Healthcare Claims Functional Analyst Glint Tech Solutions LLCHealthcare Claims Functional AnalystBaltimore, MDThe role also involves providing operational support, root cause analysis, testing, and documentation to ensure efficient claims processing operations. Research and resolve operational and systems issues by gathering facts, identifying root causes, and facilitating practical solutions.
Claims Representative I Elevance HealthClaims Representative IBaltimore, MarylandLocation: Virtual - This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Claims Appraiser - Auto Estimatics State FarmClaims Appraiser - Auto EstimaticsBaltimore, MD$64,965.62–$91,000 / yearWith 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).
Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience | Remote Sedgwick Claims Management Services, Inc.Liability Litigation Claims Examiner | Litigation, Premise, Auto, BI & Product Claims Experience | RemoteMDRemote$63,404–$88,765 / yearTo analyze GL Litigated, Premise, Auto, Bodily Injury & Product claims on behalf of our valued dedicated client to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY 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.
Claims Analyst Lumen Solutions Group, Inc.Claims AnalystBaltimore, MDThe ideal candidate will have strong experience in claims research, data validation, data entry, and Excel, with the ability to analyze issues, maintain accurate records, and support day-to-day claims operations. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.
NewContent Claims Specialist - Field - Level I Crawford & CoContent Claims Specialist - Field - Level IBaltimore, MDTo determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours. Communicate with adjusters/policyholders and industry vendors to explain their roles as Content Claims Specialists and their respective roles/contributions in the claims handling process.
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.
Remote Claims Representative -581888 Metro Public AdjustmentRemote Claims Representative -581888Baltimore, MDRemoteMetro Public Adjustment is looking for customer-oriented individuals to join our team of claims representatives. Once reviewed, If you want a face-to-face interview, we typically conduct them on Zoom: For Interview time and location, use the link below:
NewRemote Professional Claims Writer -581888 Metro Public AdjustmentRemote Professional Claims Writer -581888MarylandRemoteMetro Public Adjustment is looking for customer-oriented individuals to join our team of claims representatives. Once reviewed, If you want a face-to-face interview, we typically conduct them on Zoom: For Interview time and location, use the link below:
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeMDEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
NewSenior Provider Experience Program Manager - Healthcare Claims CVS Health CorpSenior Provider Experience Program Manager - Healthcare ClaimsMD$106,605–$284,280 / yearWhat you will do: Lead enterprise delivery of multiple, highly complex business process and technology initiatives aligned to the Provider Experience / Provider NPS program, supporting all lines of business. Drive Agile delivery of Provider Experience / Provider NPS initiatives, supporting business process and technology improvements across multiple lines of business.
Director , Product Management - AI Claims Platform CVS Health CorpDirector , Product Management - AI Claims PlatformMD$144,200–$288,400 / yearThis is a rare opportunity to own a flagship AI product in healthcare from strategy through delivery - partnering closely with Business executives, Operations teams, Enterprise technology, Data science and Engineering, with strong visibility to senior leadership. A&BC leverages advanced analytics, machine learning, modeling, and a hypothesis-driven approach to transform data into actionable, customer-centric insights to drive growth, improve health outcomes and access to health care across all our businesses in CVS Health.
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.
["Learning & Development Specialist (Claims Trainer / Customer Service Trainer)","Learning & Development Specialist (Claims Trainer / Customer Service Trainer)"] Lumen Solutions Group["Learning & Development Specialist (Claims Trainer / Customer Service Trainer)","Learning & Development Specialist (Claims Trainer / Customer Service Trainer)"]BaltimoreThe ideal candidates will have strong Instructor-Led Training (ILT) experience, exceptional presentation and facilitation skills, and the ability to effectively train both virtually and in person. CareFirst BCBS is seeking two Learning & Development Specialists to design and deliver engaging training programs for adult learners in a corporate healthcare environment.
NewManager, Large Loss Property Claims PL (NY / East PA - WFH) Nationwide Mutual Insurance CoManager, Large Loss Property Claims PL (NY / East PA - WFH)Annapolis, MDRemote$108,000–$200,000 / yearNationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. Able to make physical inspections of property loss sites; including climb ladders, balance at various heights and rooftops up to 8/12 pitch stoop, bend and/or crawl to inspect vehicles and structures; work outside in all types of weather.
Claims Processor ICONMA, LLCClaims ProcessorBaltimore, MD$27.95–$32.95 / hourResponsibilities: 50% Research and improve operations by examining and researching systems problems by obtaining facts, analyzing problems/identifying root cause recommending and facilitating resolution. In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
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.
NewBilling and Claims Analyst Porter CaresBilling and Claims AnalystAnnapolis, Maryland$58,000–$75,000 / yearDriven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. Our organization operates in a payer-contracted services model — delegated services, in-home assessments, HEDIS gap closure, and risk adjustment visits — billed through Athena in a mix of penny-claim/encounter-reporting and full-cost claim arrangements.
Workers'''' Compensation Claim Representative The Hartford Insurance Group IncWorkers'''' Compensation Claim RepresentativeMaryland, MDRemote$56,391–$84,587 / yearOur dynamic team of claim professionals provide superb customer service with the valuation, disposition and settlement of worker compensation claims while consistently adhering to our corporate claim settlement policies. Actual base pay could vary and may be above or below the listed range based on factors including but not limited to performance, proficiency and demonstration of competencies required for the role.
Associate Claim Rep, Auto Blend The Travelers Companies IncAssociate Claim Rep, Auto BlendHunt Valley, MD$45,400–$74,900 / yearThis position focuses on developing your skills and knowledge to successfully manage personal and business insurance damage claims involving various types of automobiles as well as heavy equipment, mobile equipment, and property damage. As an Associate Claim Rep, Inside Auto, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals.