NewClaims Auditor Property (Temporary/Project Based) Alan Gray LLCClaims Auditor Property (Temporary/Project Based)Boston, MAThe auditor will apply his or her experience and training, along with specific account instructions and pertinent regulations, to evaluate all aspects of claim handling, including coverage determinations, negotiations, internal and external communications, and the notation and documentation contained in the files under review. Depending on experience and ability, the position may require project management responsibilities where the individual will direct and oversee audits and manage assigned auditors.
NewAuto PD Adjuster Epitec StaffingAuto PD AdjusterWorcester, MA$55,000–$62,000 / yearResponsibilities: Manage an active pending inventory of approximately 80-120 moderately complex service claims from intake through resolution, receiving an average of 5 new claims daily. This includes determining coverage and liability, conducting thorough investigations, evaluating damages, and negotiating settlements in accordance with policy terms, best practices, and jurisdictional requirements.
NewPatient Billing Specialist ActalentPatient Billing SpecialistWestwood, MA$25–$27 / hourUnderstand hospital and professional billing practices, including reading and interpreting Explanation of Benefits (EOBs), billing commercial and government payers, resolving claim denials, and assisting with coordination of benefits (COB). If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
NewShipping & Logistics Coordinator Borg Design IncShipping & Logistics CoordinatorHudson, MAPrepare and verify complete outbound shipment and end-item documentation packages, as applicable, including packing lists, Certificates of Conformance, material certifications, special-process certifications, inspection reports, First Article Inspection documentation, source-inspection approvals, serial/lot traceability records, and customer-specific forms. The successful candidate must understand how product identification, traceability, inspection status, certifications, First Article Inspection requirements, source inspection, document control, export controls, and customer-specific requirements affect whether product can be received or released for shipment.
Claims Processor Global Channel ManagementClaims ProcessorWestford, MassachusettsReview incoming membership documents (Microsoft Excel and Word) to confirm accuracy in formatting and validity of data; includes communicating when updates are needed for successful membership enrollment and/or submission for processing. Monitor team shared Outlook mailbox for incoming membership documents sent from clients, brokers or Third Party Administrators.
NewBilling Supervisor Kelly ServicesBilling SupervisorStoughton, MA$29–$49 / hourKelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account.
NewBilling Specialist Kelly ServicesBilling SpecialistStoughton, MA$21–$27 / hourKelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account.
MMIS Business Analyst The Computer Merchant, LtdMMIS Business AnalystQuincy, MA$60–$65 / hourContractorThe Business Analyst (BA) will work on our established Provider Reimbursement and Claims processing functional areas to support the development, testing and implementation of projects and enhancements to meet the business objectives of the MassHealth (Massachusetts Medicaid) program specifically projects to support the member community. * While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and business considerations.
Claims Quality Control Auditor (44912) Neighborhood Health Plan of Rhode IslandClaims Quality Control Auditor (44912)Smithfield, RIResponsibilities include, but are not limited to the following: Review Neighborhood's claim process functions, including auto adjudicated and manually processed claims and issues, based on provider and health plan contractual agreements and claims processing guidelines. This Master IA will be created from results of the weekly Claims Adjustment Committee meeting and be used by adjusters from each delegate to reprocess claims according to the respective configuration changes in each system.
NewClaims Review Specialist, DSNP Mass General BrighamClaims Review Specialist, DSNPSomerville, MassachusettsRemoteWorking with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.
NewProcess Consultant, Stop Loss Claims Sun Life FinancialProcess Consultant, Stop Loss ClaimsWellesley Hills, MA$60,400–$90,600 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. Job Description: The opportunity: The Process Consultant, Stop Loss Claims is accountable for process governance, end-to-end documentation strategy, and continuous improvement that strengthens quality, compliance, scalability, and risk management within Stop Loss Claims Operations.
Claims Svc Rep. TPI Global (formerly Tech Providers, Inc.)Claims Svc Rep.Worcester, MAGuided by your manager, you will provide general assistance to agents, insureds, and claimants, matching their needs with our services using provided scripts to assist you in serving our customers. Proficiency in using and toggling between multiple computer applications, dual screens, and MS Office Suite products (Word/Excel, Outlook, SharePoint, Teams);Independent use of provided resources.
Claims Svc Rep. TPI Global SolutionsClaims Svc Rep.Worcester, MAGuided by your manager, you will provide general assistance to agents, insureds, and claimants, matching their needs with our services using provided scripts to assist you in serving our customers. " Proficiency in using and toggling between multiple computer applications, dual screens, and MS Office Suite products (Word/Excel, Outlook, SharePoint, Teams); Independent use of provided resources.
Stop Loss Claims Resolution Consultant Sun Life FinancialStop Loss Claims Resolution ConsultantWellesley Hills, MA$54,100–$81,200 / yearThis role combines deep technical expertise as a Stop Loss Health Claims Analyst with responsibility for managing end-to-end inquiry resolution, including research, claim determination support, documentation review, and clear customer communication. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
Senior Manager, Stop Loss & Health Claims Sun Life FinancialSenior Manager, Stop Loss & Health ClaimsWellesley Hills, MA$68,200–$102,300 / yearThrough employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.
Senior Program Manager / Project Manager - Medicaid Claims CVS HealthSenior Program Manager / Project Manager - Medicaid ClaimsMassachusettsResponsible for implementing best practices, facilitating workstreams through change, and ensuring effective delivery of projects and initiatives that enhance provider experience. Lead enterprise delivery of multiple, highly complex business process and technology initiatives aligned to the Medicaid program, supporting all lines of business.
NewClaims Examiner I Beyond Risk Management IncClaims Examiner IBeverly, MAAssist with case reserve management: Help set and monitor case reserves for assigned claimants, research medical conditions and treatment plans, and document reserve rationale with support from management. Pitch in where needed: Assist with logging new claim submissions, notifications, claims reporting, cross-training opportunities, high-volume periods, and special projects assigned by management.
Claims Service Representative OnDek SolutionsClaims Service RepresentativeWorcester, MAWe are actively seeking Claims Service Representatives to join a premier, nationally recognized Property & Casualty insurance provider at their customer service center in the Worcester, MA area. Guided by your team and structured support, you will deliver empathetic service, handle claims intake, and help policyholders get back on their feet.
Complex Claims Director, Management Liability American International GroupComplex Claims Director, Management LiabilityBoston, MA$122,000–$150,000 / yearYou will be responsible for handling all aspects of complex directors & officers claims, including securities class actions, high exposure employment practices liability and fiduciary liability matters, from inception through conclusion brought against publicly traded, privately held and not-for-profit insureds. Our Claims teams are the proven problem solvers of choice for clients, delivering consistent technical excellence and showcasing our service differentiation to create an unparalleled global claims handling experience.
Claims Casualty Adjuster AAAClaims Casualty AdjusterLincoln, Rhode Island$33.43–$44.53 / hourClaims Casualty Adjuster Job Summary The Claims Casualty Adjuster handles low to moderate-complexity claims involving material damage, property, and/or liability lines of insurance written by the Interinsurance Exchange in compliance with all regulatory and statutory requirements. With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.