Remote Claims Resolution Specialist - Healthcare
CalOptima
CalOptima Health is seeking a Claims Resolution Specialist for Covered California to oversee and streamline the claims resolution process. This role supports Medi-Cal and OneCare claims, adheres to AB1455 regulatory guidelines, and collaborates with claims management to deliver efficient adjudication. The position allows full telework with California-only travel if needed. The team emphasizes a member-centric approach, collaboration with providers and stakeholders, and maintaining high-quality #J-18808-Ljbffr
Vacancy posted 1 day ago
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$53.81k - $80.72k
...OpportunityWe are hoping you will join us as a Claims Resolution Specialist, Covered California and help shape the future of healthcare where you'll be an integral part of our... ...Environment:If located at the 500, 505 Building or a remote work location:Work is typically indoors and...Remote workTemporary workWork at officeLocal areaFlexible hoursWeekend workAfternoon shift2 days per weekCalOptima Health Partnership
Orange, CA1 day ago- ...Innovaccer Inc. is seeking a Claims Resolution Specialist I to process medical claims in line with industry... ...practices. You will work in a remote-friendly environment, handling denials... ...appeals, and AR follow-up for a national healthcare client base across CPT/ICD-10 coding...Remote work
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New York, NY2 days ago - Currance, Inc. is hiring an Account Resolution Specialist III to manage insurance claims for healthcare clients in a fully remote role across the United States. You will handle denials, appeals, and follow-up to ensure timely and accurate payments, working with multiple...Remote job
- Location: Remote in the following states: NE, TX, KS, AR, AZ Employment Type: Full... ..., TELCOR is a proven leader in healthcare software, delivering Point of Care (POC... ...with one another. Job Summary The TRCS Claims Resolution Specialist is responsible for performing revenue...Remote workFull timeCurrently hiringWork at office
- MEDHOST, a leading healthcare IT provider now part of Harris Computer, is seeking an Account Follow-up Representative II to review and resolve... ...insurance balances on hospital patient accounts. This remote role supports learning multiple hospital systems and collaborates...Remote job
- ...passionate about bridging the gap between healthcare operations and IT, with the patient... ..., and support Location: Remote, with periodic travel to client sites... ...requirements. Role Overview The Epic Resolute Hospital Billing / Claims Analyst will configure, test, and...Remote workFull timeTemporary workWork at officeLocal areaFlexible hours
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Florida Cancer Specialists
United States2 days ago - Great Expressions in Southfield, MI, is seeking a Claims Resolution Representative to help resolve aging insurance claims by contacting payers... ...schedule includes in-office Monday, Tuesday, Thursday and remote Wednesday and Friday. Ideal candidates have at least 3 years...Remote workWork at office
$76.5k - $149k
...Whether you're managing claims, supporting clients, or improving... ...is eligible for fully remote work The Claims Specialist within GB Specialty is... ...moderately complex Healthcare Professional Liability claims... ..., evaluation, and resolution, while ensuring claims are...Remote workFull timeLocal area- ...CalOptima Health is seeking a Claims Resolution Specialist for the Claims Administration team. This remote role supports Medi-Cal and OneCare claims and ensures adjudication alignment with AB1455 guidelines, while collaborating with providers and stakeholders across California...Remote workWork at office
CalOptima Health Partnership
Orange, CA1 day ago - ...United States of America Location: Florida - Remote WHY JOIN FCS At Florida Cancer Specialists & Research Institute, we believe our people are... ...Position Summary : Review all medical insurance claims for resolution and payment. Resolve any incoming inquiries...Remote workFull timePrivate practice
- ...complete moderate to higher complexity claims within assigned authority limits. Daily... ...near one of those office locations or in a remote location where we have need for in-... ...policyholders and assist claims management in the resolution of complaints and evaluate claims for...Remote workWork at officeLocal areaWork from home
Liberty Mutual Insurance Group
Chandler, AZ2 days ago - ...We at Innovaccer are looking for a Claims Resolution Specialist I (CRS-I). A successful Claims Resolution... ...-scale multi-specialty/multi-site healthcare organizations throughout the United States... ...and able to stay focused in a remote environment. Ability to demonstrate...Remote workHourly payFull timeTemporary workWork at officeLocal areaImmediate start
- ...Gallagher Bassett is seeking a Claims Specialist to manage moderately complex Healthcare Professional Liability claims with a focus on Correctional Medicine.... ...coverage analysis, investigations, evaluation, and resolution, ensuring alignment with client expectations and regulatory...Remote work
Gallagher Bassett
Houston, TX1 day ago - ...TELCOR, a Lincoln, Nebraska-based healthcare software leader, is seeking a remote TRCS Claims Resolution Specialist to perform revenue cycle tasks for TELCOR Revenue Cycle Service customers. You will handle client, insurance, and patient billing, and AR activities while...Remote work
