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34 results for Claims jobs

Claims Examiner

New Haven, CT
onsite
Temporary / Contract
32 - 35 USD / Hourly
We are seeking a detail-oriented Claims Examiner to join a fast-paced, customer-focused environment. This is a temporary, fully on-site opportunity where the Claims Examiner will manage claims from intake through resolution, ensuring accuracy, compliance, and excellent service throughout the lifecycle of each case.Key Details<ul><li>Service Type: Temporary to hire</li><li>Schedule: 5 days on-site</li><li>Hours: 8:30 AM – 5:00 PM EST</li><li>Location: New Haven, CT</li></ul>Responsibilities<ul><li>Manage workers’ compensation claims from setup through closure</li><li>Review claim and policy information to support investigations</li><li>Conduct thorough investigations, including gathering statements from claimants, insured parties, and medical providers</li><li>Determine claim compensability based on collected facts</li><li>Communicate claim decisions, including denials, to relevant stakeholders</li><li>Prepare detailed reports on investigations, settlements, and claim evaluations</li><li>Administer statutory medical and indemnity benefits in a timely manner</li><li>Set and adjust reserves within authority limits and recommend changes as needed</li><li>Monitor claim progress and recommend corrective actions to leadership</li><li>Coordinate with attorneys on hearings and litigation</li><li>Direct vendors such as nurse case managers and rehabilitation specialists</li><li>Ensure compliance with customer service standards and regulatory requirements</li><li>File necessary documentation with state agencies</li><li>Identify subrogation opportunities and support recovery efforts</li><li>Collaborate with internal teams to deliver high-quality claims handling</li></ul>
2026-04-21T00:00:00Z

Claims Examiner

Greenville, NY
onsite
Permanent / Full Time
50000 - 75000 USD / Yearly
We are looking for a detail-oriented Claims Examiner to join our team in Greenville, New York. In this role, you will be responsible for thoroughly investigating and resolving Property and Casualty claims while ensuring compliance with applicable regulations and company policies. This position demands strong analytical skills, effective communication, and the ability to handle complex situations with fairness and integrity. Responsibilities: • Conduct detailed investigations and assessments of Property and Casualty claims, including analyzing coverage and policy terms. • Oversee the claims process from initial notification through resolution, ensuring timely and accurate handling. • Engage empathetically and effectively with policyholders, agents, attorneys, and vendors to address inquiries and concerns. • Resolve disputes and conflicts with attention to detail while adhering to policy guidelines and regulations. • Negotiate settlements within your authority, even in challenging or high-pressure scenarios. • Review supporting documentation such as estimates, reports, and medical records to evaluate the validity of claims. • Monitor compliance with New York State insurance regulations and company standards throughout the claims process. • Maintain organized and accurate claim files, ensuring documentation is timely and thorough. • Identify opportunities for fraud detection or subrogation and take appropriate action.
2026-04-17T00:00:00Z

Claims Examiner - Workers Compensation

Alpharetta, GA
onsite
Temporary / Contract
29 - 31 USD / Hourly
We are looking for a skilled Claims Examiner specializing in Workers Compensation to join our team on a contract basis in Alpharetta, Georgia. This position requires someone who is detail oriented and can deliver exceptional customer service while managing claims with accuracy and efficiency. The ideal candidate will possess strong analytical abilities, excellent communication skills, and a commitment to ensuring timely resolutions of claims. Responsibilities: • Manage and investigate Workers Compensation claims, ensuring compliance with established procedures and regulations. • Deliver outstanding customer service to insureds, claimants, agents, and other stakeholders through clear and effective communication. • Accurately assess expenses and losses related to Lost Time claims, providing timely and detailed reports. • Identify and address coverage issues, potential fraud, and subrogation opportunities while adhering to company guidelines. • Develop and execute effective claim strategies to achieve early resolutions and positive outcomes. • Maintain organized and up-to-date files using a diary system to monitor progress and follow up on new developments. • Communicate trends, issues, and claim activities to internal and external customers in a timely manner. • Collaborate with team members to ensure claims are managed and resolved effectively. • Provide guidance and direction to colleagues to facilitate efficient claim processing and resolution.
2026-04-03T00:00:00Z

Insurance Coverage Attorney

Seattle, WA
onsite
Permanent / Full Time
145000 - 190000 USD / Yearly
A multi-office law firm in Seattle is seeking an experienced Insurance Coverage Attorney to join their team. The salary range for the role is 145-190k base with additional structured bonus earnings on a standard billable target of 1800. The firm offers medical, dental, vision and life insurance, unlimited PTO, 401k plus company match, transportation benefits and other perks. They offer a flexible hybrid work structure, allowing attorneys to regularly work-from-home weekly if desired.
2026-04-24T00:00:00Z

Insurance Coverage Attorney

Seattle, WA
onsite
Permanent / Full Time
165000 - 190000 USD / Yearly
We are looking for an accomplished attorney to join a boutique law firm in Downtown Seattle, with a strong focus on insurance coverage matters. This position offers the opportunity to advise clients on complex policy issues, manage sophisticated disputes, and contribute to high-level litigation strategy. The ideal candidate brings sound judgment, strong research abilities, and a proven background handling insurance-related claims and coverage analysis. Responsibilities:• Advise clients on insurance coverage questions, including policy interpretation, claims evaluation, and dispute management strategies.• Handle a portfolio of insurance coverage and related litigation matters from early assessment through resolution.• Perform in-depth legal research and translate findings into practical recommendations, motions, briefs, and case strategy.• Represent clients in court proceedings, mediations, settlement discussions, and other contested matters.• Review insurance policies, endorsements, and supporting records to assess rights, obligations, and potential exposure.• Monitor legal and regulatory developments affecting insurance law and incorporate those changes into client guidance and case planning.• Work closely with attorneys, paralegals, and administrative professionals to move matters forward efficiently and effectively. Firm offers lower billable goal than most firms and generous benefits including 3 weeks PTO, profit sharing bonuses, 401K with matching, year end bonuses, transportation stipend, hybrid work from home model, and quicker partnership track! For a confidential conversation about this opening please send your resume to Sam(dot)Sheehan(at)RobertHalf(dot)(com)
2026-04-22T00:00:00Z

