Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Health Claims Case Specialist — Adjudication

Sun Life

Sun Life is seeking a Case Specialist for Supplement Health Claims in the United States. The role involves independent claim review, eligibility determinations, and collaboration with employers and carriers to adjudicate benefits under applicable contracts and regulations. The incumbent will interpret policy language, manage data, and mentor new hires, with a focus on accuracy, efficiency, and customer service in a dynamic team environment. #J-18808-Ljbffr Sun Life

Vacancy posted 16 hours ago
Similar jobs that could be interesting for youBased on the Health Claims Case Specialist — Adjudication in Wellesley, MA vacancy
  • Sun Life in the United States seeks a Case Specialist, Supplement Health Claims to manage initial liability claims for Critical Illness, Cancer, Hospital Indemnity and Accidental plans. You will review data, investigate with claimants and partners, and determine initial... 
    Suggested

    Stryker Corporation

    Wellesley, MA
    16 hours ago
  • Mass General Brigham Health Plan is seeking a detail-oriented claims processor to work remotely, performing claims adjudication and coding verification to ensure accurate payment and compliance with billing regulations. Ideal candidates will have 2-4 years in healthcare... 
    Suggested
    Remote job
    Full time

    Mass General Brigham Health Plan

    Somerville, MA
    3 days ago
  • Mass General Brigham Health Plan is an exciting place to be within the healthcare industry...  ...more. Job Description Summary Review claims to ensure accurate coding, appropriate...  ...billing regulations and payer guidelines. Adjudicate claims to pay, deny, or pend as... 
    Suggested
    Full time
    Work at office
    Remote work
    Monday to Friday
    Flexible hours

    Mass General Brigham Health Plan

    Somerville, MA
    3 days ago
  • $26 per hour

     ...We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Waltham, MA. This...  ...Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy....  ...first call resolution to help health care providers and patients with their... 
    Suggested
    Full time
    Temporary work
    Work experience placement
    Relocation package
    Flexible hours
    Shift work

    Onco360

    Waltham, MA
    2 days ago
  • $21.1 - $44.99 per hour

    We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At...  ...underwriting exceptions/financial variances for their assigned cases to the appropriate level. Assists sales personnel in explaining... 
    Suggested
    Hourly pay
    Full time
    Temporary work
    Work at office
    Local area

    CVS Health

    Boston, MA
    2 days ago
  • Acadia Insurance, Marlborough, MA, is seeking an experienced claims professional to investigate, evaluate, and resolve high exposure commercial liability claims. You will negotiate with insureds and third parties, coordinate with underwriting and loss control, and mentor... 

    Acadia Insurance (a Berkley Company)

    Marlborough, MA
    1 day ago
  • $89.89k - $134.84k

    Who We ArePoint32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan... 
    Full time
    Work from home

    Point32Health

    Canton, MA
    16 hours ago
  • $18 - $25 per hour

    Pathways Healthcare is a leading home health and hospice provider, focused on patient-centered care. The main office is located in Westwood, MA, with a schedule Monday-Friday, 8:30 AM-5:00 PM. This full-time billing role offers an hourly rate of $18.00-$25.00. Join a mission... 
    Hourly pay
    Full time
    Work at office
    Monday to Friday

    PATHWAYS HEALTHCARE, LLC

    Westwood, MA
    4 days ago
  • $1,000 per month

     ...customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products,...  ...Adjuster, you will investigate and evaluate homeowners property claims from start to finish. You will confirm the facts of loss, determine... 
    Contract work
    For contractors
    Work at office
    Work from home
    Visa sponsorship
    Work visa
    Relocation package

    National General

    Natick, MA
    2 days ago
  • $18 - $25 per hour

    Pathways Healthcare, LLC in Westwood, MA is hiring for a full-time billing role focused on home health and hospice claims. You will audit, prepare, and follow up on documentation to ensure accurate and timely billing while supporting patient care. The position follows a... 
    Hourly pay
    Full time
    Monday to Friday

    Pathways Healthcare, Llc

    Westwood, MA
    16 hours ago
  • $100k - $165k

     ...property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of...  ...financial strength, underwriting excellence, superior claims handling expertise and local operations globally. At Chubb, we are... 
    Local area

    Chubb

    Boston, MA
    4 days ago
  • $78k - $112k

     ...product roll out. Collaborating with underwriters, operations, claims, marketing and home office product management Consistently...  ...property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of... 
    Work at office
    Local area
    Home office

    Chubb

    Boston, MA
    3 days ago
  •  ...flexibility of remote work for focused tasks and projects. The Claims Specialist works within a Claims Team, using the latest technology to...  ...compensability/liability. Establishes action plan based on case facts, best practices, protocols, regulatory issues and available... 
    Work experience placement
    Work at office
    Local area
    Remote work

    Liberty Mutual Insurance

    Boston, MA
    3 days ago
  • $69k - $98k

    Senior Claim Representative Sharing Economy - Accident and Health (Hybrid) Our employees are at the heart of what we do: helping people, businesses and society prosper in good times and be resilient in bad times. When you join our team, you are bringing this purpose to... 
    Full time
    Work at office
    Flexible hours

    Intact Insurance Specialty Solutions

    Canton, MA
    16 hours ago
  • $110k - $120k

     ...rated A+ (Superior) by A.M. Best, with an A+ claim paying ability rating by Standard & Poor’...  ...direction, handles the most complex cases and those involving the most complex questions...  ...discretionary bonus Benefits include: Health, dental, vision, dental, life, disability... 
    Full time

    Acadia Insurance (a Berkley Company)

    Marlborough, MA
    1 day ago
  • $78k - $106k

     ...leading medical and emotional and mental health benefits, dental, and vision insurance...  ...office 5 days a week. Responsibilities The Claims Specialist under the supervision of the Director of...  ...is necessary, such as medical case management, vocational rehabilitation counseling... 
    Temporary work
    For contractors
    For subcontractor
    Work at office

    Suffolk

    Boston, MA
    16 hours ago
  • USI Insurance Services seeks an experienced adjuster to manage workers' compensation claims, including lost and non-lost time cases. You will apply in-depth knowledge of claims processes, communicate with clients, carriers, and claimants, and support negotiations and resolutions... 

