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San Antonio, Texas

•

2d ago

Location: San Antonio, TX - onsite Duration: 6 months Industry Advisor CPCU, Industry Advisor, Claims expert "1520+ years in Personal Lines Claims, claims transformation, claims technology, or equivalent combination. Demonstrated success leading cross-functional initiatives that improved claims outcomes (cycle time, leakage, compliance, experience). Strong experience working within U.S. regulatory frameworks for claims operations; exposure to market conduct, internal audits, and remediation. Pro

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Third Party, Contract

50 - 60

Claims Domain Test Lead

Remote

•

19d ago

Job: Claims Domain Test Lead Location: Remote(USA) Claims Domain Test Lead: Play the role of Claims Domain lead 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 cycle. Responsible to meet customer expectations, troublesho

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Contract, Third Party

$70 - $75

Claims Examiner - Workers Compensation - W2 Only

Remote

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2d ago

Position: Claims Examiner - Workers Compensation - W2 Only Location: Remote in California Pay Range: $48/hr to $53/hr on W2. Required Skills: SIP is mandatory5+ years of relevant California Workers Compensation experience Primary Purpose: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best p

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Contract

$48 - $53

Epic Build Analyst Professional Billing (PB) Claims & Remittance

Remote

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2d ago

Job Title: Epic Build Analyst Professional Billing (PB) Claims & Remittance Duration: 6 Months Location: Remote Epic Build Analyst Professional Billing (PB) Claims & Remittance Principal Duties: Epic analyst certified in PB Claims and Remittance, must have extensive experience building payor/plans in Epic. Analyst will be covering support duties, assisting with upgrades, testing, tickets, and maintenance. Coordination with FTE's and operations, along with coordination from other applications as

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Contract

Depends on Experience

Project Manager - PBM - PMP - Claims Adjudication

Remote

•

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+

Property & Casualty Claims SME

San Antonio, Texas

•

2d ago

P&C Claims Industry Expert Location: San Antonio, TX Experience: 14 20 Years Role Overview We are seeking a seasoned P&C Claims Industry Expert to lead claims transformation initiatives and drive operational excellence across claims platforms. This role requires deep domain expertise in Personal Lines Claims, strong knowledge of U.S. regulatory frameworks, and the ability to translate business processes into scalable technology solutions. The ideal candidate will play a key role in modernizing c

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Full-time

$DOE

Claims Platform Developer / Engineer

Remote

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25d ago

Key ResponsibilitiesConfigure and customize claims platform modules (Benefits, Claims, Pricing, Provider)Develop enhancements, business rules, and workflowsBuild integrations with downstream/upstream systemsSupport data migration and system upgradesTroubleshoot claims adjudication defects and performance issuesParticipate in SIT, UAT, and production deploymentsDevelop technical documentation and configuration guidesEnsure compliance with payer regulatory requirementsRequired Qualifications5+ yea

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Contract

50 - 60

CA:GEN with Billing and claims experience - REMOTE

Remote

•

2d ago

Role: CA:GEN Specialist Location: REMOTE MetaVance Expertise: Minimum 5+ years of hands-on development experience, specifically within Claims and Benefits modules.Tooling: Expert proficiency in CA:GEN, including Guardien, Report Composer, and CA:GEN APIs.Programming & Data: Strong command of C and Oracle SQL (SQL Developer) for complex data manipulation and analysis.Domain Knowledge: Solid understanding of Healthcare Claims Processing and benefits configuration.Professional Experience Experience

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Third Party, Contract

$0 - $0

CA:GEN, MetaVance - Technical developer (Healthcare Claims) - Remote

Remote

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4d ago

Role : Technical developer (CA:GEN & Healthcare Claims) Location: Remote Duration: Contract Job SummaryProject descriptionClient is seeking a Technical Developer to support enhancements and ongoing development of the MetaVance healthcare platform. The role focuses on claims processing, benefits configuration, and pricing functionality within the MetaVance application environment. The resource will contribute to system design, development, and technical analysis while ensuring alignment with heal

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Contract, Third Party

Depends on Experience

Technical Developer (CA:GEN & Healthcare Claims)

Remote

•

5d ago

Position: Technical Developer (CA:GEN & Healthcare Claims) Location: Remote Project description: Technical Developer to support enhancements and ongoing development of the MetaVance healthcare platform. The role focuses on claims processing, benefits configuration, and pricing functionality within the MetaVance application environment. The resource will contribute to system design, development, and technical analysis while ensuring alignment with healthcare claims business processes. The target

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Contract

$45 - $50

EPIC Analyst - Claims

Remote

•

Today

HCL Technologies Limited Job Summary HCL is looking for EPIC Analyst - Claims(Certified), who are ready to work in PST time zone. Key Responsibilities * Analyst provides day-to-day application support for the Epic HB module, with a primary focus on incident and service request ticket work, system maintenance, and incremental optimization * This role supports revenue cycle operations by troubleshooting break/fix issues, maintaining existing build, and partnering with operational teams to ens

Full-time, Contract

To define

Senior Claims Platform SME – Advisory & Strategy

Remote

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25d ago

Key ResponsibilitiesProvide strategic advisory on claims platform transformation and modernization initiativesLead platform assessments, gap analysis, and optimization roadmapsDrive end-to-end claims lifecycle improvements (Enrollment, Benefits, Claims, Provider, Payment)Define enterprise architecture and integration strategy across claims ecosystemGuide platform migrations and upgrades (Facets/QNXT/HealthEdge/Diamond/Xcelys/ika)Partner with business leadership to align IT capabilities with paye

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Contract

60 - 70

Medical Claims Auditor (Remote - Texas)

Remote or Dallas, Texas

•

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 Houston, Texas

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Today

Full-time

USD 50,000.00 - 55,000.00 per year

Medical Claims Auditor (Remote - Texas)

Remote or Austin, Texas

•

Today

Full-time

USD 50,000.00 - 55,000.00 per year

W2 Role: Epic HB & PB Admin & Claims Consultant

Remote

•

2d ago

Hello, Visa: U..S..C or G..C Only - Need to work on W2 Role: Epic HB & PB Admin & Claims Consultant Duration: 6 months, CTH/full-time Location: 100% Remote Note: Need candidates from Healthcare Domain Requirements: Epic PB Admin certification (SBO & Charge Router) required. Epic HB Admin certification strongly preferred (CDM, HB Charge Router). Proven experience in PB/HB claims administration and revenue cycle workflows. Strong knowledge of HL7 interfaces and EMR-to-Meditech billing integrati

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Contract, Third Party

Depends on Experience

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