Senior Health Claims Specialist: Complex Adjudication
$18.5 - $42.35 per hourHispanic Alliance for Career Enhancement
CVS Health is seeking a Medical Claims Specialist to review and adjudicate complex medical claims. The role requires minimum 18 months of experience in medical claim processing within a health insurance payor environment. Candidates should have excellent attention to detail and the ability to manage multiple assignments efficiently. The position offers a full-time opportunity with a pay range of $18.50 - $42.35 per hour, depending on experience and qualifications. Comprehensive benefits are also included. #J-18808-Ljbffr
$18.5 - $42.35 per hour
...CVS Health is seeking a Medical Claims Adjudicator in Idaho to review and adjudicate complex medical claims while supporting customer service operations. The role requires at least 18 months of experience in medical claim processing with specific qualifications in detail...SeniorHourly payFull time$18.5 - $42.35 per hour
CVS Health is hiring a Medical Claims Processor in Oklahoma. This full-time position involves reviewing complex medical claims and providing expertise to ensure compliance with guidelines. The ideal candidate should have 18 months of experience in medical claim processing...SeniorHourly payFull time$18.5 - $42.35 per hour
A leading healthcare provider in the United States seeks a Medical Claims Specialist to review and adjudicate complex claims. The ideal candidate has at least 18 months of experience in medical claim processing within a high-volume environment and demonstrated attention...SeniorHourly payFull time$18.5 - $42.35 per hour
We're building a world of health around every individual - shaping a... ...Position Summary Reviews and adjudicates complex, sensitive, and specialized medical claims in accordance with established... ...specified claims and those that exceed specialist adjudication authority or...SeniorRemote jobHourly payFull timeWork experience placementLocal area- Liberty Mutual Insurance in the United States is seeking an experienced Claims Adjuster. This role focuses on investigating and resolving complex Workers’ Compensation claims and requires expertise in claims management strategies. You will work closely with management and...Senior
$87.5k - $129k
Sedgwick Claims Management Services Ltd is seeking a Sr. Claims Specialist for Professional Liability work. This role involves analyzing complex medical malpractice claims, negotiating settlements, and coordinating legal defenses while ensuring high levels of customer service...SeniorRemote job- Insurance Administrative Solutions, L.L.C. is seeking a Health Insurance Claims Adjuster in Idaho. The role involves analyzing claims to determine... .... The ideal candidate will have at least 1 year of claims adjudication experience, strong research and communication skills, and...
$72k - $141k
CNA Insurance in New York is seeking an experienced Claims Manager to oversee unsupported excess claims management. The role requires negotiation of complex claims and managing investigations while ensuring compliance with regulations. The ideal candidate will have at...Senior- Hiscox is seeking a Senior Claims Examiner for its US team. This hybrid role requires 3-5 years... ...liability. Responsibilities include adjudicating claims, drafting coverage letters, and... ...extensive benefits, including competitive health insurance, a 401(k) plan, and generous...Senior
- Karna LLC is looking for a Temporary, Full-Time Medical Claims Processor to join the Bakinaw-Karna Joint Venture Team. The role involves processing complex medical claims for the World Trade Center Health Program, ensuring accuracy and compliance. The ideal candidate will...Remote jobFull timeTemporary work
$100k
...unique coverage and claims-handling needs of businesses... ...Business Title(s): Senior Construction Defect Technical Claims Specialist Employment Type:... .... This role will be adjudicating our most complex construction defect... ...benefits program-including health, dental, vision, 401(...SeniorFull timeLocal areaRemote work- NYC Health + Hospitals seeks a Complex Care Coordinator to oversee patients with behavioral health issues in New York. Responsibilities include care management, coordinating services, and utilizing EMR systems for documentation. Candidates must have a master’s or bachelor...Senior
- NYC Health + Hospitals seeks a Project Manager to oversee complex departmental projects aimed at improving health care initiatives. The role includes responsible supervision of project lifecycles, collaborating with various teams, and managing deliverables from start to...Senior
$100k
...Senior Technical General Liability Bodily Injury Claims Specialist Argo Group is an underwriter of specialty... ...and is focused on adjudicating commercial General Liability... ...degree of technical complexity, potentially with... ...program—including health, dental, vision, 401(...SeniorLocal area- Tokio Marine HCC is seeking a Senior Claims Examiner in New York, NY. The ideal candidate will analyze complex claims and ensure compliance with policies and contracts. Responsibilities include reviewing claims, communicating with stakeholders, and mentoring less experienced...Senior
