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Contract Health Insurance Jobs (NOW HIRING)

Medix

Health Insurance Specialist

Erie, PA · On-site

$25/hr

Determination Specialist Position Type: Full-Time / Contract-to-Hire (High growth potential ... health insurance dispute resolution . (Candidates without direct claims dispute or appeals ...

The Benefits Boss

Health Insurance Agent

Atlanta, GA · Remote

$20K/mo

Health Insurance Agent | Remote | 1099 | Commission + Residuals | Leads Provided About The Benefits ... Contracts with 26+ carriers across health, life, and supplemental products Compensation 1099 ...

The Benefits Boss

Health Insurance Agent

Tampa, FL · Remote

$20K/mo

Health Insurance Agent | Remote | 1099 | Commission + Residuals | Leads Provided About The Benefits ... Contracts with 26+ carriers across health, life, and supplemental products Compensation 1099 ...

The Benefits Boss

Health Insurance Agent

Dallas, TX · Remote

$20K/mo

Health Insurance Agent | Remote | 1099 | Commission + Residuals | Leads Provided About The Benefits ... Contracts with 26+ carriers across health, life, and supplemental products Compensation 1099 ...

The Benefits Boss

Health Insurance Agent

Phoenix, AZ · Remote

$20K/mo

Health Insurance Agent | Remote | 1099 | Commission + Residuals | Leads Provided About The Benefits ... Contracts with 26+ carriers across health, life, and supplemental products Compensation 1099 ...

The Benefits Boss

Health Insurance Agent

Dallas, TX · On-site +1

$20K/mo

Health Insurance Agent Remote 1099 Commission + Residuals Leads Provided About The Benefits Boss ... Contracts with 26+ carriers across health, life, and supplemental products Compensation 1099 ...

Birmingham

Health Insurance Specialist

Birmingham, AL · On-site

Remains current on CMS marketing guidelines to ensure compliance with CMS contract governing ... Alabama Health and life insurance license * Four-year college degree preferred * Demonstrated ...

Computer Futures

Health Insurance Analyst

Dallas, TX · On-site

$19.75 - $27/hr

... permanent and contract roles across Asia, Europe and the US. With a proven track record in ... within healthcare insurance ( Data, Configuration, or Enrollment) Compliments the team and ...

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Contract Health Insurance information

What is contract health insurance?

Contract health insurance refers to a type of health coverage provided based on a contractual agreement, often for a specific period or project. It is commonly used by independent contractors, freelancers, or temporary workers who do not receive employer-sponsored health benefits. These plans can be purchased individually and typically cover essential medical services, though coverage options and costs may vary. It's important to review the terms of the contract to ensure the plan meets your healthcare needs, including network providers and out-of-pocket expenses.

What are the key skills and qualifications needed to thrive as a contract health insurance specialist?

To thrive as a Contract Health Insurance Specialist, you need a thorough understanding of health insurance policies, regulatory compliance, and contract negotiation, often supported by a relevant degree or certification in health insurance or healthcare administration. Familiarity with claims management software, policy administration systems, and healthcare regulations like HIPAA is typically required. Attention to detail, strong communication, and problem-solving skills help professionals excel in client interactions and complex documentation. These skills ensure accurate policy management, regulatory compliance, and effective service delivery in the dynamic health insurance industry.

What are some common challenges faced by professionals working in contract health insurance roles, and how can they be managed?

Professionals in contract health insurance often face challenges such as adapting to rapidly changing regulations, managing a diverse client portfolio, and meeting tight deadlines for policy renewals or claims processing. To manage these challenges, staying updated on industry standards, utilizing robust organizational tools, and maintaining clear communication with clients and internal teams are crucial. Additionally, strong problem-solving skills and continuous professional development can help professionals excel and deliver quality service in this fast-paced environment.

What is the difference between Contract Health Insurance vs Contract Nurse?

AspectContract Health InsuranceContract Nurse
Required CredentialsHealth insurance licenses, certifications in insurance sales or administrationRN license, nursing certifications
Work EnvironmentOffice settings, insurance companies, remoteHospitals, clinics, healthcare facilities
Employer & IndustryInsurance providers, healthcare administrationHospitals, healthcare agencies
Common Search IntentInsurance policies, coverage options, job rolesNursing assignments, healthcare staffing

Contract Health Insurance professionals focus on insurance policies and administration, often working in office environments, while Contract Nurses provide direct patient care in healthcare settings. Both roles require specialized credentials and serve different functions within the healthcare industry.

More about Contract Health Insurance jobs

What cities are hiring for Contract Health Insurance jobs?

