Healthcare Claims Adjuster

Healthcare Claims Adjuster

Location: Baltimore, Maryland (meetings and trainings)

Type: Contract To Hire

Compensation: $25/HR

Contractor Work Model: 80% Remote (must reside in D.C., MD, or VA per client)

About the Role

We're hiring a Healthcare Claims Adjuster with a strong claims processing background and exposure to adjustments, rework, or dispute resolution who wants to grow in that area. The role involves handling claims adjustments, discrepancies, and provider dispute work.

This is a fast-paced role with the opportunity to build hands-on adjustment experience and potential for long-term growth. What You'll Do Processing (Training Ramp-Up)

• Process medical claims and learn systems and workflows

Adjustments & Disputes (Core Role)

• Investigate and resolve claim discrepancies and provider disputes
• Perform adjustments, reprocessing, and corrections
• Review overpayments, underpayments, and errors

Daily Operations

• Handle high volume (~50 cases/day after ramp-up)
• Update claims systems and maintain accurate records
• Shift between processing and adjustment work

Quality & Accuracy

• Identify trends and exceptions
• Ensure accuracy and compliance

Why This Role Is a Great Fit

• Grow adjustment expertise (not just processing)
• Exposure to complex claims and dispute resolution
• High-impact work on claim backlog
• Mostly remote, flexible work model
• Contract-to-hire with potential for full-time conversion based on performance

What You Bring Required Skills:

• 2+ years of medical claims experience
• Strong claims processing background
• Adjustment experience (rework, discrepancies, or dispute resolution)
• Ability to work in a fast-paced, high-volume environment
• Strong attention to detail and problem-solving skills

Nice to Have (sets you apart):

• Payer-side experience
• FACETS or similar claims system experience
• Exposure to refunds, subrogation, or workers' compensation

System One, and its subsidiaries including Joul and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M-1 #LI-AJ1 Ref: #851-Rockville-S1

System One Holdings, LLC