Claims Specialist Remote Jobs

Join a team that's dedicated to managing external audits for Risk Adjustment processes. Oversee audit deliverables, collaborate with stakeholders, and ensure compliance while driving continuous improv...

Optimize compliance processes by leveraging your expertise in Medicare regulations. Collaborate with leadership to ensure adherence to CMS requirements, conduct risk assessments, and support audit rea...

Join a dynamic team to analyze and resolve complex Workers Compensation claims, ensuring timely adjudication while delivering exceptional service across multiple jurisdictions, including strong expert...

Empower a dynamic claims unit by leading innovative solutions, enhancing customer satisfaction, and driving performance improvements. Collaborate across functions to ensure effective claims management...

Drive accurate, evidence-based clinical claims while collaborating with Marketing, Legal, and Clinical teams. Build and manage the claims framework and evidence library to support bold, compliant mark...

Innovate data solutions by developing complex reports and analyses to support senior management and client needs. Collaborate with teams to enhance data literacy and provide technical guidance across...

Analyze complex data to develop insightful reports, support client needs, and provide technical guidance to analysts. Collaborate with senior management to enhance decision-making and drive business g...

Drive compliance excellence by executing the Medicare Compliance Advisory program, ensuring adherence to CMS regulations. Collaborate with leadership to provide regulatory guidance, conduct audits, an...

Join a team that's redefining subrogation leadership by driving strategic growth, optimizing operations, and enhancing client relationships. This role combines hands-on management with innovative tech...

Drive automation and AI initiatives in claims operations, enhancing efficiency and accuracy. Lead a team to optimize workflows, manage vendor performance, and ensure compliance while delivering measur...

Lead your career with a pivotal role in technical claim-handling, overseeing investigations and negotiations for complex property claims. Mentor team members and support audits while ensuring complian...

Join a team that's shaping the future of claims operations through innovation and AI. Leverage your expertise in business process optimization to enhance outcomes, improve efficiency, and deliver exce...

Advance your career by auditing outpatient and specialty claims, ensuring coding accuracy and compliance. Leverage your clinical and coding expertise to enhance audit processes and contribute to quali...

Unlock your potential by engaging in complex litigation, managing cases, and developing strategies in insurance coverage and bad faith matters. Join a flexible, national firm that values professional...

Join a team that's shaping the future of litigation in Southern California. We seek experienced attorneys to manage complex insurance coverage cases, offering flexible work options and opportunities f...

Unlock potential by managing complex medical malpractice claims, ensuring timely resolutions and high customer service. Utilize strong analytical skills to navigate severe injury cases while coordinat...

Lead the charge in supervising complex commercial casualty claims, ensuring effective management of 1st and 3rd party claims across multiple states. Drive operational excellence and foster team develo...

Advance your career by leading the Claims Domain for MMIS health care projects. Drive analysis, documentation, and quality processes while collaborating with clients and development teams to meet cust...

Lead the charge in expanding and underwriting a profitable Surety portfolio across the Central Region. Collaborate with brokers and leverage expertise to enhance market presence while ensuring adheren...

Drive impactful data mining initiatives by analyzing complex claims across Medicare, Medicaid, and Commercial sectors. Leverage your expertise to identify anomalies and enhance recovery opportunities...

Join the charge in managing complex litigated claims, guiding strategy, and negotiating settlements. Leverage your expertise to achieve timely resolutions while balancing costs and exposure in a dynam...

Engage healthcare providers and drive commercial performance in a defined territory. Collaborate with cross-functional teams to support product launches and ensure patient access to innovative therapi...

Unlock potential by leading comprehensive audits, ensuring accurate billing, and mentoring a team of Coding Auditors. You will evaluate documentation, validate coding, manage appeals, and maintain hig...

Drive the claims module for health care projects, providing domain expertise and analysis. Collaborate with teams to ensure quality processes, meet customer expectations, and assist in implementation...

Drive impactful projects by collaborating across teams to enhance operational efficiency and deliver innovative solutions. Leverage your expertise to influence strategic decisions and contribute to a...