Claims Adjudication Jobs

Experienced healthcare reimbursement specialist needed to define and maintain hospital payer contracts in Experian Health's Contract Manager to ensure accurate claim valuations and patient estimates.

The NYC Law Department seeks an Assistant Supervisor — Benefits Examiner Level 2 to adjudicate workers' compensation claims, calculate benefits, coordinate medical examinations, and support supervisory duties.

Lead claims operations and automation efforts for a growing TPA-focused insurer to ensure accurate, compliant, and cost-effective adjudication for self-funded health plans.

Lead AHF’s health plan claims unit as the Claims Department Manager, overseeing claims adjudication, denials and appeals, team performance, and operational improvements to ensure accurate, timely reimbursement.

Lead Gravie’s Stop Loss Claims team to ensure timely, accurate adjudication of stop loss claims and drive quality, productivity, and continuous improvement across the function.

Cognizant is hiring a remote Claims Processor to adjudicate professional and institutional medical claims accurately using Facets and standard coding guidelines.

Cognizant is seeking a US-based, fully remote Medical Claims Processor to adjudicate professional and institutional claims accurately using payer-specific rules and internal systems.

Cognizant is hiring a remote Claims Processor experienced with Facets to accurately adjudicate professional and institutional healthcare claims and ensure compliance with payer rules.

Lead the development and delivery of a patient financial incentive platform, owning claims, adjudication, and operational tooling to improve healthcare choices and outcomes.

Point C Health is hiring a Business Analyst to translate business needs into functional requirements, improve processes, and support cross-functional initiatives in a remote capacity.

Inclusive & Diverse

Diversity of Opinions

Mission Driven

Empathetic

Growth & Learning

Transparent & Candid

Medical Insurance

Dental Insurance

Vision Insurance

Learning & Development

Mental Health Resources

Social Gatherings

Fitness Stipend

401K Matching

Lead Spring Health’s payer integration portfolio to deliver timely, high-quality payer launches, improve claims performance, and manage a growing integrations team.

RightwayRx is hiring a Pharmacy Technician (CPhT) to perform utilization management tasks, process authorizations, and support specialty pharmacy coordination in their Dallas operations.

Meijer is hiring a Pharmacy Technician to deliver outstanding customer service while assisting with prescription processing, inventory management, and pharmacy operations on Zeeb Road in Ann Arbor.

Centivo is hiring a detail-oriented Business Analyst to manage incoming requirements, coordinate with stakeholders and vendors, and hand off clear tickets and timelines to the Data Integration team.

Sun Life U.S. is hiring a Client Support Liaison to serve as the primary group-claims contact for mid-market employer clients, driving service recovery, reporting, and client-facing education.

United Concordia Dental is hiring a Remote Claims Processor in Pennsylvania to accurately adjudicate and adjust dental claims while maintaining quality and compliance.

Experienced licensed pharmacist needed to provide clinical subject-matter expertise and configure prior authorization intent across PBM/claims systems for Evernorth's client-facing operations.

Experienced operations leader needed to oversee multi-site claims and call center operations for Archimedes, driving financial performance, operational efficiency, and excellent customer experience.

Ullico is hiring a working Supervisor for Group Life Claims to oversee adjudication and team performance for life, AD&D, waiver and survivor income claims.

Sedgwick is hiring a Workers' Compensation Claims Examiner in Long Beach to adjudicate complex California WC claims, negotiate settlements, and provide high-quality client and claimant communications in a hybrid work model.

Sedgwick is hiring a Remote Workers' Compensation Claims Examiner with MA jurisdiction experience to manage and resolve lost-time claims for a diverse client base.

Rightway is hiring a bilingual (English/Spanish) Certified Pharmacy Technician to provide remote member-facing pharmacy navigation and prior-authorization support during MST/PST hours.

Contribute to Sedgwick's trusted claims services as a Workers Compensation Claims Associate in a hybrid work setting.

Sutherland is hiring an experienced Associate Manager to lead and mentor a remote team focused on healthcare claims automation.