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.
Healthcare Claims Payment Policy Managing Consultant GuidehouseHealthcare Claims Payment Policy Managing ConsultantTysons Corner, VirginiaExperience supporting third-party administrator or claims operations implementation, including translating policy into business requirements, clarifying reimbursement logic, supporting testing, resolving operational questions, and tracking implementation issues. Experience leading a team or workstream, including setting priorities, assigning work, reviewing deliverables, coordinating subject matter experts, tracking deadlines, and communicating status, risks, and decisions to leadership.
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.
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.
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.
SIU Claims Investigator Lemieux & Associates LLCSIU Claims InvestigatorWashington, DC$25–$32 / hourPart timeNotary license strongly (preferred).Bilingual ability and/or degree in Criminal Justice or related field (preferred).Willingness to travel; flexible schedule (varied/irregular hours).Strong computer and internet skills. Accurately photograph evidence (accident scenes, vehicle damage, etc.).Skills & ExperienceExperience handling complex SIU/Claims cases.
Claims Recovery Specialist II (Remote) Blue Cross and Blue Shield AssociationClaims Recovery Specialist II (Remote)DCRemote$42,624–$78,144 / yearSpecialist will assist to maximize recovery amounts due to refund of payments made in error to members and/or providers, retro terms and/or focused provider audits. ESSENTIAL FUNCTIONS: Under supervision, reviews, audits, and/or initiates recovery efforts for medical, and/or dental claims to recover overpayments, ensuring all parts of the process are documented properly.
NewClaims Management Program Analyst (O-4 Billet) Non-Supervisory U.S. Department of Homeland SecurityClaims Management Program Analyst (O-4 Billet) Non-SupervisoryWashington, DCAssist in developing, evaluating, and coordinating CMP related functions to ensure adherence to industry practices in eligibility verification, authorization of care, claims management denials and appeals to minimize adverse outcomes related to timely filing and maintaining a Provider Network to provide quality specialty care to illegal aliens. 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.
Outside Property Associate Claim Representative The Travelers CompaniesOutside Property Associate Claim RepresentativeLaurel, MD$52,600–$86,800 / yearThis position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). As an Associate Claim Rep, Outside Property, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals.
Outside Property Associate Claim Representative TravelersOutside Property Associate Claim RepresentativeChantilly, VirginiaThis position requires the individual to access and inspect all areas of a dwelling or structure, which is physically demanding requiring the ability to carry, set up and climb a ladder weighing approximately 38 to 49 pounds, walk on roofs, and enter tight spaces (such as attic staircases and entries, crawl spaces, etc.). As an Associate Claim Rep, Outside Property, you will receive comprehensive training in claim handling, customer service, and policy interpretation while working alongside experienced claim professionals.
Claim Rep, Outside Property The Travelers CompaniesClaim Rep, Outside PropertyLargo, MD$67,000–$110,600 / yearDetermines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies.
Outside Property Claim Representative The Travelers CompaniesOutside Property Claim RepresentativeWashington, DC$67,000–$110,600 / yearDetermines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies.
Cyber Claim Counsel The Travelers CompaniesCyber Claim CounselChantilly, VA$111,600–$184,200 / yearTravelers' Cyber Claim Team is responsible for handling claims focusing on cyber privacy and security breach incident response, computer crime, infrastructure attacks and restoration, notification to affected parties and regulators, business interruption, consumer privacy liability, and identity fraud/theft. The First-Party Cyber Claim Team partners with and supports business units including Private-Non-Profit, Public Companies, Financial Institutions, Insurance Companies, Investment Advisors, and Professional Liability.
Outside Property Claim Manager The Travelers CompaniesOutside Property Claim ManagerWaldorf, MD$104,000–$171,700 / yearAchieve Optimal Solutions: Focus on resolution and process improvement, fulfilling all obligations while maximizing cost effectiveness, helping the business understand drivers, trends and product stress points and helping our partners attract and retain business. Provide Compelling Claim Services: Employ proper claim handling techniques to protect the integrity of our brand and providing consistent service quality and streamlined processes to add value for our customers.
Claim Specialist - Property Field Inspection State FarmClaim Specialist - Property Field InspectionFairfax, VA$69,398.62–$99,000 / yearCompetitive candidates should reside within one of the listed zip codes and will service this same territory: 20190 22003 22027 22030 22031 22032 22035 22037 22041 22042 22043 22044 22046 22101 22102 22124 22151 22180 22181 22182 22201 22202 22203 22204 22205 22206 22207 22209 22211 22213 22214 22301 22302 22303 22304 22305 22311 22312 22314. With 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!
Outside Property Claim Representative TravelersOutside Property Claim RepresentativeChantilly, VirginiaDetermines appropriate settlement amount based on independent judgment, computer assisted building and/or contents estimate, estimation of actual cash value and replacement value, contractor estimate validation, appraisals, application of applicable limits and deductibles and work product of Independent Adjusters. Investigates and evaluates all relevant facts to determine coverage, damages and liability of first-party property damage claims (including but not limited to analyzing leases, contracts, by-laws and other relevant documents which may have an impact), damages, business interruption calculations and liability of first-party property claims under a variety of policies.
Construction Claim Technical Specialist The Travelers CompaniesConstruction Claim Technical SpecialistChantilly, VA$85,600–$141,200 / yearDirectly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Actively engages in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other experts.
General Liability Property Damage Adjuster - Washington Dc/Baltimore Eagle MartinGeneral Liability Property Damage Adjuster - Washington Dc/BaltimoreWashington, DCYour EMpact: Determine appropriate methods and extent of needed investigation for all assigned claims, including conducting investigations through field visits and phone contact; obtaining contracts, job files, and appraisals; conducting insured, witness, and claimant interviews and/or statements, complete site inspections; scope, measure and write estimates, and using other fact-finding methods to evaluate liability, damages, and proper coverage. Investigate insurance claims in a variety of settings including, but not limited to: retail establishments, office buildings, residences, condominiums, apartments, hotels, corporate facilities, governmental facilities, schools, clinics, or hospitals; assess loss or damage resulting from various events including, but not limited to, inclement or catastrophic weather, construction defect, and fire.