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Remote or Pierre, South Dakota

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Today

Data Entry, Processing, Review & Verification and Associated Tasks Location: Pierre, South Dakota Contract Duration: Key Responsibilities Perform data entry and processing of claims and related records Review and validate documentation for accuracy and completeness Utilize systems such as: Mainframe systems Datacap Provider Enrollment Portal File Director Verify data against multiple sources (manual and system-based validation) Work with claims documents including: CMS-1500 UB-04 (CMS-1450

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Third Party, Contract

Data Entry & Claims Processing Specialist - Medical Services

Blunt, South Dakota

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Today

We are seeking a detail-oriented Data Entry & Claims Processing Specialist to support high-volume data operations, including data entry, document review, and claims verification. The ideal candidate will have experience working with healthcare claims documentation and multiple data systems, ensuring accuracy, compliance, and timely processing of information. Responsibilities:Perform high-volume data entry with strong attention to accuracy and detailReview and validate records and supporting docu

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Third Party, Contract

Depends on Experience

Data Entry & Claims Processing Specialist - Medical Services

Blunt, South Dakota

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6d ago

We are seeking a detail-oriented Data Entry & Claims Processing Specialist to support high-volume data operations, including data entry, document review, and claims verification. The ideal candidate will have experience working with healthcare claims documentation and multiple data systems, ensuring accuracy, compliance, and timely processing of information. Responsibilities: Perform high-volume data entry with strong attention to accuracy and detail Review and validate records and supporting d

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Contract, Third Party

Depends on Experience

Data Entry & Claims Processing Specialist - Medical Services

Blunt, South Dakota

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11d ago

We are seeking a detail-oriented Data Entry & Claims Processing Specialist to support high-volume data operations, including data entry, document review, and claims verification. The ideal candidate will have experience working with healthcare claims documentation and multiple data systems, ensuring accuracy, compliance, and timely processing of information. Responsibilities: Perform high-volume data entry with strong attention to accuracy and detail Review and validate records and supporting d

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Contract, Third Party

Depends on Experience

Claims Analyst

Pierre, South Dakota

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3d 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 Specialist

Pierre, South Dakota

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3d ago

Job Title: Claims Specialist 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 a

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Full-time

$50 - $60

Senior Data Scientist - Clinical Informatics (Claims Specialization)

Remote or New York

•

Today

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health , you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Position Summary CVS Health's Analytics & Behavior Chan

Full-time

USD 101,970.00 - 203,940.00 per year

Lead Data Scientist - Clinical Informatics (Claims Specialization)

Remote or New York

•

Today

Full-time

USD 130,295.00 - 260,590.00 per year

SAP Consultant Warranty Claims

Remote

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18d ago

Job Description: We are looking for an experienced SAP Warranty Claims Consultant with 13+ years of SAP experience and a dedicated focus on Warranty Claims processing within SAP CS/SM/WTY for a leading global heavy equipment and construction manufacturing client. This is a warranty claims-focused role not a general service management or vendor management position. The ideal candidate must have deep, hands-on expertise in both Customer Claims (IC/OC) and Vendor Claims (OV/IV) processing, with a

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Contract, Third Party

Depends on Experience

Senior Majesco Configurator (Policy / Billing / Claims) (Remote)

Remote

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5d ago

Job Role: Senior Majesco Configurator (Policy / Billing / Claims) Location: Canada/USA- Remote Exp. Start date: 1st Week of May Duration: 6+ Months Year of Experience: 8-12 Years Role Summary Looking for a hands-on Majesco Configurator with deep expertise in configuring Policy, Billing, or Claims modules. Key Responsibilities Configure Majesco modules based on business requirements Work closely with business and BA teams for requirement analysis Perform product configuration, rule setup

