NewData Exchange Analyst - Claim Ops TPA Capital Rx LLCData Exchange Analyst - Claim Ops TPANew York, NY$96,800–$121,000 / yearKey Responsibilities: Data Integration & Mapping: Design, develop, and maintain data mappings and transformations for incoming and outgoing healthcare data files: 837/835 - claims & remittance, 270/271 - eligibility and responses, 278 - Prior Auth, 276/277 - claim status, 999/TA1 - file level acknowledgement as well as proprietary formats. Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Judi Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and.
SIU Claims Investigator - Spanish Speaker Lemieux & Associates LLCSIU Claims Investigator - Spanish SpeakerStamford, CT$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 Assistant HealthCare Partners, MSOClaims AssistantGarden City, NY$21–$22.50 / hourOur network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 165+ skilled professionals dedicated to ensuring members have access to the highest quality of care while efficiently utilizing healthcare resources.
Senior Software Engineer Insurance Tech Evolution IQSenior Software Engineer Insurance TechNew York, NY$215,000–$230,000 / yearRequirements: 5+ years of engineering experience, with a track record of delivering features end-to-end by partnering with Product, defining scope, designing data models, implementing solutions, and maintaining them in production. Partner closely with Product, Data Science, and Data Engineering to deliver scalable, intuitive applications while contributing to technical design, code reviews, and engineering best practices.
Director, Claim Payment Accuracy Clover Health Investments CorpDirector, Claim Payment AccuracyNYRemote$150,000–$195,000 / yearYou will be actively leveraging AI tools like Claude, Gemini, and ChatGPT to build out ongoing monitoring and oversight trends that identify high-impact risks to support judgmental sampling and targeted audits. By championing automated monitoring and data-driven research, you will evolve the team into a proactive strategic powerhouse, ensuring Clover''s payment ecosystem achieves top-tier precision and technological sophistication.
Mitigation Project Manager | Metro NY/NJ Paul Davis Restoration of Metro New York / New JerseyMitigation Project Manager | Metro NY/NJNew York, NY$65,000–$85,000 / yearFull timeYou'll manage customer communication, field operations, documentation, budgets, and claim compliance while ensuring projects move efficiently and customers feel supported. To create opportunities for great people to deliver best-in-class results—and build lasting careers while doing it.
Accounts Receivable Specialist Oshi Health, IncAccounts Receivable SpecialistNY$47,000–$52,000 / yearYou will work closely with our Revenue Cycle leads, other members of the Revenue Cycle team, finance, and clinical teams to resolve payment discrepancies, improve AR performance, and maintain accurate financial records. Oshi Health is revolutionizing GI care with a digital clinic model that provides easy, convenient access to an integrated and multidisciplinary care team that takes a whole-person approach to diagnosing, managing, and treating digestive health conditions.
NewMedical Biller Integrity Placement GroupMedical BillerBayonne, NJ$20–$25 / hourThe ideal candidate will be responsible for accurately processing medical claims, managing insurance billing, and ensuring timely reimbursement while maintaining compliance with healthcare regulations. The practice is committed to providing exceptional patient care while helping patients achieve long-term health and wellness.
Billing Specialist - Brooklyn, NY OOS Management Corp.Billing Specialist - Brooklyn, NYBrooklyn, NY$20–$27 / hourWe here at Licensed Behavior Analyst Professional Services, PLLC are looking for a sharp and dedicated Billing Specialist to ensure our claims are submitted accurately and our revenue cycle stays healthy. Experience working denials and resubmissions with measurable recovery rates.
Counsel, Claim The Travelers Companies IncCounsel, ClaimMorristown, NJ$106,300–$175,400 / yearAs a Counsel with Travelers you will be responsible for high quality, proactive case handling and will have the opportunity to use your legal expertise and litigation skills to handle a caseload of predominantly low to moderate complexity and deliver optimal results for Travelers'' insured customers. Travelers offers the strength of a national legal organization committed to your professional development while maintaining a local focus, positioning you as a strong business partner and trusted advisor who delivers exceptional value through local expertise and outstanding client service.
Claims - Field Claims Representative Cincinnati Financial CorporationClaims - Field Claims RepresentativeGarden City, NY$68,400–$91,200 / yearThis territory allows either an experienced or entry-level representative the opportunity to investigate and evaluate multi-line insurance claims through personal contact to ensure accurate settlements. Our Field Claims department is currently seeking field claims representatives to service the territory surrounding: Garden City, NY (Nassau County).
