1,261 Claims Examiners jobs in the United States

We are seeking a dedicated and knowledgeable Senior Claims Processing Specialist to join our team. In this role, you will:

• Review and adjudicate complex and sensitive claims in accordance with established plan processing guidelines.
• Act as a subject matter expert by providing training and coaching to team members.
• Address and resolve complex issues effectively and efficiently.
• Handle customer service inquiries related to claims processing, ensuring excellent service delivery.

Your expertise will be invaluable in maintaining the integrity of our claims operations and providing exceptional support to our clients.

Remote Data Entry & Claims Processing Analyst (Healthcare Industry)
Location: Remote (U.S. only - see excluded states at the bottom)
Placement Type: Contract (Open-ended)
Schedule:
+ Training: Part-time hours starting at 8 AM MST for ~4 weeks
+ Full-Time Hours Post-Training: Must start after 7 AM MST and end by 5 PM MST
Job Overview
We are seeking a highly analytical and detail-oriented Data Entry & Claims Processing Analyst to support a fast-growing healthcare organization. This role is fully remote and focuses on manual data processing, Excel-based data manipulation, and claims submission preparation.
Key Responsibilities
+ Oversee manual data processes within Charge Entry & Claims Submission workflows
+ Generate weekly/monthly charge reports using internal systems
+ Manipulate large datasets (30K+ rows) in Excel to prepare for claims submission
+ Match values across multiple datasets, apply formulas, and use conditional formatting
+ Identify data inaccuracies and missing information, troubleshoot and resolve issues
+ Interpret and follow logic in pre-existing Excel formulas
+ Clean and validate data based on provided guidelines
+ Support automated claims submission once data is prepared
Required Skills & Qualifications
+ Advanced Excel proficiency: Must be able to work independently with raw data, build formulas, apply conditional formatting, and manage multiple sheets
+ Data migration & processing experience: Recent roles must have involved heavy Excel usage
+ Tech-savvy: Comfortable managing multiple systems and remote setup
+ Typing speed: Minimum 60 WPM with high accuracy
+ Excel Test Required: Must pass an intermediate Excel 365 test (formulas, pivot tables, filtering, formatting)
Preferred Qualifications
+ Experience in charge entry or claims processing
+ Healthcare or insurance industry background
Work Environment & Equipment Requirements
+ Fully remote (except in excluded states - please see below)
+ Must have a private, HIPAA-compliant workspace
+ Must provide own:
+ Dual monitors
+ Wireless keyboard & mouse compatible with Mac
Excluded States (Cannot Hire From):
Alaska, Arkansas, Delaware, Hawaii, Maine, Mississippi, New Mexico, Oklahoma, Puerto Rico, South Dakota, Vermont, Wisconsin
Contract Details
+ Open-ended contract: No guaranteed conversion to full-time, but top performers may be retained long-term
+ No overtime expected
Pay and Benefits
The pay range for this position is $20.00 - $20.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Sep 30, 2025.
h4>About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

**Details**
+ **Department:** Billing/Claims
+ **Schedule:** Full-Time, Days Mon. - Fri.
+ **Hospital:** Ascension St. Vincent's
+ **Location:** 3 Shircliff Way Jacksonville, Florida United States
**Benefits**
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
_Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer._
**Responsibilities**
Prepare and issues bills for reimbursement to individual and third party payers in an out-patient or medical office environment.
+ Prepare insurance claims for submission to third party payers and/or responsible parties.
+ Review claims for accuracy, including proper diagnosis and procedure codes.
+ Review claim rejections and communicates with payers to resolve billing issues.
+ Prepare and review routine billing reports.
+ Recommend process improvements based on findings.
+ Respond to complex telephone and written inquiries from patients and/or third party payers and physician practices.
**Requirements**
Education:
+ High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
+ Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
**Additional Preferences**
No additional preferences.
**Why Join Our Team**
Ascension St. Vincent's is expanding in the fastest-growing county in Northeast Florida with the addition of a fourth regional hospital, Ascension St. Vincent's St. Johns County. Serving Northeast Florida and Southeast Georgia, Ascension St. Vincent's has been providing caregivers in every discipline a rewarding career in healthcare since 1873.
Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.
**Equal Employment Opportunity Employer**
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) ( poster or EEO Know Your Rights (Spanish) ( poster.
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
Pay Non-Discrimination Notice ( note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
**E-Verify Statement**
This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.
E-Verify (

33789BR

Position Title:

PROFIT Plan Claims Processing Specialist, Retirement - Lakeland

Department:

Benefits Administration

Location:

Lakeland, FL

Description:

• Analyzing and processing PROFIT Plan distributions and withdrawals,

• Being a Subject Matter Expert (SME) for the Retirement business area,

• Processing beneficiary claims for PROFIT Plan distributions,

• Providing premier customer service to lobby visitors who are contemplating retirement and/or needing assistance and guidance about available distributions or withdrawals under the PROFIT Plan,

• Providing assistance to internal and external callers and as a backup to the Customer Service Agents during peak call volumes, and

• Participating in continuous improvement efforts and other department projects as assigned

Req ID:

33789BR

Hours of Work:

8:00 am - 4:30 pm, Monday - Friday

Facility:

Lak Publix Corporate Office B003

State:

Florida

Frequency of Pay:

Weekly

Travel Frequency:

0%

Minimum Base Pay:

19.65

Additional Information:

Please be sure to monitor your email, including your spam folder, daily for communications you may receive during the recruiting and selection process for this position. Please do not use your Publix email address when applying.

Once your application has been successfully submitted you will receive a confirmation email.

For this position, Publix does not and will not file a petition or application with the USCIS or Department of State on behalf of any noncitizen for any immigration-related benefit to work and/or to continue to work in the United States, e.g., an H-1B or TN petition or permanent residence

Address:

3300 Publix Corporate Parkway

City:

Lakeland

Year End Bonus:

To reward associates for their contributions to the company for the calendar year, Publix provides a Holiday Bonus in November. In the first year of continuous employment the bonus is equal to 15 hours of pay, and in the second year of continuous employment the bonus is equal to one week’s pay if associate remains employed through issue date of the bonus check. In subsequent years, the bonus is equal to two weeks’ pay.

Maximum Base Pay:

27.10

Required Qualifications:

• High School Diploma or equivalent experience

• 2 years customer service experience

• Knowledge of Microsoft Excel, Word and Access

• Knowledge of Continuous Quality Improvement (CQI) methodology

• Ability to be customer service-focused and maintain a positive attitude

• Strong verbal and written communication skills, including interpersonal skills

• Analytical skills with attention to detail

• Ability to multi-task

• Empathetic listening skills

• Professional telephone etiquette

• Ability to handle conflict

• Strong organizational and time management skills

• Teamwork skills

• Sound decision making skills

• Problem mitigation/resolution skills

• Ability to work independently and take initiative to complete tasks

• Ability to respond to associates with high degree of discretion and demonstrate a high level of maturity and tact

• Technical skills

• Willingness to be flexible.

Preferred Qualifications:

• Associate’s Degree in Business

• Knowledge of the SAP-based HR/Benefits/Payroll System, Stock Management System, READ, Retirement System

• 2 years retirement related experience and 2 years of claims processing experience, or 4 years customer service experience in retirement related field

• Knowledge of the Publix retirement and stock plans, including but not limited to, ensuring administrative policies and procedures are followed and processes are completed timely in compliance with plan documents, and regulations issued by the US Department of Labor (DOL) for the Employee Retirement Income Security Act (ERISA), the US Internal Revenue Service (IRS) and Securities and Exchange Commission (SEC)

• Knowledge of Publix culture, history and philosophy

• Knowledge and understanding of Publix and department procedures

• Knowledge of external and internal department processes

• Knowledge of Publix organizational structure

Potential Annual Base Pay:

40,872 - 56,368

Zip Code:

Benefits Information:

• Employee stock ownership plan that contributes Publix stock to associates each year at no cost

• An opportunity to purchase additional shares of our privately-held stock

• 401(k) retirement savings plan

• Group health, dental and vision plans plan

• Paid Time Off

• Paid Parental Leave

• Short- and long-term disability insurance

• Tuition reimbursement

• Free hot lunches (buffet-style) at facilities with a cafeteria

• Visit our website to see all of our benefits: Benefits - Jobs (publix.com) (

Job Summary:
The Insurance Claims Examiner is responsible for overseeing insurance claims and ensuring the company maintains adequate insurance coverage for all multi-family housing communities. This role combines claims management with insurance coordination, including policy review, compliance oversight, and vendor/insurer communication. The ideal candidate will safeguard the company's properties through proactive risk management and efficient handling of insurance claims. This position is on-site at our corporate office in Arcadia, CA.

Responsibilities and Duties:

• Review, analyze, and process insurance claims for property damage, liability, and habitability issues.

• Examine insurance policies and coverage to ensure adequate protection for all properties within the portfolio.

• Coordinate with insurance brokers, carriers, and adjusters regarding claims, renewals, and policy updates.

• Maintain accurate records of claims, settlements, and policy documents.

• Monitor policy expirations and ensure timely renewals.

• Assist with filing new insurance claims and track them through resolution.

• Ensure compliance with insurance requirements, industry standards, and local/state regulations.

• Evaluate insurance certificates from vendors and contractors for accuracy and coverage compliance.