TELCOR
United States2 days ago - ...Senior Complex Casualty Claims Resolution Specialist - Northeast RegionGrow Here. Go Further.At Liberty Mutual, we do more than offer a job in claims... ...is hybrid (2 days in office). Otherwise, it may be fully remote. Candidates located in the Eastern or Central time zones...Remote workWork at officeLocal areaHome office
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Plano, TX2 days ago - ...balances on hospital patient accounts. This remote role welcomes candidates anywhere in the... ...systems and handling mid-to-complex claims with payer communications. You will follow... ...information, and ensure timely resolution in line with payor and client requirements...Remote work
Harris Computer
Phoenix, AZ2 days ago - ...Supporting healthcare claims administration, the remote Healthcare Claims Operations Specialist will manage stipend payments for Primary Family Caregivers, analyze complex... ..., including payment processing and dispute resolution Experience supporting a federal healthcare...Remote workWork at office
Virtual Vocations Inc
United States1 day ago - ...Automotive, within Manheim, is hiring an Auto Claims Specialist I to learn how to resolve customer... ...departments, and work toward fair resolutions while maintaining detailed records. The... ...may require in-office presence and remote work part of the week. #J-18808-Ljbffr...Remote workWork at office
- ...work here. NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our... ...PA and 99.75% FA. Timely response and resolution of claims received via emails as priority... ...: 1-3 year(s) hands-on experience in Healthcare Claims Processing 2+ year(s) using a computer...Remote job
- ...Description Job Description The Claims Resolution Specialist is responsible for the day-to-day investigation... ...across a multi-site, multi-specialty healthcare organization specializing in pain... ...and efficiently. *This is a remote role. We are only hiring in the following...Remote work
Integrated Pain Management Medical Group, Inc.
Walnut Creek, CA18 days ago - ...Description JOIN OUR GROWING CLAIMS DEPARTMENT AT MEDLYTIX! The Claims Resolution Specialist plays a key role in resolving open... ...Skills: Experience in healthcare revenue cycle, particularly physician... ...(hybrid role) OR Ohio (fully remote) Why Medlytix ? Competitive...Remote work
Medlytix
Roswell, GA7 days ago - ...Boomerang Healthcare is seeking an AR Follow-Up Specialist to manage California Medicare, Commercial, and WC follow-up from a remote location. You will coordinate with billing... ...proactive payer outreach, claim status monitoring, denial resolution, and preparing appeal letters...Remote work
Integrated Pain Management Medical Group, Inc.
Phoenix, AZ2 days ago - ...Description: Position Summary The Claims Resolution Specialist I is an hourly, non-exempt individual... ...Minimum two (2) years of healthcare revenue cycle, medical billing, collections... ...Maintain a secure, distraction-free remote work environment. Reasonable accommodations...Remote workHourly payWork at office
Sunbelt Medical Billings
Fort Lauderdale, FL11 days ago - ...Boomerang Healthcare is seeking an AR Follow-Up Specialist to manage California Medicare and Commercial... ...Management department. This remote role supports Workers' Compensation... ...include payer outreach, claim status monitoring, denial resolution, and collaboration with...Remote work
Integrated Pain Management Medical Group, Inc.
Yuma, AZ5 days ago - ...Role: Health Insurance Claims Specialist This position reports to the... ...office If you’re seeking a remote role, this position will... ...underpaid claims and work toward resolution Track and manage a... ...least 1 year of experience in healthcare or an office-based role...Remote workWork at officeMonday to Friday
Prosper Infusion
Largo, FL26 days ago $24 - $26.45 per hour
...technology that reduces unnecessary healthcare costs, achieves better... ...Management, theMedical Claims Specialist (ARManager)is responsible for... ...escalated to the RCM team. Resolution of SalesForce cases and... ...Technical Requirements (for remote workers only, not applicable...Remote workHourly payFull timeContract workWork at officeLocal areaHome officePrivia Health LLC
Houston, TX4 days ago$23.15 - $28.29 per hour
...looking for passionate Medical Claims Specialists to join our team. We are a... ...high-quality mental healthcare . Why Bright Futures Psychiatry... ...scheduling with in-office, remote, or hybrid options, depending... ...payment posting, denial resolution, and reimbursement optimization...Remote workWork at officeFlexible hours- ...Baystate Health’s Health New England is seeking a detail-oriented Claims Production Specialist to join the Claims team in Springfield, MA. The role focuses on accurate processing, adjustments, and timely finalization of medical claims in a regulated environment. You...Remote work
8510 Health New England, Inc.
United States1 day ago - ...Handling a high volume of third-party claims, the full-time Claims Resolution Analyst will ensure accurate... ...follow-up activities while working remotely. Key responsibilities Manages the... ...management and/or billing experience in a healthcare revenue cycle environment...Remote workFull timeWork at office
Virtual Vocations Inc
United States1 day ago
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