Claims processor IconmaClaims processorRemote, AZRemote$12–$15 / hourRecord Keeping: Maintain detailed records of claims processed, decisions made, and communications with claimants for auditing purposes, and report daily results to the lead at the end of each day without fail. Conduct thorough evaluations of claims to assess legitimacy while meeting monthly production and quality targets.
Claims Processor Self-Funded Marpai Administrators LLCClaims Processor Self-FundedColumbia, SCRemoteFull timeMarpai Administrators (“Marpai”) is an AI-powered national TPA (third party administrator) using deep learning and machine learning to maximize population health outcomes with the greatest cost efficiency for any health plan budget. Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.
Claims Processor 3 Zenith American SolutionsClaims Processor 3San Francisco, CaliforniaWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. High school diploma or general education degree (GED); two years related experience processing all types of group health and/or dental benefit claims.
Claims Processor 1 Zenith American SolutionsClaims Processor 1San Francisco, CaliforniaWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Claims Processor Zenith American SolutionsClaims ProcessorPortland, OregonWe are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide.
Claims Processor II InnovAgeClaims Processor IIDenver, Colorado$22.84–$27.40 / hourFull timeInnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. Regardless of past practices, all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.
Claims Processor Redeemer HealthClaims ProcessorPhiladelphia, PennsylvaniaFull timeResponsible to reconcile daily import, acceptance and rejection reports and collaborates with Billing Manager on all issues causing claim delays and achieving the HRHS CBO clean claims targets established by Senior Leadership. The Corporate Finance Department strives to contribute to this mission by working with the entire organization to provide the most positive financial climate possible, for continued caring, comforting and healing for all in need.
Claims Processor Holy Redeemer Health System IncClaims ProcessorPhiladelphia, PAResponsible to reconcile daily import, acceptance and rejection reports and collaborates with Billing Manager on all issues causing claim delays and achieving the HRHS CBO clean claims targets established by Senior Leadership. The Corporate Finance Department strives to contribute to this mission by working with the entire organization to provide the most positive financial climate possible, for continued caring, comforting and healing for all in need.
Dental Claims Processor I Moda HealthDental Claims Processor IMILWAUKIE, OR$17.34–$18.36 / hourFor more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees.
Associate, Claims Receipt Processor Ametros Financial CorpAssociate, Claims Receipt ProcessorWilmington, MA$20–$23 / hourAmetros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds.
Claims processor ICONMA, LLCClaims processorRemote, AZRemote$12–$15 / hourRecord Keeping: Maintain detailed records of claims processed, decisions made, and communications with claimants for auditing purposes, and report daily results to the lead at the end of each day without fail. Conduct thorough evaluations of claims to assess legitimacy while meeting monthly production and quality targets.
Associate, Claims Receipt Processor Ametros FinancialAssociate, Claims Receipt ProcessorMassachusettsAmetros's team works closely with patients, insurers, employers, attorneys, brokers, medical providers, and Medicare to create a seamless experience for our clients. Ametros is changing the way individuals navigate healthcare by providing them with the tools and support necessary to make educated decisions on how to spend their medical funds.
Claims Specialist - USFHP Providence St. Joseph HealthClaims Specialist - USFHPSeattle, WAFull timeOur strong team environment and respect for our people-at all levels and from all backgrounds-allow us to provide authentic care that achieves the highest-quality patient outcomes, backed by the strong network of resources and support through our affiliation with the Providence family, including local partners like Swedish Health Services. Pacific Medical Centers (PacMed) is a private, not-for-profit, primary and integrated multi-specialty health care network with outpatient clinics and primary and specialty care providers in King, Snohomish and Pierce counties.
Senior Claims Specialist / Insurance Follow-Up - Physicians Billing (REMOTE - WA Providence St. Joseph HealthSenior Claims Specialist / Insurance Follow-Up - Physicians Billing (REMOTE - WASeattle, WARemoteFull timeIt is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Supervisor, Medical Claims Moda HealthSupervisor, Medical ClaimsMilwaukie, OR$59,922.05–$74,902.56 / yearControls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
Medical Claims Auditor (Hybrid) Northwest Administrators, IncMedical Claims Auditor (Hybrid)Federal Way, WA$30.70–$41.54 / hourAs a Health and Welfare Claims Auditor, the main focus will be to review the work completed by the Health and Welfare Medical, Dental, Vision, Time Loss and Life Claims Processors. This position requires collaboration with other auditors, outside vendors, account executives, department supervisors and managers, and medical consultants.