Medical Claims Analyst

Raleigh, NC
onsite
Temporary to Hire
26.6 - 30.8 USD / Hourly
We are looking for a detail-oriented Medical Claims Analyst to join a team supporting Medicaid audit and claims review activities in Raleigh, North Carolina. This contract opportunity is ideal for someone who can evaluate provider billing practices, examine payment accuracy, and contribute to compliance-focused reviews with growing independence. The role offers the chance to apply analytical judgment, strengthen audit documentation, and help improve the integrity of Medicaid-related claims operations. Responsibilities: • Review provider billing records and medical claim activity to identify discrepancies, validate payments, and assess adherence to Medicaid guidelines • Carry out structured audit procedures for claims, denials, rejected claims, and billing documentation to support program integrity efforts • Interpret applicable Medicaid requirements and federal regulatory standards when analyzing audit results and determining potential issues • Develop clear working papers, summaries, and preliminary findings that accurately document testing performed and conclusions reached • Partner with internal stakeholders to clarify claim exceptions, address audit questions, and support corrective action recommendations • Analyze medical billing and Medicaid claim data to detect patterns, trends, and areas requiring additional review • Contribute to compliance examinations involving provider assessments, payment verification, and operational claim review activities
2026-04-27T00:00:00Z

Medical Claims Analyst

Raleigh, NC
onsite
Temporary to Hire
27.7115 - 32.087 USD / Hourly
We are looking for a Medical Claims Analyst to join our team in Raleigh, North Carolina on a Contract to permanent basis. This position is ideal for a detail-oriented individual who can evaluate Medicaid-related claims activity, support audit initiatives, and help maintain compliance with healthcare payment standards. The role offers the opportunity to work independently on analytical reviews while partnering with internal teams to strengthen accuracy, documentation, and regulatory alignment. Responsibilities: • Review provider records and claims activity to assess payment accuracy and identify discrepancies requiring follow-up. • Perform audit procedures tied to Medicaid claims, billing practices, denials, and rejected claims to support program integrity efforts. • Interpret Medicaid rules and applicable federal guidance when evaluating findings and determining compliance outcomes. • Prepare organized workpapers, summaries, and preliminary reports that clearly document testing results and supporting analysis. • Investigate claim issues and collaborate with stakeholders to address exceptions, recommend corrective actions, and support resolution plans. • Analyze medical billing and reimbursement data to detect trends, payment concerns, and areas of potential financial risk. • Support compliance reviews involving provider activity, claim adjudication, and payment validation across assigned cases.
2026-04-27T00:00:00Z

Medical Claims Analyst

Charlotte, NC
onsite
Temporary / Contract
27.55 - 31.9 USD / Hourly
We are looking for a detail-oriented Medical Claims Analyst to support audit activities, payment reviews, and compliance evaluations for Medicaid-related claims in Charlotte, North Carolina. This Long-term Contract opportunity is ideal for someone who can examine claim activity carefully, interpret regulatory standards, and contribute to accurate audit outcomes. The role requires strong analytical thinking, clear documentation practices, and the ability to help resolve claim and payment issues through structured review and reporting. Responsibilities: • Review provider records and claims activity to assess billing accuracy and identify payment discrepancies. • Conduct validation testing on medical and Medicaid claims to confirm compliance with applicable policies and reimbursement guidelines. • Analyze denied, rejected, and disputed claims to determine root causes and support appropriate resolution steps. • Prepare organized audit workpapers, supporting analyses, and written summaries of findings for internal review. • Interpret Medicaid rules and relevant federal guidance when evaluating claim transactions and provider payment practices. • Assist with compliance-focused examinations related to program integrity and recommend corrective actions when issues are identified. • Collaborate with stakeholders to address audit questions, clarify documentation, and support follow-up on outstanding findings.
2026-04-27T00:00:00Z

Insurance Coverage Counsel

New York, NY
onsite
Permanent / Full Time
200000 - 225000 USD / Yearly
We are looking for an experienced Insurance Coverage Counsel to join our dynamic legal team in New York, New York. In this role, you will provide strategic legal expertise to insurance carriers and self-insured entities, focusing on complex insurance coverage matters and litigation. This is an excellent opportunity for an experienced attorney to work on high-profile cases and collaborate with a team of skilled professionals. Responsibilities: • Analyze and interpret insurance policies to deliver comprehensive coverage opinions. • Manage complex insurance coverage litigation from initiation through resolution. • Draft pleadings, motions, and detailed coverage position letters to support legal strategies. • Represent clients in mediations, arbitrations, and court proceedings, ensuring effective advocacy. • Offer strategic counsel to insurers on high-stakes claims and exposure issues. • Work closely with litigation teams to address overlapping defense and coverage matters. • Conduct thorough legal research to support case strategies and recommendations. • Ensure compliance with relevant laws and regulations while advising clients. • Collaborate with clients to develop tailored solutions for intricate coverage disputes.
2026-04-14T00:00:00Z