Remote Calaim Jobs

We're looking for a Claims Solutions Partner — the claims-operations expert who sits inside our sales cycle and makes technically complex deals winnable.

You'll sit within our Claims team, owning auto property damage liability claims from first notice to resolution, and making sure every customer feels heard and fairly

🚧 What You’ll Do We are looking for a detail-oriented Billing Specialist to own pre-submission billing accuracy and ensure clean claims

The admin work - credentialing, claims, payment reconciliation - is a nightmare. We've automated that. But we're going further.

Own how claims data comes into Turquoise.

experienced SIU Investigator to help protect honest policyholders and keep sophisticated fraud networks from gaming the system — while making sure legitimate claims

experienced SIU Investigator to help protect honest policyholders and keep sophisticated fraud networks from gaming the system — while making sure legitimate claims

The Senior Manager, Claims Adjudication Logic will be the subject matter expert on how our claims move through the system: the rules that determine whether a claim

, claims recovery procedures, and capital strategies align with operational capabilities and corporate goals.

Escalate disputes, hardship cases, fraud claims, and complaints to the right team. Meet daily productivity and quality goals.

Technical & Modeling Expertise: Advanced proficiency in actuarial modeling, claims data extraction, and financial modeling tools (e.g., SQL, Python,

🚧 What You’ll Do Own rejections, denials, and denied claims workflows from identification through resolution

plan and approves pended orders, and Lighthouse executes the resulting prescription, laboratory order, or referral — then documents the encounter, submits the claim

The admin work - credentialing, claims, payment reconciliation - is a nightmare. We've automated that. But we're going further.

claim holds and re-submitting / appealing claim denials Resolve behavioral health claim denials for inactive coverage, coordination of benefits