Medical Claims Auditor Hybrid Northwest Administrators IncMedical Claims Auditor HybridSeattle, WA$30.70–$41.54 / hourAs a Health and Welfare Claims Auditor, the main focus will be to review the work completed by the Health and Welfare Medical, Dental, Vision, Time Loss and Life Claims Processors. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
Sr. Medical Claims Examiners (3+ years of Xcelys required) NTT DATASr. Medical Claims Examiners (3+ years of Xcelys required)remote, TXRemoteAs part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
Xcelys Medical Claims Examiner-REMOTE NTT DATAXcelys Medical Claims Examiner-REMOTEOntario, CARemoteActual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
PROGRAMS CLAIM PROCESSOR Pilgrim's Pride CorpPROGRAMS CLAIM PROCESSORGreeley, CO$19–$21 / hourThe Programs Claims Processor is responsible for supporting sales programs by processing and reconciling trade payments, maintaining program agreements, and resolving payment discrepancies while partnering with Sales, Customers, and Brokers to ensure accurate and timely execution. For individuals assigned and/or hired to work in states where it is required by law to include a reasonable estimate of the compensation for any given position, compensation ranges are specific to those states and takes into account various factors that are considered in making compensation decisions, including but not limited to a candidate's relevant experience, qualifications, skills, competencies, and proficiencies for the role.
PROGRAMS CLAIM PROCESSOR JBS USA LLCPROGRAMS CLAIM PROCESSORGreeley, CO$19–$21 / hourThe Programs Claims Processor is responsible for supporting sales programs by processing and reconciling trade payments, maintaining program agreements, and resolving payment discrepancies while partnering with Sales, Customers, and Brokers to ensure accurate and timely execution. For individuals assigned and/or hired to work in states where it is required by law to include a reasonable estimate of the compensation for any given position, compensation ranges are specific to those states and takes into account various factors that are considered in making compensation decisions, including but not limited to a candidate's relevant experience, qualifications, skills, competencies, and proficiencies for the role.
NonIT - Claim and Benefits Processor 2 Veterans Sourcing GroupNonIT - Claim and Benefits Processor 2Salem, ORRemoteThe main function of the Benefits Processor is to analyze disability claim information, make benefit decisions and payments on lower liability claims; administer low maintenance claims; provide administrative support for the department's management of disability claims including the set-up and distribution of new claims; provide responsive customer service to claimants, policyowners, Benefits staff, and group offices. •Investigate, secure and analyze information pertaining to claimant's medical condition, insured status and other policy provisions to accurately determine eligibility for, and entitlement to disability benefits for low liability and short duration claims; identify, file/fact discrepancies and outstanding issues and secure additional documentation as needed while investigating within prescribed time frames.
Transaction Processor Claim Resolution MMC GroupTransaction Processor Claim ResolutionHelena, MTThroughout the past 35+ years, MMC, one of the most trusted names in workforce management services, has successfully delivered strategic solutions to large and small businesses in numerous industries. As a Transaction Processing Associate on the Claims Resolution Team, you'll be responsible for accurately entering and reviewing claim data to ensure integrity, compliance, and timely resolution.
Supervisor, Healthcare Services Claims Moda Partners IncSupervisor, Healthcare Services ClaimsPortland, OR$59,922.05–$74,902.56 / yearControls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
Medical Claims Examiner Employ-TempsMedical Claims ExaminerUniontown, OHYou can view all our jobs by copying and pasting this link in your browser: https://employtemps.com/jobs/. Demonstrate a positive and cooperative work attitude and promote teamwork.
Claims Examiner \ 105 Paladin Consulting, Inc.Claims Examiner \ 105Irving, TX$21.33 / hourInternational non-profit healthcare system headquartered in Irving, Texas founded in 1999, provides comprehensive healthcare services through a network of more than 60 hospitals, hundreds of clinics and outpatient facilities, and virtual care services across Texas, Louisiana, Arkansas, New Mexico, as well as parts of Mexico, Chile, and Colombia. Looking for a Junior Claims Processor with 1–2 years of healthcare claims processing experience to join growing team.
Distinguished Architect, Software Development - Claims Processing Platform CVS Health CorpDistinguished Architect, Software Development - Claims Processing PlatformTX$175,100–$334,750 / yearAs the technical visionary for this initiative, you will define the architectural roadmap, evaluate and recommend the target technology stack-balancing engineering needs with enterprise direction-and guide a large engineering organization through a multi-year transformation from legacy mainframe systems to modern, cloud-enabled, API-driven architectures while maintaining operational stability for mission-critical processing. This ecosystem will unify intelligent workflow tools, operational platforms, a modernized claims adjudication user interface, and supporting services into a cohesive solution that transforms how claims processors interact with adjudication systems across all lines of business.
