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Medical Claims Processor, Xcelys, Remote

Remote

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Today

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

Director of Claims

Hybrid in Hopkins, Minnesota

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Today

Job Title:Director Of Claims Location: Eden Prairie, MN (Hybrid) Salary:$ 110,000-140,000annually PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.ESSENTIAL RESPONSIBLITIES MAY INCLUDEResponsible for overall operations management for all assigned locations/offices.Establishes policy and procedures to assure compliance to best practices, claims manageme

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Full-time

110,000 - 140000

Claims Analyst

Pierre, South Dakota

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25d ago

Job Title: Claims Analyst Work Location & Mode: Pierre, SD, Onsite Duration: 36 months, Job Description & Responsibilities The role involves augmenting staff for data entry, processing, and verification of medical services records. Technical Skills & Qualifications Qualified candidates must demonstrate the following: System Proficiency: Thorough familiarity with Datacap, Provider Enrollment Portal, and File Director. Claims Knowledge: Understanding of claims documents, specifically CMS-1500 an

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Full-time

$40 - $50

Claims Processing Specialist

Rancho Cordova, California

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13d ago

Claims Processing SpecialistLocation:Rancho Cordova, CA (onsite)Contract : 3+ Month (potential to extend)Work Schedule (Shift/Work Hours):6-2:30 or 7-3:30, M-F Job Description:The Claims Processing Specialist identifies and provides solutions for processing unique claims, refunds, overpayments, and underpayments. Other duties include processing special claims which may involve manual review of actual treatment compared to authorized treatment, and adjudicating VA CCN claims. ESSENTIAL DUTIESPerf

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Contract

Depends on Experience

Claims Operations Analyst

San Antonio, Texas

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Today

Job Title: Claims Operations Analyst Location: San Antonio, TX: 9800 Fredericksburg Rd,78288 (Onsite)Duration: 7-month contract (05/04/2026 12/31/2026)Schedule: Monday Friday, 40 hours/week Position Overview We are seeking detail-oriented Insurance Operations Analysts to support back-office functions within a claims-focused environment. This role will focus on ensuring accuracy, compliance, and quality across claims processing, underwriting support, and policy servicing activities. The ideal can

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Contract

USD0 - USD0

EPIC Resolute Certified - Claims Applications Analyst - REMOTE

Remote

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7d 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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5d 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 Testing:

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Third Party, Contract

$50 - $55

Guidewire Claims QA Automation | independent

Hybrid in Erie, Pennsylvania

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Today

Guidewire Claims QA Automation Location: Erie, PA (Day 1 Complete Onsite) Duration: Long Term Skills: Bachelors degree in computer science, Information Technology, or related field. Minimum 5+ years of experience in testing Guidewire Claim Center Configuration and Insurance Suite applications (Policy Center, Billing Center, Contact Manager) Integration implementations. Strong understanding of P&C insurance, including both Personal Lines and Commercial Lines. Experience in Claims creation, FNOLs

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Contract

Depends on Experience

Project Manager - PBM - PMP - Claims / Medicare - Medicaid

Remote

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22d ago

PBM is a must. Pharmacy or Health PlansClient PortalsProvider Network Management and/or Clinical Programs. Claims Adjudication is always a plus.

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Contract

$60+

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

Senior AI Software Engineer, Risk - Insurance Claims Management

San Francisco, California

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Today

Full-time

USD 148,000.00 - 185,000.00 per year

Sr. Analyst - PBM - Claims / formulary adjudicator - Healthcare - Medicaid

Remote

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22d ago

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

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Contract

$50+

Medical Claims Auditor (Remote - Texas)

Remote or Dallas, Texas

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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 Medical Claims Auditor is responsible for reviewing and analyzing medical claims to ensure accuracy, compliance, and adhere

Full-time

USD 50,000.00 - 55,000.00 per year

Medical Claims Auditor (Remote - Texas)

Remote or Austin, Texas

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Today

Full-time

USD 50,000.00 - 55,000.00 per year

Medical Claims Auditor (Remote - Texas)

Remote or Houston, Texas

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Today

Full-time

USD 50,000.00 - 55,000.00 per year

Business Analyst - Medical Claims Processing | Contract-to-Hire | Philadelphia - Hybrid

Philadelphia, Pennsylvania

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6d ago

Job Title: Business Analyst AHA Philadelphia, PA 19103 - Hybrid 0(Tues, Wed, Thurs in office / Mon, Fri remote) Contract-to-Hire | Will convert to full-time in 3 months Pay rate: $45/HR - $52/HR W2 (negotiable) Job Description Seeking strong Business Analyst to support claims daily operations. This support will assist to move forward resolution of operational challenges, improve current processes and support project management initiatives. You will work closely with other team members and cros

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Contract

Depends on Experience

LTD Claims Consultant - PART TIME

Tampa, Florida

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Today

Software Guidance & Assistance, Inc., (SGA), is searching for an LTD Claims Consultant - PART TIME for a CONTRACT assignment with one of our premier Insurance clients. This position is fully remote. The LTD Claim Consultant evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the LTD Claims Consultant is required to exercise independent judgment, critical thinking skills, exemplary customer service skil

Contract

USD 46.00 - 50.00 per hour

Senior Business Analyst - Healthcare Claims - MMIS

Indianapolis, Indiana

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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 Senior Business Analyst - Healthcare Claims - MMIS at Gainwell, you can contribute your skills as we harness the power of

Full-time

USD 69,400.00 - 99,200.00 per year

Advisor Barch Developer (UNIX/C/Claims)

Frankfort, Kentucky

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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 - 115,000.00 per year

Sr. Technical Lead - C/Unix Batch Development (Healthcare Claims)

Jackson, Mississippi

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Today

Full-time

USD 80,000.00 - 95,000.00 per year

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