Remote Medi-Cal Claims Specialist | Detail-Driven Adjudication
Qualfon
Qualfon is seeking detail-oriented Medi-Cal Claims Processing Specialists to review and resolve suspended claims accurately and efficiently in a home-based setup. Ideal candidates have knowledge of healthcare billing, strong analytical skills, and the ability to apply policies and regulations while ensuring HIPAA compliance. Responsibilities include verifying eligibility, reviewing records, correcting errors, and applying Medi-Cal guidelines to adjudicate claims within deadlines. #J-18808-Ljbffr
- Qualfon is seeking detail-oriented Medi-Cal Claims Processing Specialists to review and resolve suspended claims accurately and efficiently in a home-based setup... ...errors, and applying Medi-Cal guidelines to adjudicate claims within deadlines. #J-18808-Ljbffr QualfonRemote jobWork from home
$24 per hour
...Medi-Cal Claims Processing Specialist Overview Qualfon is a global provider... ..., purpose-driven team. Responsibilities... ...Qualfon is seeking detail-oriented Medi-Cal... ...and make appropriate adjudication decisions.... ...service while working remotely. What We Offer...Remote workWork at officeLocal areaWork from home- Qualfon is seeking a detail-oriented Medi-Cal Claims Processing Specialist to review and resolve suspended claims accurately and efficiently. The ideal candidate will have knowledge of healthcare billing, strong analytical skills, and the ability to apply policies and regulations...Remote job
- Qualfon is a global provider of omnichannel customer experience and business support solutions. As a Medi-Cal Claims Examiner, you will review, process and adjudicate suspended healthcare claims to ensure accurate and timely payment in line with Medi-Cal policies and reimbursement...Suggested
- Qualfon is seeking a Medi-Cal Claims Examiner to review, process, and adjudicate suspended healthcare claims to ensure accurate and timely payment. You’ll apply... ...familiarity with CPT, HCPCS, ICD-10 coding, and strong attention to detail in a fast-paced #J-18808-Ljbffr QualfonSuggested
- ...New Paradigm Staffing is seeking a detail-driven Claims Intake Specialist for a fully remote role supporting healthcare payers and billing departments. You will review incoming materials, verify completeness, and prepare claims for processing, while maintaining strict...Remote work
- Allied Tech is seeking a Claims Specialist to support clients by entering claim details, reviewing files for completeness, and... ..., timely processing. This fully remote role offers a clear path for advancement... ...and a collaborative, detail-driven environment. The position...Remote job
$45k - $55k
...Our partner is looking for a Claims Adjudication Specialist based in the United States.... ...skills and attention to detail will help protect customers... ...Working in a dynamic, technology-driven environment, you will... ...-enabled service delivery. Remote work: A remote position...Remote workFlexible hours- Firstsource Healthcare in Dallas seeks a detail-oriented Claims Examiner to join our team. The role involves reviewing claims for eligibility,... ...software, and strong attention to detail. This position supports a remote-friendly, fast-paced environment with focus on accuracy and...Remote job
- Crawford & Company in Dallas, Texas is seeking a Senior Claims Clerk to join our claims team. This role focuses on detail, accuracy and supporting operations by managing documentation, processing claim-related information, and delivering essential administrative support...Remote job
$23 per hour
...Onco360 Pharmacy is seeking a Pharmacy Claims Adjudication Specialist in Salt Lake City, UT. This full-time, remote/hybrid role requires active Utah Pharmacy Technician... ...rejections, ensuring accurate CPR+ patient setup, and communicating copay details. #J-18808-LjbffrRemote workHourly payFull timeRelocation package$24 per hour
...We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy working... ...-Time position.This is a remote/hybrid opportunity,... ...Specialist will adjudicate pharmacy claims, review claim responses for... ...deadlines and be flexible, detail-oriented, great time-management...Remote workFull timeTemporary workWork experience placementRelocation packageFlexible hoursShift work- ...Partnership HealthPlan of California is seeking a Claims Examiner II to review, research, and resolve Medi-Cal claims within production and quality standards. You... ...maintaining logs. The role requires attention to detail, good judgment, and ability to work with sensitive...
