NewWorkers Compensation Claims Representative | Medical Only Workers Compensation | VA Jurisdiction Sedgwick Claims Management Services, Inc.Workers Compensation Claims Representative | Medical Only Workers Compensation | VA JurisdictionVARemote$45,000–$60,000 / yearPRIMARY 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. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
Complex Claims Consultant - Epl, Private & NFP D&O CNA Financial Corp.Complex Claims Consultant - Epl, Private & NFP D&OWashington, DC$72,000–$141,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Manages an inventory of highly complex Financial Lines claims, with large exposures that require a high degree of specialized technical expertise and coordination, by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits. Resolves claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
NewWorkers’ Compensation Claims Examiner GreenLife Healthcare StaffingWorkers’ Compensation Claims ExaminerWashington, DCJob Qualifications & Certifications: Bachelor’s degree and at least two years of workers’ compensation claims adjusting experience; or eight years of progressively responsible claims-handling experience, including at least three years of workers’ compensation claims adjusting experience. Complete required claim contacts, including 24-hour four-point contacts with injured workers, supervisors, medical providers, and other stakeholders; document activity in the claims management system.
Claims Resolution Representative Metasys TechnologiesClaims Resolution RepresentativeMcLean, VARemote$18.62–$23.27 / hourThis position serves as a crucial liaison between members, providers, agencies, and the internal claims department, demonstrating leadership, collaborative skills, and commitment to achieving results. Review paper claims and attachments, scanning them using scanning equipment to attach the documents to corresponding transaction control numbers.
Claims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsGaithersburg, Maryland$69,398.62–$91,000 / yearFull timeWith the opportunity to initially earn up to 20 days annually plus parental leave, paid holidays, celebration day, life leave (40 hours/year), bereavement leave, and community service/education support days, there will be plenty of time for you! Additional Details: Employees must successfully complete all required training, including applicable proficiency, licensing exam(s), Motor Vehicle Record (MVR) checks, and background checks required of various state(s).
Python Backend Engineer Healthcare Claims & Oracle Pyramid Consulting, IncPython Backend Engineer Healthcare Claims & OracleMaryland, MDRemote$56–$65 / hourBy applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Our client is a leading Biopharmaceutical Industry, and we are currently interviewing to fill this and other similar contract positions.
NewClaims Management Program Analyst (O-5 Billet) Non-Supervisory U.S. Department of Homeland SecurityClaims Management Program Analyst (O-5 Billet) Non-SupervisoryWashington, DCLiaises regionally and, or, nationally with applicable stakeholders internal and external stakeholders [e.g., Customs and Border Patrol, Office of Field Operations, Homeland Security Investigation (HSI) and third-party claims vendor] regarding claims processes, trainings, and principles. Should possess some knowledge of International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), current procedural terminology (CPT), diagnosis-related group (DRG), and other Centers for Medicare and Medicaid Services (CMS) coding/billing requirements.
Claims Counsel (Insurance Defense) Williams & Connolly LLPClaims Counsel (Insurance Defense)Washington, DC$165,000–$180,000 / yearResponsibilities include, but are not limited to:* Developing a case strategy* Answering complaints* Drafting and responding to discovery* Client communications* Handling all communications with opposing counsel* Hiring and managing expert witnesses as needed* Drafting motions and responses to motions* Conducting and defending depositions* Drafting mediation statements* Conducting mediations* Appearing in court as needed* Pre-trial preparations* Conduct trials* Drafting settlement agreements* Administrative duties related to case tracking and reporting . This position requires the ability and flexibility to manage a high-volume caseload in cooperation with firm management, partners, associates, other Claims Counsel, and firm employees in a professional manner as well as the ability to manage and prioritize a large volume of work assignments, meeting all deadlines.
Claims Inventory Manager ApolisClaims Inventory ManagerBaltimore, MDRemote$90–$95 / hourThe ideal candidate will have a strong understanding of the claims lifecycle, the ability to bridge business and technical teams, and proven experience leading cross-functional initiatives in a healthcare environment. We are seeking an experienced Claims Inventory Manager with expertise in healthcare claims processing and Facets configuration.
Enterprise Claims Library Admin, Project Management Capital OneEnterprise Claims Library Admin, Project ManagementMcLean, VirginiaCDX is responsible for Capital One’s digital customer experiences, including its award winning mobile app, its online presence, and Enterprise-grade products and platforms used across all lines of business. Our team is responsible for administering and governing these platforms, and advising on the large-scale transformation of our content supply chain to unlock highly personalized, intelligent experiences for millions of current and prospective customers.
Medical Claims (Billing) Team Leader GT Independence CareersMedical Claims (Billing) Team LeaderSilver Spring, MarylandGT Independence is a family-founded, leading national Financial Management Services (FMS) provider that supports individuals participating in self-direction programs, helping them manage their long-term care and support services at home and in community-based settings. Dedicated to promoting personal choice, independence, and quality of life, GT Independence delivers reliable, person-centered financial and administrative services that empower individuals to direct their own care.
