NewClaims Negotiation Analyst (Out of Network Mandates) Horizon Healthcare ServicesClaims Negotiation Analyst (Out of Network Mandates)Newark, New JerseyPrepares written responses including negotiation outcomes by completing a written justification on how Horizon BCBSNJ adjudicated the initial and adjusted claim, but not limited to, benefits, contracts, payment and pricing methodology, proof of plan and providing explanation of benefits within regulated timeframes. $58,029 - $77,074 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.
Sr. Claims Counsel, Miscellaneous Professional Lines Sompo InternationalSr. Claims Counsel, Miscellaneous Professional LinesMorristown, NJ$125,000–$175,000 / yearSalary Range: $125,000-$175,000 Actual compensation for this role will depend on several factors including the cost of living associated with your work location, your qualifications, skills, competencies, and relevant experience. Below is a summary of our current comprehensive U.S. benefit programs: Two medical plans to choose from, including a Traditional PPO & a Consumer Driven Health Plan with a Health Savings account providing a competitive employer contribution.
Complex Claims Consultant - Private & NFP D&O CNA Financial CorpComplex Claims Consultant - Private & NFP D&ONew York, NY$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.
Remote | Medical Billing & Claims Operations Consultant — Up to $60/hour 24-MagRemote | Medical Billing & Claims Operations Consultant — Up to $60/hourNew York, New YorkRemoteWe are sharing a specialised part-time consulting opportunity for United States-based healthcare revenue cycle professionals experienced in medical billing, claims submission, payer billing requirements, clearinghouse workflows, billing compliance, claim edits, electronic transactions, and revenue cycle operations. Selected professionals will apply billing and claims expertise to evaluate AI-generated billing outputs, review claim edits and payer requirements, identify compliance or submission issues, and provide structured feedback based on detailed project criteria.
Medical Billing & Denials Specialist Rochester Regional Health SystemMedical Billing & Denials SpecialistNY$20.66–$29.99 / hourSUMMARY: A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims, and ensuring timely reimbursement for healthcare services. Appeals & Reimbursement Review: Conduct detailed reviews of denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to ensure successful claim outcomes.
Case Manager Finch LegalCase ManagerNew York City, New York$60,000–$85,000 / yearYou’ll focus on the operational heart of pre-litigation—opening claims, managing medical record requests, securing police reports, and resolving lien issues—so attorneys can work with complete, timely information. We combine expert operators with purpose-built AI to handle intake, claim opening, medical records, police reports, lien management, demands, and everything in between.
Comprehensive Project Manager Solera Holdings LLCComprehensive Project ManagerNJTravel to loss locations throughout the U.S. to create physical inventories of damaged contents, often in difficult conditions (i.e., fire damaged homes without heat/electricity) • Correspond with adjusters, insureds and other points of contact to coordinate claim documentation and damage assessment, via email and phone • Correspond with teammates regarding scheduling, travel expenses, and project coordination / updates, via email, phone and MS Teams • Oversee the valuation process including identifying high value items for special processing • Track and log time and expenses daily for both billing and utilization purposes • Update tasks within our Contents Express system and follow detailed process flows • Comb through large volumes of supporting documents (receipts, prior appraisals and photographs) to match to damaged items • Cross-reference lists for duplication and additional detail, merge information as needed • Review completed contents valuation inventories for accuracy, deliver reports to adjuster, and follow up on adjuster questions • Proactively manage up to 20+ claims in various stages of the process, maintaining timely communication and claim momentum even when traveling or onsite. • This position requires frequent travel, both local and overnight, up to 60% of the time, often on short notice • Ability to physically inspect damaged contents, including maneuvering heavy contents in tight storage spaces and itemizing contents in homes without heat or electricity, for up to 8 hours a day • Experience working in the insurance industry or around a high-end property industry such as interior design, art, or fashion and/or equivalent education in the relevant areas • Experience in leadership and/or project management is a plus • The successful candidate will exemplify professionalism, have excellent written and verbal communication skills, and be a team player • Person must be extremely detail-oriented and possess excellent problem-solving and organizational skills • Ability to sit for multiple hours at a time and to remain alert and focused for multiple hours a day at a computer keyboard • Ability to track and document time and expenses daily • Excellent MS Office (including Excel), Outlook, and computer skills • Bachelors or Graduate Studies in Business, Art, Art History, Fashion, Interior Design or related field desired • Valid REAL ID and drivers license.
CLX Squad Lead, Contractor Operations Lemonade IncCLX Squad Lead, Contractor OperationsNY$80,000–$92,500 / yearYou'll sit within our property leadership team, managing contract adjusters across both day-to-day desk claims and catastrophe surges - making sure our external operation runs with the same precision, speed, and quality we hold ourselves to internally. Provide direct day-to-day oversight, performance management, and guidance to contract adjusters handling desk claims - both steady-state and catastrophe (CAT).
Supervisor, Risk Consulting (Insurance) RSMSupervisor, Risk Consulting (Insurance)New York, NY$88,900–$168,300 / yearAs a Supervisor in RSM's growing Financial Services Risk Consulting Practice, you will have the opportunity to draw from your experience and knowledge while continuing to grow your leadership skills through a high degree of client and industry exposure, career development and mentorship opportunities, and a diverse and inclusive culture. Proactively seek out opportunities to learn from or teach team members, build a coaching/mentoring network and take advantage of training opportunities to continually expand skills and demonstrate leadership capability.
