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Today

Hello , My name isCharles PowellandI am a staffing Specialist atVoto Consulting LLC. I am reaching out to you on an exciting job opportunity with one of our clients. Job Title : Lead Copywriter w/ Digital Claims experience and P&C (Property and Casualty) - REQUIRED Location : Remote Duration : 12 Months Job Requirement: Develop concepts and write copy for a wide range of projects. Consult with sales and marketing representatives to obtain information on product or service and obtain requiremen

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Contract

60+

Claims Adjuster

Remote

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11d ago

Job Description, Day to Day, Education, Certification, etc.: Notes: Remote Job PURPOSE: Investigate and perform adjustment of claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines. Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit

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Third Party, Contract

Depends on Experience

Claims Adjuster

Hybrid in Baltimore, Maryland

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Today

Immediate position for a Claims Adjuster / Processor! The selected candidate will process claims AND investigate/perform adjustments of complex Healthcare (payor) claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines. The selected candidate will verify healthcare insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending cha

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Contract

22 - 25

Claims Domain Test Manager - Remote with limited travel

Remote

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8d ago

Claims Domain Test Manager Location: Atlanta, GA or remote with limited travel during critical phases 6+ months contract to Hire Play the role of Claims Domain test manager 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

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Third Party, Contract

Depends on Experience

Programmer Analyst - (Claims - Pharmacy / medical)

Remote

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15d ago

Medical Claims or Pharmacy claims or membership information. SQL Server and SQL writing Some recent experience with Data modeling & Data Warehousing (Any platform is ok, does not have to be snowflake) EDI transaction experience API integration into Data Warehouse with EDI 834 and 837.

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Contract

$50 - $60

Claims Examiner --Hybrid Role

Hybrid in Brea, California

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Yesterday

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 time

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Contract

Depends on Experience

Claims Project Manager

Remote

•

Yesterday

Job Title: Claims Project Manager Job Location: Remote / Home Based Description: AgreeYa is a global Systems Integrator and is seeking an experienced Claims Project Manager / Scrum Master to join our growing team. The ideal candidate will have a strong background in healthcare or insurance claims processing, project delivery, and Agile methodologies. This role requires dual responsibility as both a Project Manager and Scrum Master, leading large-scale platform modernization and transformation

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Contract

Depends on Experience

Physician Emergency Department Claims Reviewer

Remote

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Today

< data-start="65" data-end="90">Required Skills:Active US Physician license (MD/DO).35 years of recent clinical experience (within the last 23 years) in Emergency Department (ED) Medicine.Experience in Internal Medicine is also acceptable.Experience in Managed Care environments.Expertise in conducting clinical review of claims and UM authorization requests for medical necessity.Hands-on experience with Utilization Management (UM) case reviews.Knowledge of medical coding, including CPT and HCPCS

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Contract

Depends on Experience

Physician ED Claims Reviewer

Remote

•

Today

Required skills: Physician with an active US licensed with experience in with medical coding (CPT/HCPCS) and managed care to conduct clinical review of claims and UM authorization requests for clinical necessity.Minimum of recent (last 2-3 years) 3-5 clinical experience in emergency dept medicine, experience in internal medicine will be considered. Experience in managed care, clinical UM case reviews. Knowledge of claims and medical coding (CPT/HCPCS codes). Proficient working in various system

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Third Party, Contract

Depends on Experience

Project Manager (Healthcare Claims Domain)

East Hartford, Connecticut

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Today

Job Description Project Manager (Healthcare Claims Domain)Position: Project Manager (PM) Domain: Healthcare Claims Experience: 10+ Years Location: Hartford, CT Job SummaryWe are looking for an experienced Project Manager with strong Healthcare Claims domain expertise to lead and manage large-scale enterprise projects. The ideal candidate should have proven experience managing projects with budgets exceeding $3M and successfully delivering complex healthcare initiatives involving claims process

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Third Party, Contract

Depends on Experience

Customer Relationship Manager (Healthcare Claims)