Medical Claims Resolution Analyst - Remote Montana Gainwell Technologies LLCMedical Claims Resolution Analyst - Remote MontanaMTRemote$35,000–$50,000 / yearGainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. The pay range for this position is $35,000 - $50,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
Medical Claims Resolution Analyst - Remote US Gainwell Technologies LLCMedical Claims Resolution Analyst - Remote USMTRemote$35,000–$50,000 / yearGainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. The pay range for this position is $35,000 - $50,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
Supervisor, Healthcare Services Claims - Internal Applicants Only Moda HealthSupervisor, Healthcare Services Claims - Internal Applicants OnlyPortland, OR$59,922.05–$74,902.56 / yearControls workflow and quality by checking date and amount of work in processors queues, assigns work to ensure time service goals, tracks processors production and quality. Facilitates problem solving for employees and Manager by answering claims related questions dealing with contract interpretation of benefits, procedures and claims systems.
NewMedical Claims Analyst SouthEast Alaska Regional Health ConsortiumMedical Claims AnalystJuneau, Alaska$31.83–$44.56 / hourPartners with PRC leadership, Finance, providers, and other stakeholders to resolve complex claims issues, improve claims processing workflows, support provider communication, and ensure accurate and timely payment of authorized services. Supports reporting projects for finance leadership and the executive team by gathering, validating, analyzing, and summarizing claims data, utilization trends, outstanding liabilities, denial activity, payment status, and other information needed for operational, financial, and strategic decision-making.
Medical Claims Specialist Redirect HealthMedical Claims SpecialistPhoenix, ArizonaMedical Claims Specialist helps ensure claims are handled accurately and thoughtfully, so people can focus on getting the care they need without stress, confusion, or unexpected costs. In this role, you will: Serve members, clients, providers, and internal operations teams who rely on clear, accurate claims processing.
First Party Medical Claims Adjuster Gainsco IncFirst Party Medical Claims AdjusterRichardson, TXAs a First Party Medical Claims Adjuster to process first-party medical claims across multiple states, ensuring accurate and timely payments in accordance with company guidelines. You'll review medical bills and supporting documentation, respond to customer/provider inquiries, and help customers understand benefits and next steps throughout the medical claims process.
Medical Billing Claims Specialist Caddis Capital ManagementMedical Billing Claims SpecialistSalt Lake City, UTFull timeWe are currently seeking Medical Billing/Claims Specialist who will be responsible for billing insurance claims to patient's insurance companies, following up on Accounts Receivable and coordinating collections on unpaid claims, as well as answering billing inquiries and assisting patients on their accounts as necessary. What We'd Also Like to See: While not required, some big marks in your favor would include: prior experience with medical insurance providers, any previous HME experience, an Associate's degree, and bilingual skills (Spanish/English).
Medical Claims Assistant Phaxis LLCMedical Claims AssistantManhattan, NY$26–$28 / hourThis role focuses on accurate data entry, insurance verification, and proper handling of claims in accordance with payer guidelines and healthcare regulations. The position requires strong attention to detail, the ability to interpret medical and insurance documents, and proficiency in Microsoft Excel for tracking and reporting purposes.
Medical Claims Specialist Ultimate Staffing ServicesMedical Claims SpecialistCarlsbad, California$55,000–$65,000The ideal candidate will have at least 3 years of experience in managing medical claims processes, ensuring accurate and efficient handling of claims, and delivering exceptional service to clients and providers. Ultimate Staffing is actively seeking an experienced Medical Claims Specialist to join a dedicated team in Carlsbad, CA.
Claims Auditor- Remote American Health PlansClaims Auditor- RemoteFranklin, TNRemoteFull timeIn partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. American Health Plans, a division of Franklin, Tennessee-based American Health Partners Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reside in long-term care facilities.
QUALITY ASSURANCE CLAIMS SPECIALIST – REMOTE LoanCareQUALITY ASSURANCE CLAIMS SPECIALIST – REMOTERemote$22.45–$37.69 / hourFull timeWe provide the necessary equipment; all you need is a quiet, private place in your home and a high-speed internet connection with a minimum network download speed of 25 megabits per second (MBPS) and a minimum network upload speed of 10 MBPS. Lifestyle & Learning Perks : Enjoy discounts on gym memberships, pet insurance, and employee purchasing programs, plus access to a tuition reimbursement program that supports your continued education and professional growth.