$67.9k
Senior Claims Examiner Seneca is looking for a senior claims specialist who enjoys being a key part of a dynamic team. As a Senior Claims... ...mid-to-high level of risk and complexity. You will also be expected to... ...benefits that go beyond health, dental & vision. Our programs...SeniorRemote jobWork at officeFlexible hours$140k - $170k
...Join our dynamic and forward-thinking Claims team! Here, you’ll be part of an... ...IL; Manhattan, NY; West Hartford, CT. Senior Complex Claims Specialist - Professional Liability Our Senior Complex... ...Professional Liability, A&E, Allied Health, and Media claims from inception to...SeniorPermanent employmentTemporary workWork at office2 days per week- HCC Service Company, Inc. is seeking a Senior Claims Examiner in New York, NY to analyze coverage and process complex claims efficiently. You will be responsible for reviewing submitted claims, drafting action plans, and ensuring compliance with department workflows. Ideal...Senior
$130k - $170k
Aon is seeking a Property Claim Consultant in New Jersey to provide senior-level advisory services for complex commercial property insurance claims. This role involves leading claim preparation efforts, strategic guidance on loss quantification, and direct client interaction...SeniorRemote job$130k - $170k
Aon Corporation is seeking a Property Claim Consultant for a senior-level role involving complex property insurance claims. This position offers the flexibility of hybrid or remote work and requires strong advisory skills. The consultant will provide strategic guidance...SeniorRemote work$68.04k - $118.8k
...of the nation’s largest not for profit health insurers, serving members across New York... ...and explore new opportunities. Provide Claims project management oversight to ensure that... ...with Cognizant Claims Tower to manage adjudication of problematic claims until system...SeniorContract workH1bVisa sponsorship$125k - $175k
...Senior Claims Specialist Date: Jan 7, 2026 Company: Odyssey Headquartered in New York City with offices throughout the U.S. and in Vancouver,... ...policies. Determine potential subrogation and fraud within complex cases. Provide timely updates to management and underwriting...SeniorWorldwide$94.85k
R T Specialty, LLC in New York is hiring a Senior Binding Authority Underwriter to leverage extensive industry knowledge and underwriting expertise. This role requires evaluating complex risks, negotiating terms, and managing relationships with brokers and clients. A minimum...Senior- Integrated Specialty Coverages, LLC is seeking a Senior Underwriter (Accident & Health) to work remotely. The role focuses on developing a portfolio by reviewing complex insurance applications and cultivating broker relationships. This position also contributes to team...SeniorRemote jobWork at office
$18 per hour
...A leading healthcare provider is hiring a Senior Claims Examiner to work from home, ensuring accurate adjudication of complex claims for SCCIPA contracted plans. The ideal candidate will have a high school diploma and two years of experience in claims processing. Responsibilities...SeniorHourly payFull timeRemote workWork from home$117k - $184.4k
...XL is an Equal Opportunity Employer. Our Claims team sets us apart. Our experienced Claims... ...expertise to handle even the most complex claims seamlessly. You focus on excellence... ...offer a competitive retirement savings plan, health and wellness programs, and many other benefits...Senior$100k - $140k
...Senior Claims Specialist Headquartered in New York City with offices throughout the U.S. and in Vancouver, Canada, Hudson is a market-leading... ...Specialist is responsible for managing all aspects of complex third-party liability claims, including class actions and high...SeniorWorldwide- ...Merchant Cash Advance Underwriter to join their in-house underwriting team in New York. This senior-level position requires a disciplined credit professional adept at assessing complex files and comfortable dealing with both clean and high-risk transactions. The ideal...SeniorWork at office
$85k - $130k
...taking part in the selection process. Claims Specialist – Employment Practices Liability & Ancillary... ...Liability while engaging with complex insureds on significant and dynamic disputes... ...medical plans for you and your family, health and wellness programs, retirement plans...SeniorWork at officeShift work3 days per week- ...liability and technology E&O claims. Investigate and analyze coverage... ...; draft routine and complex coverage correspondence; effectively... ...salary for the Sr. Claims Specialist, Casualty, & PL, Cyber is $78... ...to select from multiple health, dental and vision insurance...SeniorFull timeWork from home
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