Hybrid in Baltimore, Maryland

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6d ago

Job Title: Customer Relationship Manager (Healthcare Claims) Location: Baltimore, MD (Occasional Travel required) Duration: 6-12 Months+ Notes: Hybrid onsite (DMV locals only) Occasional Travel required PURPOSE: This position is a critical resource for large accounts within the Account Management Team providing day to day expertise on benefit administration and serves as the primary client contact for service issue resolution. Builds and cultivates effective long-term relationships and a

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Third Party, Contract

Depends on Experience

Project Manager Life Insurance Claims-Plano, TX- Only Locals

Hybrid in Plano, Texas

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Today

We are seeking an experienced Project Manager with Life Insurance Claims expertise to lead and deliver strategic initiatives across claims operations, process transformation, and technology implementations. Required Qualifications: Bachelor's degree in Business Administration, Information Systems, Finance, or a related field.8+ years of project management experience with at least 3+ years supporting Life Insurance Claims operations or related insurance domains.Strong understanding of life insura

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Contract

Depends on Experience

Senior Healthcare Business Analyst (Payer Claims / Medicare / Medicaid)

Remote

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4d ago

Job Title: Senior Healthcare Business Analyst (Payer Claims / Medicare / Medicaid)Location: [Remote]Employment Type: Full-Time Job DescriptionWe are seeking an experienced Senior Healthcare Business Analyst with extensive knowledge of the healthcare payer domain and strong expertise in commercial claims processing, Medicare, and Medicaid systems. The ideal candidate will serve as a liaison between business stakeholders and technical teams, driving requirements gathering, solution design, and su

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Full-time

$60,000 - $80,000

System Analyst - Medicaid Claims Processing/ Local to Austin, TX

Hybrid in Austin, Texas

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5d ago

Title: System Analyst 2 - 529601701 Location: Austin, TX/ Hybrid Duration: 4+ Month Position will be 3 days remote with 2 days (Mon & Tues) required to be onsite at the location listed above. **Subject to change per the hiring team** Program will only allow candidates who are LOCAL TO THE AUSTIN AREA ONLY (Within 50-mile radius). Understands business objectives and problems, identifies alternative solutions, performs studies and cost/benefit analysis of alternatives. Analyzes user requirements,

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Third Party, Contract

Depends on Experience

Data Scientist (Healthcare claims Must)(12+ Years) (C2H)

Hybrid in Altamonte Springs, Florida

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7d ago

Role: Data Scientist Exp: 12+ Years Location: Hybrid onsite in Altamonte Springs, FL Skills Required: Healthcare exp is a must- claims exp is a must. SQL is a must; Snowflake is preferred, traditionally python. A good understanding of statistics do they know how to prep, prepare, t test, regressions, squared models, someone who can help me apply a more academic rigor and make sure that we're not Lighter on the modeling side and heavy on the ML side.

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Contract

Depends on Experience

Healthcare Claims Operations Team Lead - Washington, DC (On-site)

Seattle, Washington

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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 As a Healthcare Claims Operations Team Lead at Gainwell, you will lead a team responsible for medical claims processing, resolut

Full-time

USD 50,000.00 - 55,000.00 per year

Business System Analyst with Medicaid Claims

Austin, Texas

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11d ago

Position: Business System Analyst with Medicaid ClaimsLocation: Austin, TX - OnsiteDuration: 12 MonthsJob Description:This position requires someone with 47 years of experience who can bridge the gap between non-technical business stakeholders and technical development teams throughout the Software Development Life Cycle. The ideal candidate will gather and document requirements, create use cases and process flows, perform testing, and ensure clear communication across all project stakeholders

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Contract, Third Party

60 - 65

Director of Claims - W2 only

Hybrid in Las Vegas, Nevada

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14d ago

Position: Director of Claims W2 Only Direct Hire role Location: Las Vegas, NV (Hybrid work schedule -3 days per week in office) Skills: Education & Licensing Bachelor''s degree from an accredited college or university preferred. CPCU, ARM, AIM, and/or AIC certifications preferred. Licenses as required.Experience: Ten (10) years claims management experience including three (3) years prior supervisory experience or equivalent combination of education and experience required.Skills & Knowledge: St

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Full-time

Depends on Experience

Experienced Claims Business Analyst

New York, New York

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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 86,800.00 - 124,000.00 per year

Senior AI Software Engineer, Risk - Insurance Claims Management

Seattle, Washington

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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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