Workers’ Compensation Claims Examiner III - Hybrid TEEMAWorkers’ Compensation Claims Examiner III - HybridLakewood, CO$80,000–$90,000This role is ideal for an experienced examiner with strong Colorado Workers’ Compensation knowledge who can independently manage files, make sound compensability decisions, and move claims efficiently from first report through resolution. You will manage an active caseload of approximately 150 claims, including medical-only, indemnity, lifetime medical, and permanent partial benefit files.
Data Exchange Manager - Claims Operations Capital Rx, Inc.Data Exchange Manager - Claims OperationsDenver, CO$150,800–$188,500 / yearThe role oversees analysts and specialists responsible for healthcare data integrations, client onboarding, EDI transactions, eligibility feeds, claims exchanges, configuration setup, data quality monitoring, and operational issue resolution. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
General Liability Claims Consultant CNA Financial Corp.General Liability Claims ConsultantLittleton, CO$72,000–$141,000 / yearThis individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line(s) of business. Performs a combination of duties in accordance with departmental guidelines: Manages highly complex investigations of claims, including coverage issues, liability, compensability and damages.
Administrative Assistant II - Claims (Hybrid) Intact Specialty SolutionsAdministrative Assistant II - Claims (Hybrid)Englewood, Colorado$54,000–$63,000 / yearIn return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society. Files documents, office product, and other materials, performs data entry of applicable office/division/group information, and maintains product library, references, and other indexes, as applicable.
Administrative Assistant II - Claims (Hybrid) Intact InsuranceAdministrative Assistant II - Claims (Hybrid)Englewood, CO$54,000–$63,000 / yearIn return, we promise you support, opportunities and performance-led financial rewards in a flexible work environment where you can: Shape the future: Help us lead an insurance transformation to better protect people, businesses and society. Files documents, office product, and other materials, performs data entry of applicable office/division/group information, and maintains product library, references, and other indexes, as applicable.
Claims Recovery Director CNA Financial Corp.Claims Recovery DirectorLittleton, CO$97,000–$189,000 / yearPerforms a combination of duties in accordance with departmental guidelines: Leads the work activities of Recovery Services professionals and/or managers and has full management responsibility for setting and communicating expectations, providing direction and coaching, facilitating ongoing training and development, managing employee performance and contributing to employee engagement. Responsibilities include managing direct staff, as well as outsourced vendor programs, while delivering superior business results through effective leadership of Recovery Services teams, driving continuous performance and operational improvements.
Oracle PL/SQL Developer Healthcare Claims Pyramid Consulting, IncOracle PL/SQL Developer Healthcare ClaimsDenver, CO$55–$65 / hourBy applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Key Responsibilities: Analyze and interpret US healthcare claims data to identify trends, risks, operational gaps, and strategic opportunities.
Casualty Claims Representative Auto-Owners Insurance CompanyCasualty Claims RepresentativeBroomfield, ColoradoThis job requires mastery of claims-handling skills and requires the person to: Investigate assigned casualty claims by collecting statements, physical evidence, and legal documentation. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.
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.
Grievance & Appeals Claims Specialist - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement.) Denver Health and Hospital AuthorityGrievance & Appeals Claims Specialist - Denver Health Medical Plan (Must Live in Colorado. Weekly On Site Requirement.)Denver, ColoradoOur benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center.
NewClaims Audit Analyst - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) Denver Health and Hospital AuthorityClaims Audit Analyst - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)Denver, ColoradoInteract and collaborate with other corporate groups such as Provider Relations, Member Services, Information Systems, Compliance, Third Party Recovery, Finance, Patient Accounts, Enrollment, Utilization Management and Product Line Managers. Daily data analysis and research of claims processing to ensure benefit structures and operation processes are adhering to the rules, regulations and contractual requirements by CMS, DOI, contracted and non- contracted providers.
Experienced Catastrophe Claims Representative Auto-Owners Insurance CompanyExperienced Catastrophe Claims RepresentativeBroomfield, ColoradoAdditional benefits include: generous paid time off including holidays, vacation days, personal time, sick leave and parental leave; adoption assistance; discounts on personal insurance; education matching gift program, a student loan assistance program and a gym membership and fitness class reimbursement program. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs.
Director, Product Delivery (Claims) VizientDirector, Product Delivery (Claims)Centennial, CO$117,600–$206,000 / yearYou will engage with healthcare leaders to understand client needs, reinforce product value, and elevate the overall analytics delivery experience while driving operational excellence and scalability. Summary: In this role, you will lead the delivery strategy and execution for Sg2 claims analytics products, including Share of Care, Provider Connections, and Patient Flow, within the strategy discipline.
Sr. Default Claims Specialist Cornerstone Capital BankSr. Default Claims SpecialistEnglewood, ColoradoCornerstone Servicing, a division of Cornerstone Capital Bank, is a best-in-class mortgage servicer with a reputation for amazing service, customer satisfaction, employee retention and happiness! We honor God by using our talents to make a positive difference in the lives of our Team Members, Clients, Shareholders, Communities, and the People who provide services to us.
Medical Claims Review Medical Director - Surgeon - Remote UnitedHealth Group Inc.Medical Claims Review Medical Director - Surgeon - RemoteDenver, CORemote$248,500–$373,000 / yearThe Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members.
NewMedical Claims Review Medical Director - Remote UnitedHealth Group Inc.Medical Claims Review Medical Director - RemoteDenver, CORemote$248,500–$373,000 / yearThe Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members.
Roofing or Claims Canvasser | Outside Sales A2z BuildersRoofing or Claims Canvasser | Outside SalesDenver, ColoradoYour responsibilities will include creating and submitting sales reports, building rapport with new and existing customers within your territory, evaluating their needs, and negotiating successful deals. Building or remodeling a home is best described as a collaborative effort between a client and designer, representing a valuable investment within your home.
Data Exchange Analyst - Claims Operations Capital Rx, Inc.Data Exchange Analyst - Claims OperationsDenver, CO$96,800–$121,000 / yearThis role is responsible for executing and monitoring outbound eligibility, claims, formulary, and network reporting; supporting manual claims activities; assisting with custome data feed configurations; and participating in historical data loads and connectivity setups for JUDI Rx clients. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
SIU Claims Investigator - Retired Law Enforcement Lemieux & Associates LLCSIU Claims Investigator - Retired Law EnforcementDenver, CO$25–$32 / hourPart timeAccurately photograph evidence (accident scenes, vehicle damage, etc.).Skills & Experience· Experience handling complex SIU/Claims cases.· Our leadership team brings over 25 years of field experience and is committed to fostering a professional, results-driven environment.
NewSenior Claim Representative - Liability (Hybrid) Onebeacon Professional Insurance IncSenior Claim Representative - Liability (Hybrid)Englewood, CO$88,000–$92,000 / yearSome of the Senior Claim Representative responsibilities include but are not limited to: Makes timely and appropriate contacts, determines and completes appropriate level of investigation to make determination of coverage, assess liability and determine damages. We currently have an opportunity for a Senior Claim Representative to join our Liability team based in our Plymouth, MN; Denver, CO; Canton, MA; New York City, NY; Chicago, IL; Alpharetta, GA; Irvine, CA; Southfield, MI offices on a hybrid schedule.