Commercial General Liability Specialist (primarily New York venues) Utica National Insurance GroupCommercial General Liability Specialist (primarily New York venues)New York, NY$75,000–$109,500 / yearWe believe strongly that talented people are core to our success and are attracted to companies that provide competitive pay, comprehensive benefits packages, career advancement and challenging work opportunities. The Commercial Lines Claims Specialist will be responsible for investigating, evaluating, negotiating, and resolving primarily non-litigated New York commercial general liability claims with moderate complexity.
NewTEMP-Senior Medical Pricing Specialist Argo Group International Holdings IncTEMP-Senior Medical Pricing SpecialistNew York City, NY$37.66–$44.33 / hourBoston metro area, California outside of Los Angeles & San Francisco metro area, Connecticut, Chicago metro area, Denver metro area, New Jersey (outside of New York City metro area), New York State (outside of New York City metro area), Washington, D. C. Qualifications / Experience Required: A practical knowledge of medical terms, procedures, and management along with the litigation process, as well as exceptional customer service focus typically achieved through: A minimum of 2 years of experience in medical billing, medical pricing, or Workers' Compensation claims processing.
Claim Administrator Barasch & McGarryClaim AdministratorManhattan, NYFull timeTime Management & Prioritization — effectively manages multiple priorities, deadlines, and client needs in a fast-paced environment Client Experience Mindset — delivers empathetic, high-quality service that builds trust and supports a positive client journey. The Claim Administrator/Client Advocate supports clients throughout the Victim Compensation Fund (VCF) process by serving as their primary point of contact, helping them gather required documentation, and navigate program requirements.
Sr. Litigation Specialist -Remote CSAA Insurance GroupSr. Litigation Specialist -RemoteNJRemote$89,865–$99,850 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 19 more}. Most employees hold Home-Flex roles, working primarily from home, often with the flexibility to work from various locations including CSAA offices.
Revenue cycle specialist Affinity Med SolutionsRevenue cycle specialistpark ridge, NJFull timeThis is an excellent opportunity for someone who is detail-oriented, enjoys solving complex billing issues, and takes pride in maximizing reimbursement while providing exceptional service to our physician clients. Affinity Med Solutions is growing, and we're looking for an experienced Medical Biller with a strong background in orthopedic billing to join our team.
Associate Attorney - Insurance Coverage GpacAssociate Attorney - Insurance CoverageMorristown, NJ160000–260000GPAC (Growing People and Companies) is an award-winning search firm specializing in placing quality professionals within multiple industries across the United States since 1990. My goal is not only to help my clients hire exceptional attorneys, but also to help legal professionals make informed career decisions.
NewRevenue Cycle Specialist (New Jersey, Neurology) Privia Health Group, IncRevenue Cycle Specialist (New Jersey, Neurology)NJ$24–$26.45 / hourThe Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers. Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings.
Director Of Insurance Hospital for Special SurgeryDirector Of InsuranceNew York, NY$112,000–$170,875 / yearNegotiation, Communication & Market Execution: Demonstrated success leading negotiations with brokers, and insurers to secure favorable coverage terms, pricing, and service structures, coupled with the ability to clearly and effectively communicate concepts, both verbally and in writing, to senior leadership and stakeholders across the organization. Serve as the Hospital's lead strategic advisor for insurance and risk financing, directing executive-level relationships with brokers (Alliant and Marsh) carriers, captive partners, consultants, and other key partners to optimize insurance program performance and market positioning.
Sales Representative Mighty Dog RoofingSales RepresentativeParamus, New JerseyNeither HorsePower Brands and its affiliates, including HPB Recruitment LLC nor Brand, Location #, and Geography Location shall be deemed a joint employer of the other’s employees, and nothing in this Agreement shall be deemed or construed to create a joint venture, partnership, fiduciary or agency relationship between the Parties for any purpose. Applicant acknowledges, understands, and agrees that Applicant is applying for an employment position of Brand, Location #, and Geography Location and not HorsePower Brands or its affiliates, and that if hired, the Applicant shall be an employee of Brand, Location #, and Geography Location and not HorsePower Brands or its affiliates.
Clinic Services Representative I - Billing Rutgers The State University of New JerseyClinic Services Representative I - BillingNew Brunswick, NJAligned with Rutgers University-New Brunswick and collaborating university wide, RBHS includes eight schools, a behavioral health network, and five centers and institutes that focus on cancer treatment and research, neuroscience, advanced biotechnology and medicine, environmental and occupational health, and health care policy and aging research. Under Policy 100.3.1 Immunization Policy for Covered Individuals, if employment will commence during Flu Season, Rutgers University may require certain prospective employees to provide proof that they are vaccinated against Seasonal Influenza for the current Flu Season, unless the University has granted the individual a medical or religious exemption.
NewAuto Damage Adjuster (Field) GEICO GENERAL INSURANCE COMPANYAuto Damage Adjuster (Field)Trenton, NJ$36.63–$46.80 / hourAs an experienced Adjuster, you should have a minimum of 12 months of Auto Damage experience and demonstrated a track record of success delivering excellent customer service while promptly and accurately settling claims. Factors include, but are not limited to, the scope and responsibilities of the role, the selected candidate's work experience, education and training, the work location as well as market and business considerations.