Principal Data Scientist, Customer Protection Agentic Claims Data Science Capital OnePrincipal Data Scientist, Customer Protection Agentic Claims Data ScienceMcLean, VirginiaCurrently has, or is in the process of obtaining one of the following with an expectation that the required degree will be obtained on or before the scheduled start date: A Bachelor's Degree in a quantitative field (Statistics, Economics, Operations Research, Analytics, Mathematics, Computer Science, or a related quantitative field) plus 5 years of experience performing data analytics. As a Data Scientist at Capital One, you’ll be part of a team that’s leading the next wave of disruption at a whole new scale, using the latest in computing and machine learning technologies and operating across billions of customer records to unlock the big opportunities that help everyday people save money, time and agony in their financial lives.
Claims Consultant CoreTechsClaims ConsultantBethesda, MDRemote$110,000–$160,000 / yearSUMMARY/OBJECTIVE: The Claims Consultant will be responsible for conducting impact analysis, analyzing risk on complex projects, and performing forensic schedule and cost analysis consisting of identifying critical path delays, schedule disruptions, evaluating labor productivity, and pricing general conditions costs. Perform construction claims forensic analysis including document review and organization, key issue identification, schedule analysis, labor productivity studies, general conditions calculations, pricing, and graphic exhibits for input to expert reports.
IT Production and Systems Support Engineer (Mainframe and Claims Processing) MindlanceIT Production and Systems Support Engineer (Mainframe and Claims Processing)Columbia, MDThe ideal candidate will combine mainframe expertise, application support, data analysis, and incident management skills to support both legacy and modern platforms while delivering high-quality service to internal teams and external plan vendors. This role is responsible for ensuring stability, performance, and continuous improvement of applications supporting claims vouchering, adjudication, and EDI processing.
NewFalse Claims Act (FCA) Litigation Partner / Counsel Orion PlacementFalse Claims Act (FCA) Litigation Partner / CounselWashington D.C., WashingtonRemoteYou will have the flexibility to work remotely, lead sophisticated matters, build meaningful client relationships, mentor attorneys, and play an important role in the continued growth of a nationally focused False Claims Act and complex litigation practice. Note: Candidates must have 10+ years of private practice legal experience, including 5+ years of substantive False Claims Act investigations and/or litigation experience, and a portable book of business of at least $250,000.
Epic Resolute Professional Billing (PB) & Claims Analyst InterscriptsEpic Resolute Professional Billing (PB) & Claims AnalystChantilly, VirginiaThe ideal candidate will have hands-on experience in implementing, configuring, supporting, and optimizing the Epic Resolute Professional Billing (PB) module, with expertise in claims management and physician revenue cycle workflows. The candidate will collaborate with billing, coding, revenue cycle, and operational teams to enhance billing accuracy, streamline claims processing, and improve reimbursement outcomes.
Epic HB/PB Resolute Claims Analyst InterscriptsEpic HB/PB Resolute Claims AnalystChantilly, VirginiaWe are seeking an experienced Epic Resolute Hospital Billing (HB),or Professional Billing (PB), and Claims Analyst to support, maintain, and optimize Epic Revenue Cycle applications. The ideal candidate will have hands-on experience with Epic Resolute HB, PB, Claims, and Revenue Cycle workflows, along with strong analytical and troubleshooting skills.
Principal Solutions Architect - Claims Processing (Remote) Blue Cross and Blue Shield AssociationPrincipal Solutions Architect - Claims Processing (Remote)Baltimore, MDRemote$155,600–$278,135 / yearMust have recent solution/domain architecture experience with Facets G6 real-time and batch claims processing, pre-adjudication validation, EDI-based transaction data management, claim editing engines, and third-party integrations with partner organizations that provide these services. Has an expert knowledge of integration solutions and communicates with business owners, domain architects, other Solution Architects, technical delivery staff, and key technical stakeholders, including Security, Data, and Technology Centers of Excellence.
NewVeterans Claims Examiner U.S. Department of Veterans AffairsVeterans Claims ExaminerWashington, DC$52,766–$68,597 / yearPlease use this checklist to make sure you have included other documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50s (current/former Federal employees), documentation to support Veterans preference claims, or ICTAP/CTAP documentation (for displaced Federal employees). Examples of experience include: (1) Experience reading, analyzing, interpreting and applying laws, regulations, directives manuals, or training materials; (2) Experience in developing information and evaluating evidence to determine a decision; (3) Maintain pertinent files/documents electronically in a claims process; (4) Monitor case files for compliance with legal regulations.
NewWorker's Compensation Claims Examiner Greenlife Healthcare StaffingWorker's Compensation Claims ExaminerWashington, DCBachelor’s degree and at least two years of workers’ compensation claims adjusting experience; or eight years of progressively responsible claims-handling experience, including at least three years of workers’ compensation claims adjusting experience. Complete required claim contacts, including 24-hour four-point contacts with injured workers, supervisors, medical providers, and other stakeholders; document activity in the claims management system.