Cities with the most Contract Health Insurance job openings:

What are the most commonly searched types of Health Insurance jobs?

The most popular types of Health Insurance jobs are:

What states have the most Contract Health Insurance jobs?

States with the most job openings for Contract Health Insurance jobs include:

What job categories do people searching Contract Health Insurance jobs look for?

The top searched job categories for Contract Health Insurance jobs are:

Contract Health Insurance jobs near you
Infographic showing various Contract Health Insurance job openings in the United States as of September 2026, with employment types broken down into 2% As Needed, 77% Full Time, 16% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution.

Health Insurance Specialist

Erie, PA • On-site

Medix
Recruiting and Staffing Services • 1 - 5K employees
Learn more about Medixexternal

$25/hr

Full-time

Re-posted 12 days ago

Key responsibilities

  • Evaluate and adjudicate complex out-of-network payment disputes between healthcare providers and health plans in strict accordance with No Surprises Act guidelines

  • Analyze submitted evidence, fee benchmarks, and documentation from both provider and payer to select the appropriate final payment offer

  • Maintain precise, audit-ready case records within federal government portals

Job description

Job Title: Determination Specialist
Position Type: Full-Time / Contract-to-Hire (High growth potential)
Location: Remote (IT Equipment Issued)
Industry: Healthcare / Federal Contracting (GSA)
About the Role
Are you an analytical healthcare claims specialist with direct experience handling payment disputes, provider appeals, or billing arbitrations? We are seeking an experienced Determination Specialist to join our team supporting a federal Independent Dispute Resolution Entity (IDRE) program.
Under the federal No Surprises Act, an IDRE is certified to resolve out-of-network payment disputes between healthcare providers and health plans. In this role, you will leverage your specialized background in provider dispute resolution to evaluate complex documentation, apply federal regulatory criteria, and render final, binding payment determinations for emergency services, facility care, and air ambulance cases.
This position requires demonstrated expertise in healthcare dispute resolution, claims appeals, or out-of-network payment adjudication. If you thrive in an ever-changing environment, excel at solving complex problems in the "grey," and want to apply your dispute experience to high-profile federal oversight, we want to hear from you.
Key Responsibilities
  • Dispute Adjudication: Evaluate and adjudicate complex out-of-network payment disputes between healthcare providers and health plans in strict accordance with No Surprises Act guidelines.
  • Binding Payment Determinations: Analyze submitted evidence, fee benchmarks, and documentation from both provider and payer to select the appropriate final payment offer.
  • Regulatory Compliance: Interpret complex federal and state billing regulations to ensure every dispute determination is legally sound, impartial, and compliant.
  • Case Documentation & Data Entry: Maintain precise, audit-ready case records within federal government portals.
  • Performance Metrics: Manage a active portfolio of dispute cases, meeting strict turnaround deadlines and high quality-assurance standards.

Qualifications & Requirements
Essential Experience (Required):
  • Direct Dispute & Appeals Background: Minimum 2+ years of experience specifically in provider payment disputes, claims appeals, out-of-network reimbursement, or health insurance dispute resolution. (Candidates without direct claims dispute or appeals experience will not be considered.)
  • Analytical Expertise: Demonstrated track record of reviewing complex medical claims, Explanation of Benefits (EOBs), contract terms, and regulatory guidance to solve payment discrepancies.
  • Technical Skills: Advanced data entry skills and proficiency in Microsoft Office (specifically Excel for data analysis and case tracking).
  • Compliance & Screening: Must clear all background checks and meet strict federal conflict-of-interest requirements.

Preferred Knowledge:
  • Education: Bachelor's degree or equivalent combination of specialized dispute-resolution experience.
  • Regulatory Knowledge: In-depth understanding of the Independent Dispute Resolution (IDR) process, the No Surprises Act, and varied plan types (Commercial, Medicare, Medicaid, Self-Funded/ERISA).

Core Competencies & Soft Skills
  • Mastery in Ambiguity: Ability to make sound, independent decisions in complex cases where guidelines require nuanced interpretation.
  • Precision & Detail: High level of accuracy when evaluating conflicting evidence and numerical data from opposing parties.
  • High-Volume Execution: Capacity to maintain quality and speed in a fast-paced environment with a heavy backlog of cases.

What We Offer & Why You Should Join
  • Massive Growth Opportunity: Backed by steady case volume and 50+ open FTE positions, offering exceptional stability and conversion to permanent roles for strong performers.
  • Equipment Provided: Complete IT equipment package provided upon hire.
  • High-Impact Work: Utilize your niche expertise in payment disputes on a vital federal GSA program shaping national healthcare reimbursement standards.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients
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About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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