- ...Consultant I to review Treatment Authorization Requests (TARs) and medical records for Medi-Cal beneficiaries. Under the supervision of the Medical Consultant II, you will provide medical adjudication support to field offices and headquarters nursing staff. This role requires...Remote work
$26 - $28 per hour
...organization that is client-centered, trauma-informed, collaborative, and committed to justice and equity. Position Details Title: Medi-Cal Claims Billing Specialist Classification: Part-Time (1.0 FTE) Non-Exempt (Hourly), 20 hours per week Location: Oakland, CA /...Hourly payPart timeRelocation packageMonday to Friday$42.77k - $61.55k
...Pay Plan Title: Claims Specialist II Working Title: Claims Specialist... ...46 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact... ...collaborative, mission-driven work environment... ...auditing and finalizes adjudication results for claims designated...Remote workWork at officeLocal areaImmediate startWork from homeFlexible hours$35.9k - $51.3k
...seeking an experienced Medi-Cal Conlan Team Lead to support... ...member reimbursement claims. You will serve as a... ...preferred. Ability to follow detailed policies, procedures,... ...that is primarily remote with occasional in-office... ...customer-focused, metrics-driven healthcare operations...Remote workFull timeWork at officeFlexible hours- Gainwell Technologies is seeking an experienced Claims Suspense Team Lead to support California's Medi-Cal program. This remote role leads a team of Claims Examiners,... ...optimize workflows in a fast-paced, compliance-driven environment. #J-18808-Ljbffr Gainwell TechnologiesRemote job
- ...UNITE HERE HEALTH seeks a Claims Adjudicator II to review and adjudicate medical, disability, vision and dental claims, ensuring eligibility... ...systems. The position offers a 37.5-hour week, with fully remote work after one week of onsite training in Oak Brook, IL. Fluency...Remote work
- ...The Oregon Department of Human Services is seeking a Health Insurance Analyst (Administrative Specialist 1) to input third-party insurance details, verify Medicaid coverage, and support enrollment in Coordinated Care. You will participate in Lean teams, manage referrals...Remote work
- ...Controls and QA Analyst - Claims Adjudication Specialist - Remote Role and Responsibilities The Controls and QA Analyst is responsible for developing, monitoring, assessing, reviewing, and recommending changes to Liviniti’s quality and control procedures to ensure the...Remote workFull timeLocal areaImmediate startMonday to FridayWeekend work
- MedPOINT Management in Sherman Oaks, CA is seeking a detail-oriented Claims Examiner to join our growing team. This role focuses on accurate and timely processing of medical claims within a healthcare management context. You will review claims, verify eligibility, apply...Remote job
- Blue Shield of California is seeking a Claims Processor, Intermediate to review and adjudicate claims and adjustments for services in and outside California. The role reports to the Operations Supervisor and focuses on meeting operational, financial, and service requirements...Remote jobWork at office
$23 per hour
...Oncology Pharmacy in Scottsdale, AZ is seeking a Pharmacy Adjudication Specialist for a full-time, hybrid role with initial onsite training.... ...comprehensive company-paid coverage. The specialist will adjudicate claims, ensure COB accuracy, engage with insurers, manage #J-18808...Remote workHourly payFull timeRelocation package- ...Adjustment Service, Inc. is seeking a part-time Casualty Claims Adjuster to handle casualty claims remotely from initial assignment through resolution, with... ...settlements within guidelines, maintaining detailed records and ensuring compliance while working independently...Remote jobPart time
$25 per hour
Onco360 is seeking a Pharmacy Claims Adjudication Specialist in the St. Louis area. The role involves adjudicating pharmacy claims, confirming claim... ...rejections to ensure timely medication delivery. Some remote work may be possible with Missouri Pharmacy Technician credentials...Remote jobHourly payRelocation package- A data-driven organization is seeking a Specialist, Data Entry Junior to join as a remote Data Entry Operator. This entry-level role emphasizes accuracy, data maintenance, and... ...ideal candidate should have a passion for detail-oriented work and a commitment to data security...Remote work
- Onco360 is seeking a Pharmacy Claims Adjudication Specialist in Columbus, OH. The role requires OH Pharmacy Technician credentials and offers a full-time schedule with potential remote work between 8am and 8pm. Starting pay is $23/hour with a $5,000 sign-on bonus for hires...Remote jobFull timeRelocation package
- JobRx, Inc. is seeking a Pharmacy Adjudication Specialist to work full-time in St. Louis, Missouri, with options for remote work. Responsibilities include adjudicating pharmacy claims and resolving third-party rejections. The ideal candidate should have a High School Diploma...Remote jobFull timeRelocation package
- Western & Southern Financial Group seeks a Claims Analyst to evaluate Gerber Life Insurance claim information and determine appropriate... ...will interact with policyholders and professionals to gather details and render decisions, ensuring compliance and professional ethics...
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