Experienced Medical Claims Biller II POM RecoveriesExperienced Medical Claims Biller IIFarmingdale, New YorkJoin our team as an Insurance Claims Follow-up Specialist, where you'll leverage your expertise in medical collections, denial processing, appeal submission, and EOB review to resolve unpaid claims effectively. Are you a seasoned professional with a minimum of 2 years of hospital in-patient and out-patient claims follow-up experience?
Medical Only Claims Specialist CorVel Enterprise Claims, Inc.Medical Only Claims SpecialistGlen Allen, VARemote$16.74–$26.92 / hourPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
Supervisor, Claims Medical Only Amtrust Financial Services IncSupervisor, Claims Medical OnlyPrinceton, NJ$66,900–$92,000 / yearSalaries are based upon a wide range of factors considered in making the compensation decision, including, butnot limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations. This may encompass supervision of administrative tasks and staff or oversight of the investigation of insurance claims involving workers compensation, property or casualty claims based on coverage, appraisal and verifiable injury or damage.
Medical- Dental Claims Specialist Mountain State Oral & Facial SurgeryMedical- Dental Claims SpecialistHurricane, WVOur company has been a prominent provider specializing in oral and maxillofacial surgery throughout the state of West Virginia for over 25 years with recent expansion into the Kentucky and Virginia regions. Our skilled surgeons utilize advanced oral and facial surgical techniques to deliver exceptional care.
Medical Billing & Claims Manager (DHPI98) Tuba City Regional Health Care CorpMedical Billing & Claims Manager (DHPI98)Tuba City, AZProvides technical assistance to management, medical providers, patients and other facility personnel by obtaining information relative to medical billing requirements, covered services, audit reports, or billing statistics, Coordinates and oversees work of staff; has the responsibility of distributing workloads as. Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job.
Medical Billing & Claims Manager (DHPI98) Tuba City Regional Health Care CorporationMedical Billing & Claims Manager (DHPI98)Tuba City, ArizonaFull timeProvides technical assistance to management, medical providers, patients and other facility personnel by obtaining information relative to medical billing requirements, covered services, audit reports, or billing statistics, Coordinates and oversees work of staff; has the responsibility of distributing workloads as. Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job.
Medical Biller - Healthcare Claims Guidehouse IncMedical Biller - Healthcare ClaimsSan Marcos, CA$38,000–$63,000 / yearCompensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
Medical Billing Claims Clerk Global Channel ManagementMedical Billing Claims ClerkPalm Harbor, FloridaMedical Billing Claims Clerk duties: following up with customers, verifying the clients information, scheduling installations, sending emails, creating customer accounts, utilizing product and pricing information to assist in answering questions and provide quotes. Proficient in medical billing clearinghouse Availity and Emdeon (Change Healthcare) Accounts payable and receivable knowledge is a plus.
Supervisor, Claims Processing Turo IncSupervisor, Claims ProcessingArizona, AZ$62,000–$78,000 / yearWhether you're flying in from afar or looking for a car down the street, searching for a rugged truck or something smooth and swanky, Turo puts you in the driver's seat of an extraordinary selection of cars shared by local hosts. The Claims Processor Supervisor leads a team responsible for operational claims support, ensuring efficient workflows, high-quality claim handling, and an exceptional customer experience for hosts and guests.
Medical Claims Examiner Ultimate Staffing ServicesMedical Claims ExaminerPasadena, California$21–$29 / hourThis role ensures accurate and timely processing of claims while maintaining compliance with federal and state regulations and providing high‑quality service to providers and members. The Medical Claims Examiner is responsible for reviewing, analyzing, and adjudicating medical insurance claims in accordance with policy provisions, regulatory guidelines, and organizational procedures.
Medical Claims Reviewer (RN) Broadway VenturesMedical Claims Reviewer (RN)Remote$60,000–$63,000 / yearWhere that is the case, the position and its final compensation are contingent upon award of the contract to Broadway Ventures and on the terms of the awarded contract, including any government-approved labor rates and the applicable wage determination. Actual pay offered depends on job-related factors, which may include skills, experience, education, certifications and licensure, geographic work location, contract funding and budget.
NewClaims Operations Quality Assurance Specialist Pacific LifeCorpClaims Operations Quality Assurance SpecialistOmaha, NE$32–$37 / hourHow You'll Make an Impact: Perform detailed quality audits of claims transactions across Pay QA, Set-Up QA, and Follow-Up QA, including claim payment accuracy, interest review and calculation, post-death interest, initial claim setup, documentation, beneficiary/payee information, follow-up requirements, and completion of required claim actions. How you'll help move us forward: Consistently apply sound judgment and accountability when evaluating pay accuracy, interest review and calculation, post-death interest, claim setup completeness, follow-up activity, documentation quality, and adherence to claims procedures.