    USI Insurance Services

    Burlington, MA
    1 day ago
  • USI Insurance Services in Needham, MA is seeking an experienced claims adjuster for workers' compensation claims. You will adjust lost time and non-lost time claims, communicate with clients and carriers, and review and authorize related expenses. You will influence outcomes... 

    USI Insurance Services

    Needham Heights, MA
    1 day ago
  • $59.9k - $98.2k

    Zurich is looking for an accomplished Workers Compensation Claims Specialist II to serve our Northeast region. This position offers a hybrid...  ...coverage. Work to have a timely resolution to claims by developing case strategy and case evaluation, and escalating issues as... 
    Full time
    Temporary work
    For contractors
    Apprenticeship
    Work at office
    Local area
    Remote work
    Visa sponsorship

    Zurich North America

    Boston, MA
    3 days ago
  • $83k - $157k

    Schedule: Full-Time Salary Range: USD $83000.00 - $157000.00 Job Category: Claims Description Looking for an amazing new claims opportunity? Senior Complex Construction Claims Specialist - Complex CGL & Construction Liability (Litigated, $500K+) Overview... 
    Full time
    Work at office
    Local area
    Immediate start
    Remote work
    Home office

    Liberty Mutual Insurance

    Boston, MA
    1 day ago
  • $49.01k

     ...nurse, nutritional counseling, and mental health resources Tuition assistance programs...  ...once trained. Job Responsibilities Claim Service Specialists act as advocates for our customers....  ...and fairly. They thoroughly check claim case facts, determine coverage, liability,... 
    Full time
    Work experience placement
    Remote work
    Flexible hours

    Arbella Insurance Group

    Wakefield, MA
    1 day ago
  • DentaQuest is building a better future for oral health in the United States. The incumbent will perform statistical and trend analyses of corporate accounts to monitor profitability and drive pricing decisions. This role supports the underwriting department by providing... 

    DentaQuest - Boston, MA

    Boston, MA
    3 days ago
  • $72k - $141k

     ...direction, and within broad authority limits, to manage commercial claims with high complexity and exposure for a specific line of...  ...on oversight/watch lists, and preparing and presenting succinct case summaries to senior management.Maintains subject matter expertise... 
    Full time
    Work experience placement
    Work at office
    Local area
    Flexible hours
    Shift work

    CNA Financial

    Boston, MA
    4 days ago
  • $101.18k - $119.78k

     ...meet the unique coverage and claims‑handling needs of businesses....  ...York City and is focused on adjudicating first and third party commercial...  ...tasks to ensure that cases move to the best financial outcome...  ...comprehensive benefits program‑including health, dental, vision, 401(k) with... 
    Full time
    Local area
    Remote work

    Argonaut Management Services, Inc

    Boston, MA
    1 day ago
  • This Opportunity WSP is currently initiating a search for a Early Career Human Health Risk Assessor for our Chelmsford, Massachusetts office. Be involved in projects with our Earth & Environment Team and be a part of a growing organization that meets our client’s objectives... 
    Work at office

    WSP

    Chelmsford, MA
    16 hours ago
  • A leading environmental consulting firm in Chelmsford, Massachusetts is seeking an Early Career Human Health Risk Assessor to join their team. The role involves conducting risk assessments for various environmental projects and requires a Bachelor's degree in a relevant... 

    WSP

    Chelmsford, MA
    4 days ago
  • Early Career Human Health Risk Assessor - Chelmsford, Massachusetts, USA. WSP is seeking a motivated candidate to join our Earth & Environment Team, executing multimedia risk assessments (air, water, soil, biota) across government and commercial projects. Responsibilities... 

    WSP in the U.S.

    Chelmsford, MA
    4 days ago
  • A leading environmental consulting firm is seeking an Early Career Human Health Risk Assessor in Chelmsford, Massachusetts. The role involves conducting multimedia risk assessments and using Microsoft Excel for data analysis and calculations. Candidates should have a Bachelor... 

    WSP in the U.S.

    Chelmsford, MA
    1 day ago
  • $37.66 - $44.33 per hour

     ...meet the unique coverage and claims-handling needs of businesses....  ...Rockwood (PA). This role will adjudicate indemnity workers'...  ...and complete tasks to ensure cases move toward the best financial...  ...benefits program, including health, dental, vision, 401(k) with... 
    Hourly pay
    Temporary work
    Remote work

    Argonaut Management Services, Inc

    Boston, MA
    2 days ago
  •  ...experienced Automotive Warranty Administrator to join our team in the Norwood area. The role focuses on accurate processing of warranty claims, verifying coverage, and reconciling receivables with manufacturers, while collaborating with service staff and suppliers. We value... 

    Nucar Family of Dealerships

    Norwood, MA
    4 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Health Claims Case Specialist — Adjudication. Be the first to apply!