data Analytic - Healthcare/Claims

Hybrid in Quincy, Massachusetts

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8d ago

Winner of the Best and Brightest Companies to Work for in Boston and in the Nation by the National Association for Business Resources (NABR) for the third consecutive year Payer Expertise, Analytics Depth, and Pipeline Responsibility Are you passionate about using data to drive real change in healthcare? Were looking for aHealthcare Data Analyst / Engineer to join our IT team and play a pivotal role in delivering accurate, high-quality demographic, eligibility, and claims data. In this role, you

Easy Apply

Full-time

80,000 - 110,000

Snowflake Architect with (EHR, Claims Data, Clinical Research Data)

Remote

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30+d ago

Job Title: Snowflake Architect with (EHR, Claims Data, Clinical Research Data & Healthcare or Life Sciences) Location: Fully Remote Position type: Long term Contract Rate: DOE Description:- Healthcare Data Ecosystems: 10+ years in IT with a focus on Electronic Health Records (EHRs), claims data, and clinical research data. Snowflake Implementations: 35+ years architecting multi-tenant Snowflake environments specifically for healthcare or life sciences. Compliance Leadership: Extensive exp

Easy Apply

Contract

60 - 65

Performance Tester (Medicare / healthcare claims systems)

Remote

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2d ago

We are seeking to hire a Performance Tester with experience in Medicare / healthcare claims environments to join our team working on a new multi-year award we have within a State Govt client, updating their Medicare/Medicaid claims systems. This role is 100% remote. Being a US Cit is required for working on this program. This position pays a strong salary package with full benefits (including choice of healthcare plans, dental, vision, life insurance, 3 weeks PTO, 11 Paid Federal Holidays, and

Easy Apply

Full-time

Depends on Experience

Workers Compensation Claims Adjuster

Birmingham, Alabama

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5d ago

Workers Compensation Claims Adjuster Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home United States Reporting To: Gregory Uditis Compensation: $72,000 - $82,000 / year Description Our Story Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America , we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part

Full-time

USD 72,000.00 - 82,000.00 per year

Intern - Tort Claims and Engineering Audit Support

New York, New York

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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

Senior Claims Manager

Seattle, Washington

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Today

Join Grange Insurance Association, a well-established leader in the insurance sector for over 130 years! Headquartered in the city of Seattle, with a footprint stretching across six Western states, we've been protecting families, farms, and businesses with unwavering commitment. As you embark on a fulfilling career with Grange, discover why our average employee tenure surpasses a decade. Make your mark with an organization that values quality, service, and the lasting impact you can bring! Posi

Full-time

USD 79,276.00 - 147,228.00 per year

Claims/Adjudication Tester/Validator-FACETS SQL-Hybrid

Hybrid in Elkridge, Maryland

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Yesterday

Job Description Our client is seeking a Claims Adjudication System Tester/Validator to join our clients Testing Department as an FTE employee. This position is responsible for developing system test plans, automated and manual test scripts, and test cases for functional and regression testing for health insurance claims processing systems and other support applications. Although this position is primarily remote, our client may request the selected candidate to come onsite, in the BWI Maryland a

Easy Apply

Full-time

90,000 - 93,000

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