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Remote

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Today

Hiring for Senior Business Analyst Location - Remote Senior Business Analyst Claims module: Play the role of Claims Domain lead for MMIS health care projects. Drive the claims module and process, domain knowledge, performs analysis of business requirements, designs and develops documentation, ensures quality process, coordinates with customers. Works in team environment and provides guidance throughout the entire life cycle. Responsible to meet customer expectations, troubleshoot problems in th

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Full-time

$60,000 - $80,000

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

Remote

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6d 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

Healthcare Business Analyst (Claims,Jira - Need Locals)

Hybrid in Eagan, Minnesota

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Today

If you are interested in below position, please send your resume. Title: Healthcare Business Analyst ( Claims, Jira ) Location: Eagan, MN (Hybrid) Duration : 6 + months (long term) Role Summary The Impact You Will Have Assist with the development of a flagship AI tool aimed at reducing the administrative burden of Case Managers in documentation and research, to allow them to practice at the top of their license and remain focused on member care. Responsibilities Lead and facilitate cross-functio

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Contract

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

Business Analyst (Healthcare Claims)

Remote

•

Yesterday

Job title : Business Analyst Location : Remote Employment Type : Fulltime Senior Business Analyst Claims module: Play the role of Claims Domain lead for MMIS health care projects. Drive the claims module and process, domain knowledge, performs analysis of business requirements, designs and develops documentation, ensures quality process, coordinates with customers. Works in team environment and provides guidance throughout the entire life cycle. Responsible to meet customer expectations, troub

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Full-time

Depends on Experience

Senior AI Software Engineer, Risk - Insurance Claims Management

Seattle, Washington

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2d ago

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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2d ago

Full-time

USD 148,000.00 - 185,000.00 per year

Sr. Manager, Claims Operations

New York, New York

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25d ago

About us Coalition is the world's first Active Insurance provider designed to help prevent digital risk before it strikes. Founded in 2017, Coalition combines comprehensive insurance coverage and innovative cybersecurity tools to help businesses manage and mitigate potential cyberattacks. Opportunities to make an impact with bold thinking are real-and happening daily at Coalition. About the role Coalition's Claims team is redefining how policyholders experience claims-combining technical excelle

Full-time

USD 126,000.00 per year

Senior Systems Analyst (Resolute Physician Billing & Claims)

Houston, Texas

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2d ago

Job Description We're searching for a Senior Systems Analyst (Resolute Physician Billing & Claims), someone who's ready to be part of the best ranked children's hospital in Texas, and among the best in the nation. The Senior Systems Analyst will play a crucial role in designing, building, testing, deploying, and supporting Epic applications to optimize clinical and operational workflows. This position requires a deep understanding of healthcare workflows, system integration, and project managem

Full-time

Claims Data Solutions Sr. Analyst

Lebanon, Pennsylvania

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17d ago

Job Description The Claims Data Solutions Sr. Analyst will report to VP, Claims Data Solutions and Insights. This is a crucial role to the delivery of claims operational and data transformation solutions. Primary Responsibilities: Bring a distinct data consumer prospective to ensure that business intelligence, operational metrics, modeling, analytics, and reporting requirements are effectively fulfilled. This encompasses a comprehensive understanding of how claims data flow into, within, and out

Full-time

USD 104,800.00 - 178,100.00 per year

Data & Reporting Senior Analyst, Claims Fraud & Recovery

Charlotte, North Carolina

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2d ago

Job Summary As a member of the Fraud and Recovery Analytics team, the Data & Reporting Senior Analyst will be responsible for reporting, analysis, and data management for GI Claims Fraud and Recovery (F&R). This position will work globally and cross functionally with internal and external teams such as F&R Leadership, Regional Leads, Country Managers, F&R Performance as well as Claims, Risk, Legal, Compliance, Underwriting, and the Data Office. The Data & Reporting Senior Analyst will also be

Full-time

Claims Representative - Liability W2 only

Remote

•

Today

Position: Claims Representative - Liability Duration: 02+ Months contract length. Contract extension and/or Conversion to direct employee is possible Location: 100% Remote ship Required. Manager Notes: Any specific skill/ certification/ experience: 3-4 years bodily injury claims low exposure up to 25KYears of experience: 3-4years Job Description: Duties: To process low level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards a

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Contract

20 - 25

Claims Adjuster

Remote

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13d 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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Contract, Third Party

Depends on Experience

Claims Adjuster

Hybrid in Baltimore, Maryland

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2d ago

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 Examiner - Workers Compensation W2 Only

Remote

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Today

Position: Claims Examiner - Workers Compensation Duration: 03+ Months contract length. Contract extension and/or Conversion to direct employee is possible Location: Remote in California Pay Range: $52/hr to $56/hr on W2 without Benefits ship Required. Manager Notes: Experience - min 3 years of experience is needed. Public entity and County of Los Angeles Experience is a plus.SIP is mandatory.Shift timings: 8:00 4:30 Primary Purpose: To analyze complex or technically difficult workers'' compen

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Contract

52 - 56

Claims Domain Test Manager - Remote with limited travel

Remote

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10d 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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17d 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

Delivery manager - (Insurance) Domain is required - insurance domains (Claims, Policy, Finance)

Raleigh, North Carolina

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Yesterday

Job Title: Delivery manager (Insurance) Location: Raleigh, NC (Locals preferred as they need to go to office when required) Job Description : Overview Seeking an experienced Onshore Delivery Lead to drive execution of a data platform modernization and reporting transformation program within an insurance environment. The role will act as the primary onsite interface, ensuring alignment between business stakeholders and offshore delivery teams while driving high-quality, timely outcomes.

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Third Party, 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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2d ago

< 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

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