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Contract, Third Party

$75 - $80

Senior Claims Technical Specialist - Financial Lines

Remote

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3d ago

Job Title: Senior Claims Technical Specialist - Financial Lines Location: This can be onsite (NYC, Chicago, or Plano, Texas) or remote, but there would be some travel expectations for mediations, settlement conferences, etc. Duration: 12+ Months Senior Claims Technical Specialistspecifically need staff familiar with Architects' and Engineers' Errors and Omissions claims. (This is must-have.) Job Summary:The purpose of this role is to oversee the examination, evaluation, and processing of comple

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Contract, Third Party

Depends on Experience

Technical Architect – Salesforce (Vlocity Insurance / Claims)

Remote

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3d ago

Key Responsibilities 1. Platform & Architecture Assessment Evaluate current Salesforce + Vlocity (Insurance/Claims) implementationAssess usage of:Claims data modelOmniScripts, FlexCards, DataRaptorsIntegration procedures and APIsIdentify deviations from Vlocity best practices and over-customization risks2. CSR Workflow & Friction Analysis Analyze end-to-end claims lifecycle:Intake Triage Investigation Adjudication PayoutPartner with business stakeholders to map day in the life workflowsIdent

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Contract

40 - 50

Disability Claims Specialist (LTD)

Remote

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23d ago

We are looking for a LTD Disability Claims Specialist for a 12+ Months contract position. Please send your resume along with hourly rate expectation if interested. Position: LTD Disability Claims Specialist Location: Remote Duration: 12+ Months Part time position: 20 hours per week (Must be able to work during normal business hours within their residential time zone) Required: 3+ years of LTD/IDI Insurance Claims experiencePrior experience with independent judgement and decision making while re

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Contract

Up to 50

Epic Resolute Professional Billing Claims Remittance

Remote

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26d ago

Title- Senior Systems Analyst (Application Analyst - Epic Resolute Professional Billing & Claims and Remittance) Location- Oakland, CA/Hybrid/Remote Job Description: Job Title: Application Analyst - Epic Resolute Professional Billing & Claims and Remittance Role Description: We are seeking a skilled and experienced Application Analyst with expertise in Epic Resolute, and Claims and Remittance modules to join our dynamic team. This Epic Applications Analyst plays a critical role in the implementa

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Contract

Depends on Experience

Claims Technical Specialist

Remote or Hybrid in Texas City, Texas

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6d ago

Title: Senior Claims Technical Specialist - Financial Lines Location: 2400 Dallas Parkway, Ste. 350, Plano, TX Duration: 12+ Months Job Description: Manage a diverse portfolio of complex claims which includes conducting fact, liability and loss investigations and interpreting insurance contracts in an effective and efficient mannerEvaluate and negotiate the resolution of assigned claims in a timely manner, within appropriate authority and in accordance with applicable laws, regulations, statute

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Contract, Third Party

$90 - $100

EPIC Resolute Certified - Claims Applications Analyst - REMOTE

Remote

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18d 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

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

Remote

•

Today

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+

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

Remote

•

Today

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 Majesco Configurator (Policy / Billing / Claims) - SMC 26-04318

Remote

•

Today

Job Title: Senior Majesco Configurator (Policy / Billing / Claims)Location: USA / Canada (Remote) Experience: 8 12 Years Role Summary We are seeking a skilled Senior Majesco Configurator with strong hands-on experience in configuring insurance platform modules such as Policy, Billing, or Claims. The ideal candidate will have deep domain knowledge and the ability to translate business requirements into effective system configurations. Key ResponsibilitiesConfigure Majesco modules based on busines

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Third Party, Contract

Depends on Experience

QA Manager - Healthcare EDI Claims 837, 835

Remote

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5d ago

Skill Matrix: Skill Rating 1-5 Exp QA Manager EDI transactions (e.g., 837, 835, 270/271, 276/277) MMIS ( Medicaid Management information system ) SQL ALM, JIRA Job Description: Lead end-to-end testing activities for healthcare projects, including requirement analysis, test planning, test estimation, and risk assessment.Develop test plans and test schedules.Resource must understand how claims work(EDI 837), how claims get priced and paid. How does the member benefit works after the claim submiss

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Full-time

Up to $120,000

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