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Yesterday

Claims Reimbursement Analyst 100% Remote Job Title: Claims Reimbursement Analyst Location: 100% Remote Job Type: Contract / Full-Time Job Summary: We are seeking a detail-oriented Claims Reimbursement Analyst to support claims processing, reimbursement analysis, and payment accuracy initiatives. The ideal candidate will have strong experience working with healthcare claims, payer systems, reimbursement methodologies, and data analysis within a healthcare environment. Responsibilities: Ana

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Contract, Third Party

$20 - $26

Claims Reimbursement Analyst

Remote

•

Today

Claims Reimbursement Analyst Remote initially hybrid after 12 months 12 Months Denver/CO We are looking for a Claims Reimbursement Analyst for a Denver-based health plan client. This is a 12-month contract with potential to convert to full-time. The role focuses on complex Medicare reimbursement policy and claims adjudication not basic fee-for-service review. Ideal candidates have hands-on experience with Medicare reimbursement methodologies, can manually price claims without a tool, and can cl

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Contract, Third Party

Claims Reimbursement Analyst

Hybrid in Denver, Colorado

•

Yesterday

Job Title:Claims Reimbursement Analyst Location: Denver CO Mode:hybrid with 2-3 days on-site per week Duration: 12-month contract Job Description: The role focuses on complex Medicare reimbursement policy and claims adjudication not basic fee-for-service review. Ideal candidates have hands-on experience with Medicare reimbursement methodologies, can manually price claims without a tool. Can clearly explain reimbursement concepts to non-technical stakeholders. Thanks & Regards. Kirti Singh VOT

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Contract

20 - 24

Claims Reimbursement Analyst

Hybrid in Denver, Colorado

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Yesterday

Role: Claims Reimbursement Analyst Location:Hybrid Denver co (Local candidates only) Duration:12-month contract Mode of Interview: Skype Candidate Prescreening Questions: Walk me through how you would manually price a complex Medicare claim without a tool.Which of the following have you worked with hands-on: DRG, OPPS, APC, site-neutral, No Surprises Act, EAPG, MAC pricing, per diems, LTAC?Have you ever interpreted CMS guidance or transmittals independently to determine how a claim should pay?

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Contract

25 - 26

EPIC Resolute Certified - Claims Applications Analyst - REMOTE

Remote

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17d 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

QA Test Engineer with Medicaid and Claims - Remote

Remote

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9d ago

Should have strong MMIS health care domain experience and should have good knowledge of Medicaid and Medicare. Should have hands-on experience on claims processing and Adjudication processes. Must have good experience in Reference code/data sets required in Claims adjudication. Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems. In depth understanding of Claims and Claims lifecycleClaim System: Testing knowledge and E2E Tes

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Contract, Third Party

Depends on Experience

Sr. Epic Professional billing and claims analyst

Remote

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Today

Job Title: Sr. Epic Professional billing and claims analyst Location: Fully remote Duration: 6 month contract Interview: Video Need genuine submission . Please check candidate should not be submitted prior to K-Force Please ask if they have been submitted to by anyone else UnityPoint areseeking a Senior Epic Professional Billing & Claims Analyst consultantto provide remote support for tickets and project-based workduring an active implementation and post-go-live period. This role will help ma

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Contract, Third Party

Depends on Experience

Sr. Pharmacy Claims Analyst

Remote

•

Yesterday

Position: Senior Pharmacy Claims Analyst Location: Remote Duration: 3 Months Contract-to-Hire Potential About the Role: We are seeking a Senior Pharmacy Claims Analyst with deep, hands-on expertise in prior authorization (PA) and the end-to-end drug approval lifecycle. In this role you will own the analysis and adjudication review of pharmacy claims from the point of submission by covered entities through to final approval or denial, including the management of clinically appropriate drug subst

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Contract

Depends on Experience

Claims Resolution Analyst Remote-Vermont

Remote or Burlington, Vermont

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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 Claims Resolution Analyst is responsible for reviewing and researching suspended claims, identifying and resolving issues a

Full-time

USD 35,000.00 - 50,000.00 per year

Medical Claims Processor, Xcelys, Remote

Remote

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10d ago

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our companys growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. For more than 25 years,NTT DATA Serviceshave focused on impacting the core of your business operations with industry-leading outsourcing ser

