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Senior Business Analyst with Claims - Remote with Travel

Remote

•

Today

1. Candidate should have strong health care domain experience and should have good knowledge of Medicaid and Medicare.2. Candidate should have hands-on experience on claims processing and Adjudication processes.3. Must have good experience in Reference code/data sets required in Claims adjudication.4. Must have prior experience or understanding in configuring benefits or programs in claims system across various sub-systems.5. Should be able to run queries and perform basic system analysis, RCA e

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Third Party, Contract

$50

Technical Business Analyst with Medicaid & Claims Module experience - Remote

Remote

•

Today

10-12 years of experience as a Business Analyst with 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 X12 Adjudication Payment Cycle (Finance) Reporting Encounters and Capitation EDI X12 formats like837P/I/D X12 formats 835,834,270/271,276/277 Familiarity with systems like CMdS, GHS, Facets and etc Ability to validate Test scenarios and test plans, test data. SQL: To vali

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Contract, Third Party

Depends on Experience

Sr. Epic Professional billing and claims analyst

Remote

•

4d ago

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

Programmer Analyst - (Claims - Pharmacy / medical)

Remote

•

Today

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

Sr. Pharmacy Claims Analyst

Remote

•

5d ago

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 Reimbursement Analyst

Remote

•

4d ago

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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Third Party, Contract

Claims Reimbursement Analyst-Remote

Remote

•

5d ago

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

Hybrid in Denver, Colorado

•

5d ago

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

EPIC Resolute Certified - Claims Applications Analyst - REMOTE

Remote

•

21d 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

Claims UAT Tester

New York, New York

•

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

Senior Manager, Claims Vendor Strategy & Operations

New York, New York

•

2d ago

Not your everyday company Lemonade completely reinvented how insurance works. As a customer-centric tech company, we created an insurance experience that is smart, instant, and delightful. At Lemonade, you'll be working with a group of like-minded makers, who get a kick out of moving fast and delivering great products. We surround ourselves with some of the smartest, most motivated, creative people who are filled with positive energy and good karma. Unlike most publicly traded companies, we're n

Full-time

USD 110,000.00 - 135,000.00 per year

Senior AI Software Engineer, Risk - Insurance Claims Management

Seattle, Washington

•

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

•

Today

Full-time

USD 148,000.00 - 185,000.00 per year

Insurance Claims Specialist

Cicero, Illinois

•

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

•

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

Staff Counsel - Liability Claims

Coppell, Texas

•

Today

The Staff Counsel - Liability Claims leads all aspects of liability claims management for a large commercial transportation and logistics company with a fleet primarily leased from independent contractors. They are responsible for the strategic direction, financial oversight, and operational execution of the company?s liability claims program ? encompassing commercial auto liability, cargo claims, general liability, and catastrophic loss events. They serve as the primary liaison between operatio

Full-time

Sr. Manager, Claims Operations

New York, New York

•

8d 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

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

Remote

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3d 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 Batch Developer (UNIX/C/Claims)

Frankfort, Kentucky

•

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

Claims Data Solutions Sr. Analyst

Lebanon, Pennsylvania

•

Today

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

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