NewSenior Coverage Counsel Fortegra FinancialSenior Coverage CounselStamford, CTThis role will partner closely with Underwriting, Product, Regulatory, Reinsurance, Operations and business leadership to advise on complex risk issues, craft and interpret policy and contract language, assess claim and coverage positions, and support the development, distribution and administration of insurance and warranty products. This is a hands-on insurance and warranty product development and legal construct-focused role for an attorney who understands how insurance products work in practice - from policy language, exclusions, and coverage determinations to state insurance considerations, product structures, claims disputes, and specialty program operations.
NewDental Billing Specialist scotchplain fanwood sdentalcareDental Billing Specialistfanwood, NJFull timeThe ideal candidate will be responsible for handling billing and insurance claims, processing patient payments, verifying insurance benefits, and supporting front office operations. This role is essential to ensuring accurate and timely financial transactions and maintaining excellent patient communication regarding billing matters.
NewInvestigator Ethos Risk ServicesInvestigatorLong Island, NYPart timeCONDITIONS:While we aim to keep assignments within a 2-hour drive of your residence, occasional further travel and overnight stays (covered by the company) may be requiredMost surveillance cases start at 6:00AM. REQUIREMENTS:Previous Experience: Demonstrated proficiency in covert surveillance techniques, capturing high-quality video footage, and preparing thorough, well-organized investigative reports.
Medical Collections Specialist High End HiringMedical Collections SpecialistNew York, NY$28–$32 / hourWe are seeking an experienced Medical Collections Specialist to join our team and help manage insurance collections, claim follow-up, and revenue recovery from a variety of commercial insurance carriers, including BCBS and other out-of-network payers. If you are a motivated collections professional with a strong understanding of insurance reimbursement and a passion for helping healthcare practices succeed, we would love to hear from you.
Commercial Insurance Analyst - Remote CSAA Insurance GroupCommercial Insurance Analyst - RemoteNYRemote$110,700–$123,000 / yearAlabama - Home Teleworkers, Alabama - 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, Nebraska - Home Teleworkers {+ 20 more}. Pursuit or completion of industry-relevant continuing education, including graduate degrees, MBS, risk and insurance designations from The Institutes (AINS, AIC, ARM, CPCU, etc.), or actuarial exams and designations (ACAS, FCAS, CERA).
Member Revenue Analyst Progyny, Inc.Member Revenue AnalystNew York, NY$65,000–$75,000 / yearHeadquartered in New York City, Progyny has been recognized for its leadership and growth as a TIME100 Most Influential Company, CNBC Disruptor 50, Modern Healthcare's Best Places to Work in Healthcare, Forbes' Best Employers, Financial Times Fastest Growing Companies, Inc. 5000, Inc. Our benefits solution empowers patients with concierge support, coaching, education, and digital tools; provides access to a premier network of fertility and women's health specialists who use the latest science and technologies; drives optimal clinical outcomes; and reduces healthcare costs.
Vice President, Marketing & GTM Insurance SaaS Evolution IQVice President, Marketing & GTM Insurance SaaSNew York, NY$260,000–$275,000 / yearAs part of CCC Intelligent Solutions, a publicly traded technology company (NASDAQ: CCC) serving the P&C insurance industry, we combine EIQ''s AI-native product development with CCC''s 40 years of proprietary data and deep carrier relationships. About Us: EvolutionIQ''s mission is to deliver state-of-the-art technology that helps insurance claims teams make claims handling more accurate, fair, and efficient, so that more people impacted by injury or illness can continue their lives with dignity and stability.
Staff Software Engineer Insurance Tech Evolution IQStaff Software Engineer Insurance TechNew York, NY$245,000–$270,000 / yearDeep architectural experience with existing systems, not just greenfield: evaluating, modernizing, and replatforming, including multi-tenant, multi-user backends and solid relational database design. You''ll help architect systems and set the engineering best practices others build on, think hard about where and how to bring AI to bear (the right tools, in the right systems, at the right time), and write the code that turns those decisions into value for our customers.
Agentic Solutions Consultant (Insurance Saas) EvolutionIQAgentic Solutions Consultant (Insurance Saas)New York, NYThis includes helping customers understand how EvolutionIQ's solutions will integrate with their claims systems, policies, eligibility feeds, data flows, and workflows, and shaping the transformation narrative that allows executive sponsors to secure buy-in internally. Create reusable solution design artifacts, workflow maps, reference architectures, ROI templates, customer assessment frameworks, and implementation playbooks that help EvolutionIQ scale the agentic sales motion.