Claims Review Jobs

Regulatory Intern supporting North America and EU/UK regulatory activities at e.l.f. Beauty, assisting with reviews, submissions, and regulatory documentation in a hybrid New York role.

Dane Street is seeking an experienced RN QA Specialist to perform clinical quality assurance on long-term disability physician reports and ensure timely, accurate deliverables for clients.

Dane Street is hiring a detail-focused Disability Customer Service Representative to handle case intake, system drafting, physician assignment, and client communication for disability and workers' compensation reviews.

Pentair is hiring a Senior Insurance & Risk Analyst to lead insurance program administration, claims management, and risk analytics while supporting captive operations and enterprise risk governance.

Presbyterian Healthcare Services seeks a detail-oriented Health Services Assistant in Albuquerque to manage prior authorizations, claims-related documentation, provider coordination, and data entry to support patient care and clinical operations.

Experienced group benefits professional needed to manage client relationships, execute RFP/RFI processes, and resolve day-to-day issues for a collaborative, remote-first team serving employer benefit plans.

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

Work remotely as a Medical Coding Reviewer I at Centene, conducting clinical claim and record reviews to ensure accurate coding, compliance, and identification of billing issues.

O-I Glass seeks a detail-oriented Legal Specialist in Perrysburg to manage litigation support, e-discovery, legal holds, and records management in a hybrid role.

Experienced utilization review professional needed to manage authorizations, appeals, audit tracking, and serve as an SME for the UR team at Saint Mary of Nazareth in Chicago.

Oscar Health is hiring a Payment Integrity Analyst in Tempe to investigate dual coverage, verify claim payments, and support Coordination of Benefits initiatives.

Presbyterian Healthcare Services is hiring a Health Services Assistant in Albuquerque to manage prior authorizations, medical records coordination, claims research, and provider communications.

EnableComp is hiring a Resolution Analyst to manage denials and underpayment appeals, leveraging contract review and proprietary RCM tools to recover revenue for healthcare clients.

Humana seeks a licensed Texas DDS/DMD with clinical and utilization review experience to serve as Dental Director, providing clinical oversight of claims, appeals, policy development, and quality initiatives for its Texas member population.

AECOM is hiring an experienced Program Master Scheduler / Estimating Manager to lead program-level cost estimating and controls for large, schedule-driven infrastructure programs in Sacramento.

Lead SFO’s enterprise risk, insurance and compliance programs, managing staff and stakeholders to identify, mitigate and insure against risks across operations, capital projects and emerging digital assets.

Remote Clinical Support Coordinator (Certified Medical Assistant) role reviewing claims and preparing DBQ orders for timely provider completion at MPF Federal.

Invivyd is hiring a Senior Director, Commercialization and Development Counsel to lead legal strategy and risk mitigation for commercialization, regulatory, and development activities across the business.

MPF Federal is looking for a remote Clinical Support Coordinator (CMA) to review claims records, set up DBQ orders, and prepare accurate, quality-backed documentation for examiner review.