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Contract

Depends on Experience

Technical Business Analyst with Claims Module experience- Remote

Remote

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15d ago

Minimum of 8+ years of experience in health care experience especially in MMIS domain.In depth understanding of Claims and Claims lifecycle:Claim submission Paper and EDI X12Adjudication Payment Cycle (Finance)ReportingEncounters and CapitationEDI X12 formats like837P/I/DX12 formats 835,834,270/271,276/277Familiarity with systems like CMdS, GHS, Facets and etcAbility to validate Test scenarios and test plans, test data.SQL: To validate data in backend tables (e.g., claim status, payment details

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Third Party, Contract

$55

Supervisor Operations - Claims Processing | 40% Remote

Hybrid in Philadelphia, Pennsylvania

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6d ago

Job Title: Supervisor of Operations Claims Processing Philadelphia, PA 19103 Contract-to-Hire | Will convert to full-time in 3 months Pay rate: $40/HR - W2 TheSupervisor of Operations Offshore Vendor Oversightis responsible for the day-to-day operational oversight, performance management, and quality assurance of an offshore claims processing vendor supporting Independences Claims Processing operations. This role ensures that all vendor-managed functions are completed promptly, accurately, p

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Contract

Depends on Experience

Claims Recovery Analyst - On-site Montgomery, AL

Montgomery, Alabama

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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 32,700.00 - 46,700.00 per year

Warranty Claims Adjuster

Peoria, Illinois

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8d ago

Avanciers are hiring an experienced Warranty Claims Adjudicator with strong background in Property & Casualty claims and warranty administration for heavy machinery/construction equipment. Requirements7+ years of warranty claims adjuster experienceExperience with heavy equipment, engines, and component failuresActive Adjuster License in 23 U.S. states (willing to obtain all 50 states)Strong knowledge of warranty claims validation and adjudicationExperience reviewing repair orders, service record

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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

Claims UAT Tester

New York, New York

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Today

Job DescriptionJob Title : Claims UAT Tester Location : 50 Water St #7, New York, NY 10004 Duration : 2+ Months Contract Education : Bachelor s degree or 8+ years related work experience post high school.5+ years of information technology quality assurance and systems/application testing experience Shift Details : M-F 9am - 5pm, 35hrs/week Job Description: Claims UAT is the last stage of the testing process prior to production move. The claims UAT Tester is the primary Claims Tester to validate

Full-time

Application Claims Architect – Claims IVR & Amazon Connect

Remote or Hybrid in Phoenix, Arizona

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7d ago

Application Claims Architect Claims IVR & Amazon ConnectRole SummaryThe Application Claims Architectis responsible for designing and governing the endtoend Claims IVR architectureon Amazon Connect, ensuring seamless integration with existing Claims systems, compliant handling of customer data, and a scalable, modernized customer experience. This role bridges IVR modernization, lightweight AI/Virtual Agent capabilities, and Claims application integration, while honoring the constraint of no new

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Contract

Depends on Experience

Insurance Claims Specialist

Cicero, Illinois

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Today

Stable, growing Insurance company with terrific career growth, benefits, team seeks dedicated Insurance Claims Specialist to join - Hybrid role! This Jobot Job is hosted by: Catherine Reid Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $80,000 - $100,000 per year A bit about us: We are a well-established, growing insurance company offering a great team, hybrid work environment, long-term stability and excellent career growth opportunities!

Full-time

USD 80,000.00 - 100,000.00 per year

Workers Comp Claims Adjuster - Contract - HYBRID

Bernards, New Jersey

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Today

Contract role - Full Health Benefits - Hybrid Schedule This Jobot Consulting Job is hosted by: Billy Mewton Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume. Salary: $32 - $36 per hour A bit about us: Our client, a leading insurance carrier / TPA, is seeking an experienced Workers' Compensation Claims Adjuster for a contract assignment. This role is responsible for managing a caseload of workers' compensation claims from inception through resolution,

Contract

USD 32.00 - 36.00 per hour

Senior AI Software Engineer, Risk - Insurance Claims Management

San Francisco, California

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Today

At Lyft, our mission is to improve people's lives with the world's best transportation. To accomplish this, we start with our community by creating an open, inclusive, and diverse organization. About the Team The Risk Tech engineering organization is committed to tangibly reducing accident frequency, saving lives, and managing costs to enhance the safety and affordability of rides. Claim Management is a core financial function for Lyft. Each claim touches complex workflows, multiple stakehold

Full-time

USD 148,000.00 - 185,000.00 per year

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