NewAttorney - FCA/Healthcare Fraud Enforcement JobotAttorney - FCA/Healthcare Fraud EnforcementWashington, DC$150,000–$400,000 / yearExperience representing hospitals, health systems, physician groups, Medicare Advantage organizations, managed care organizations, pharmacy benefit managers (PBMs), healthcare technology companies, or private equity-backed healthcare platforms. Demonstrated experience representing clients before the U.S. Department of Justice (DOJ), U.S. Attorney's Offices, Department of Health and Human Services Office of Inspector General (HHS-OIG), Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, and other federal or state enforcement authorities.
459763 Public Adjuster Metro Public Adjustment459763 Public Adjusterbaltimore, MDFull timeConduct a virtual walk-through inspection of the property, take some pictures, and fill out about 5 minutes worth of paper work. We are seeking motivated, self-starters in your area, who want to succeed.
NewOutside Sales Representative AmeriPro RoofingOutside Sales RepresentativeGermantown, MD$120,000–$250,000 / yearWe are always looking for committed and hard-working people to join our team and have job openings ranging from project manager and sales representatives to property inspectors through to joining the management team, plus everything in-between!\r\nCareers Icon\r\nPositions are full time, W2 positions!\r\nWe invite you to build and advance your career with AmeriPro Roofing and help contribute to the future success of our company. AmeriPro Roofing has been featured in Fortune 500 Magazine and was named a Top 100 Roofer by Roofing Contractor Magazine.\r\nTrophy Icon\r\nAmeriPro Roofing has earned the rank of Platinum Preferred Contractor with Owens Corning as well as being the Top Volume Contractor in the nation with Owens Corning 6 years in a row.
NewCustomer Service Representative Klinger Insurance GroupCustomer Service RepresentativeGermantown, MDUsing your impeccable communication skills and work ethic, you will apply critical thinking skills, work independently and anticipate agency needs and client questions. We’re on a mission to build long lasting relationships with our clients, have a positive societal impact through our work, and build an inclusive culture where all people can thrive and do their best work.
NewTreatment plan coordinator/Front desk receptionist Lakeview Dental PcTreatment plan coordinator/Front desk receptionistWaldorf, MDAs the first point of contact, our Front Desk Receptionist plays a crucial role in ensuring a seamless and positive experience for every patient. We are a patient-centered dental office committed to providing high-quality care in a warm and professional setting.
NewPsychologist - (Part-time) - Fairfax, VA Commonwealth Medical ServicesPsychologist - (Part-time) - Fairfax, VAFairfax, VA$600–$750 / yearWhether you are an experienced psychologist seeking a more flexible role or looking to transition into a lower-stress practice setting, this opportunity offers the ability to continue making a meaningful impact while maintaining work-life balance. Step away from the demands of traditional clinical practice and enjoy a structured, low-stress environment with 1099 compensation , work-life balance, and built-in support.
NewCommercial Lines Account Manager The Misch GroupCommercial Lines Account ManagerFairfax, VAIndustries: Contractors, non-profits, wholesalers, retailers, restaurants/caterers, apartments, unions, chemical manufacturers, transportation, auto leasing, professional services firms, terminal operators, and more. This individual will provide professional, high-quality customer service, manage a diverse commercial book of business, and support producers in servicing and marketing new and renewal accounts.
NewCustomer Service Representative - State Farm Bilingual Spanish Dovie E Metzger Insurance Agency InCustomer Service Representative - State Farm Bilingual SpanishAnnapolis, MD$18–$20 / hourAs a Customer Service Representative with the Dovie E. Metzger Insurance Agency, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
NewAdministrative Assistant Ace Home Health Care LLCAdministrative AssistantWoodbridge, VAYou will perform clerical and administrative functions, intake applications, claim processing and keep the office in order. Previous experience in office administration or other related fields.
NewClaims Processor Total Recon Auto CenterClaims ProcessorRockville, Maryland$23–$26 / hourpointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]"> Position Overview: As a Claims Processor at Total Recon, a Tesla-approved body shop, you will be the primary liaison with insurance companies. You will ensure that all claims progress smoothly and are properly compensated, while keeping the Production staff and Customer Service Representatives (CSRs) informed on all claim-related matters.
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 - Adjuster, Claims I Ampcus IncorporatedClaims - Adjuster, Claims IBaltimore, MD$20–$25.75 / hourVerifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records. Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services.
Senior Claims Adjuster, Casualty Claims, Hamilton Select Hamilton GroupSenior Claims Adjuster, Casualty Claims, Hamilton SelectUSA, Richmond, Virginia, VAWorking remotely or based in Richmond, Virginia or the tri-state area and reporting to a Claims Manager who is based in Richmond, you will be responsible for the direct handling of casualty and/or specialty claims, including both primary and excess placements, along with assisting in the mentoring of future claims adjusters. Hamilton Select is our US excess and surplus lines insurer based in Richmond, Virginia, underwriting hard-to-place accounts in the small and middle-market space through an appointed wholesale broker network.
Claims Bluecard Analyst IV, Lead Healthcare Management AdministratorsClaims Bluecard Analyst IV, LeadWashingtonAs a Claims Bluecard Analyst Lead, this role ensures accurate, compliant adjudication across complex BlueCard claims, translates BlueWeb and Association changes into operational action, partners closely with Regence and InterPlan stakeholders, and monitors and improves IPP (InterPlan Program) performance. The Claims Bluecard Analyst Lead serves as an enterprise escalation point, leads cross-functional initiatives, and drives training, quality, and process improvements that safeguard claim outcomes and member experience.
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.
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.
NewProcess Consultant, Stop Loss Claims Sun Life FinancialProcess Consultant, Stop Loss ClaimsBaltimore, MD$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.
Stop Loss Claims Resolution Consultant Sun Life FinancialStop Loss Claims Resolution ConsultantBaltimore, MD$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.
Stop Loss Claims Specialist Marsh McLennanStop Loss Claims SpecialistWashingtonThe primary role of the Stop Loss Claims Analyst role is to manage the stop loss claims process for the MMA Stop Loss Center of Excellence including establishing the claims submission process in accordance with vendor processes, overall tracking and auditing to assure timely payment of eligible stop loss claims managed by the Center of Excellence. REQUIRED EDUCATION AND EXPERIENCE : Minimal of High School Graduate with Associate’s Degree in Risk Management & Insurance, Actuarial Science, Mathematics and/or other related field is preferred or equivalent experience preferred; Minimum of two years prior work experience the Benefits Brokerage, Consulting, or Insurance industry; Strong background in self-funding, stop loss or claims administration required.
Senior Manager, Stop Loss & Health Claims Sun Life FinancialSenior Manager, Stop Loss & Health ClaimsBaltimore, MD$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.