• Provide support in risk assessments and recommend coverage adjustments as needed.

• Prepare reports for leadership regarding claims trends, costs, and insurance adequacy.

• Collaborate with property management teams to educate staff on insurance protocols and risk management practices.

Qualifications:

• Bachelor's degree in Business, Finance, Risk Management, or related field preferred.

• Prior experience in insurance claims, risk management, or insurance coordination (property management or multi-family housing experience preferred).

• Knowledge of insurance policies, coverages (including habitability insurance), and claims handling procedures.

• Strong analytical and organizational skills.

• Excellent communication and negotiation abilities.

• Proficiency with Microsoft Office Suite and claims management systems.

• Ability to manage multiple priorities in a fast-paced environment.

Work Environment:

• Full-time, Monday-Friday schedule.

• Based at corporate office with occasional property site visits as needed.

Proficiency in Microsoft Office Suite; experience with insurance or Yardi software is a plus.

Patient Support Medical Claims Processing Representative

Contract Remote Role Location (Open to Remote US)

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies.

IQVIA has the world's largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.

We are excited to announce that currently we are looking for a 100% remote (work from homeWFH) contact Patient Support Medical Claims Processing Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Patient Support Call Center Representative is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

Job Responsibilities:

• Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be paid or rejected
• Exceptional organizational skills are required
• May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
• Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
• Ability to work 40 hours per week (shifts available: 9:00 am 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST 8:00pm EST) under moderate supervision

Minimum Education & Experience:

• High School Diploma or equivalent
• Experience in claim processing required
• Medical Billing Certification required
• Coding Certification required
• Ability to interpret Explanation of Benefits (EOB)
• HIPPA certified
• Customer Service Experience preferred
• Pharmacy Technician experience preferred
• Bi-lingual (English/Spanish) preferred

The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located. IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere.

Patient Support Medical Claims Processing Representative

Contract Remote Role Location (Open to Remote US)

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies.

IQVIA has the world's largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.

We are excited to announce that currently we are looking for a 100% remote (work from homeWFH) contact Patient Support Medical Claims Processing Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Patient Support Call Center Representative is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

Job Responsibilities:

• Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be paid or rejected
• Exceptional organizational skills are required
• May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
• Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
• Ability to work 40 hours per week (shifts available: 8:00am - 5:00pm EST or, 9:00am - 6:00pm EST or, 10:00am - 7:00pm ET or, 11:00am - 8:00pm EST) under moderate supervision

Minimum Education & Experience:

• High School Diploma or equivalent
• Experience in claim processing required
• Medical Billing Certification required
• Coding Certification required
• Ability to interpret Explanation of Benefits (EOB)
• HIPPA certified
• Customer Service Experience preferred
• Pharmacy Technician experience preferred
• Bi-lingual (English/Spanish) preferred

The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.

IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

Patient Support Medical Claims Processing Representative

Contract Remote Role Location (Open to Remote US)

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies.

IQVIA has the world's largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.

We are excited to announce that currently we are looking for a 100% remote (work from homeWFH) contact Patient Support Medical Claims Processing Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Patient Support Call Center Representative is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

Job Responsibilities:

• Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be paid or rejected
• Exceptional organizational skills are required
• May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
• Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
• Ability to work 40 hours per week (shifts available: 9:00 am 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST 8:00pm EST) under moderate supervision

Minimum Education & Experience:

• High School Diploma or equivalent
• Experience in claim processing required
• Medical Billing Certification required
• Coding Certification required
• Ability to interpret Explanation of Benefits (EOB)
• HIPPA certified
• Customer Service Experience preferred
• Pharmacy Technician experience preferred
• Bi-lingual (English/Spanish) preferred

The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located. IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere.

Patient Support Medical Claims Processing Representative

Contract Remote Role Location (Open to Remote US)

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product's value to payers, physicians, and patients. A significant part of our business is providing patient support programs on the behalf of our customers. With the right experience, you can help provide support to patients in need of available therapies.

IQVIA has the world's largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.

We are excited to announce that currently we are looking for a 100% remote (work from homeWFH) contact Patient Support Medical Claims Processing Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Patient Support Call Center Representative is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

Job Responsibilities:

• Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be paid or rejected
• Exceptional organizational skills are required
• May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
• Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
• Ability to work 40 hours per week (shifts available: 9:00 am 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST 8:00pm EST) under moderate supervision

Minimum Education & Experience:

• High School Diploma or equivalent
• Experience in claim processing required
• Medical Billing Certification required
• Coding Certification required
• Ability to interpret Explanation of Benefits (EOB)
• HIPPA certified
• Customer Service Experience preferred
• Pharmacy Technician experience preferred
• Bi-lingual (English/Spanish) preferred

The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located. IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere.