Remote Claims Research & Resolution Specialist
Humana
- Remote job
Humana is seeking a Claims Research & Resolution Representative 3 to manage complex medical claims through investigation, collaboration with providers, and timely settlements. You will report to the Supervisor, Claims & Research Resolution and support a remote, US-based workflow. The role requires healthcare customer service experience, call center knowledge, and proficiency with Excel/Word, plus familiarity with Medicare/Medicaid terminology and claims processes. #J-18808-Ljbffr Humana
- ...Humana is seeking a Claims Research & Resolution Representative 3 for a remote role. You will manage complex medical claim investigations, work with providers and members, and report to the Supervisor, Claims & Research Resolution. The position requires 1+ year of...Remote workClaimsMonday to FridayShift work
- ...Humana is seeking a Claims Research & Resolution Representative 3 to manage claims operations involving customer contact, investigation, and settlement... ...Supervisor, Claims & Research Resolution. Join Humana’s remote team to collaborate with providers, members, and third-...Remote workClaims
- Humana is seeking a Claims Research & Resolution Representative 3 to manage complex medical claims through investigation, documentation verification, and settlements. You will work with providers, members, and third-party services, reporting to the Supervisor, Claims &...Remote jobClaims
- Jobgether SRL is seeking a Healthcare Claims Support Specialist in the United States to investigate and resolve complex medical claims by... ...documentation, and apply policies to reach timely resolutions. A remote work setup is available with training and career development...Remote jobClaims
- Humana is seeking a Claims Research & Resolution Representative 3 to manage claims operations involving customer contact, investigation, and settlement... ...Supervisor, Claims & Research Resolution. You will work remotely with occasional travel to Humana offices for training or...Remote jobClaims
- ...support a growing team, the full-time Claims Resolution Specialist will review medical insurance claims... ...open account balances while working remotely. Key responsibilities Review all... ...denials from insurance providers by researching and responding to documentation requests...Remote workClaimsFull time
- ...Managing insurance claims for clients, the fully remote Account Resolution Specialist III will ensure timely and accurate payment processing, handle claim denials and appeals, and perform follow-ups with commercial payers. Key responsibilities: Submit and manage medical...Remote workClaimsWork at office
- Digitech is seeking a detail-oriented Insurance Account Resolution Specialist to manage and resolve insurance claims after submission to commercial carriers. This remote role requires reviewing pending/denied claims and following through to payment, with strong analytical...Remote jobClaimsMonday to Friday
- ...Description Job Description The Claims Resolution Specialist is responsible for the day-to-day investigation... ...performs detailed claim reviews, researches payer requirements, corrects claim... ...and efficiently. *This is a remote role. We are only hiring in the following...Remote workClaims
$28 - $35 per hour
...Claims Resolution Specialist The Claims Resolution Specialist is responsible for the day-to-day investigation... ...performs detailed claim reviews, researches payer requirements, corrects claim... ...and efficiently. *This is a remote role. We are only hiring in the following...Remote workClaimsHourly pay$17 per hour
...Wizard Flexible hours & work from home remote option Starting salary: $17 AND UP (... ...over insurance denials, ensuring prompt resolution and securing payments for all stakeholders... ...secrets of insurance eligibility, correcting claim denials with superhero finesse, and...Remote workClaimsWork at officeWork from homeFlexible hours- ...Working remotely from home, the Claims Resolution Adjuster will investigate automobile accidents involving bodily injury, assess coverage and damages, and negotiate fair settlements while providing exceptional customer service. Key responsibilities Conduct liability investigations...Remote workClaimsWork from homeMonday to FridayShift work
$110k - $120k
...Multiple remote perm, full-time Epic Certified Lead Analyst, Resolute PB positions. Location: CST Time Zone. Salary: $110-120K + Full Benefits. *** Remote option... ...Epic Certification in Resolute PB Admin or PB Claims. Hands-on experience with application configuration...Remote workClaimsPermanent employmentFull timeVisa sponsorshipWork visa$16.25 - $18.25 per hour
...Position: Dispute Resolution Analyst Overview: J29, Inc. (J29) has been supporting... ...processing, review, and analysis of medical claims, records, data, and audits between areas... ...Diploma or equivalent Location: Remote Salary: $16.25-18.25 per hour J29,...Remote workClaimsHourly payWork at officeImmediate start- ...manage a caseload of Workers' Compensation claims across multiple jurisdictions. The role... ...timely, compliant, and cost‑effective resolution while supporting injured associates through... ...(1 day in‑person at a core location, 4 remote days) and requires applicants to be...Remote workClaimsFull time
- Fusion Claims Consultants, LLC in Belcamp, MD seeks a Claims Handler for a full-time, hybrid role that allows partial remote work. You will manage claims processes, liaise with clients and... ...our team to achieve fair and timely resolutions. The ideal candidate brings proven...Remote workClaimsFull time
- REVCO SOLUTIONS INC. is seeking an experienced MVA/TPL Resolution Specialist II to independently investigate, negotiate, and resolve complex hospital... ...involving Motor Vehicle Accident and Third-Party Liability claims. You will work with insurers, attorneys, patients, and other...Remote jobClaims
- ...expanding its lien division. We seek a detail-oriented Lien Resolution Specialist Paralegal to handle EDD and medical provider liens for insurance... ...defense while aligning with California regulations. Strong claims management experience is preferred. #J-18808-Ljbffr Russell...Remote jobClaims
- Southern California Edison is seeking a Claims Resolution Associate Specialist to support claims recovery and investigation for third‑party damages. The... ...in a hybrid environment, with facility days and remote work, and involves data analysis, documentation, and coordination...Remote workClaims
- ...doing it well. Whether you're managing claims, supporting clients, or improving processes... ...: This role is eligible for fully remote work How you'll make an impactApply claims... ...process to ensure effective communication and resolution. Provide exceptional customer service to...Remote workClaimsLocal area
- ...will serve as the primary contact for members and providers, delivering first-call resolution and high-quality service. You will troubleshoot inquiries about eligibility, benefits, and claims, and navigate multiple systems to ensure accurate responses and timely...Remote jobClaims
- Southern California Edison seeks a Claims Resolution Associate Specialist to support the claims organization in investigating and resolving third-party... ...California, this hybrid role combines office collaboration with remote work options to balance priorities while serving...Remote workClaimsWork at office
- Sovereign Insurance Group is seeking a Claims Specialist to manage the claims lifecycle from notice to resolution. The role collaborates with customers and carriers to ensure... ...work options are available in Berwyn, PA, with remote opportunities in PA/NJ. #J-18808-Ljbffr...Remote jobClaims
- Job Summary The Elite Job is looking for a detail-oriented and highly organized Medical Coding and Healthcare Claims Resolution Specialist to join our remote healthcare operations team. This role involves analyzing medical records, assigning accurate diagnostic and procedural...Remote workClaimsFull timePart timeCasual workLocal areaWork from homeFlexible hoursAfternoon shift
- Humana is seeking a Claims Research & Resolution Representative 3 to manage complex medical claims through investigation, verification, and settlement... ...knowledge of Medicare/Medicaid claims; the position is remote with travel for training or meetings as needed. #J-18808-...Remote jobClaims
- ...is seeking a customer service specialist for a high-volume call center... ..., and resolve Home Warranty claims while delivering strong customer... ...cases from investigation to resolution, reviewing information, and... ...Bilingual Spanish is a plus; remote role with competitive hourly...Remote jobClaimsHourly payFor contractors
- MedReview Inc. seeks a Pricing Resolution Specialist II to review and reprice healthcare claims across Medicare, Medicaid, and Commercial lines. You will apply CMS... ...accurate pricing determinations. The role can be remote or in-office based on needs, with a PHI-secure workspace...Remote jobClaimsFull timeWork at office
$20 per hour
...Days in Office, 2 Days Remote Join Our High-... ...As a Patient Account Specialist, you will play a vital... ...insurance inquiries, claims, and billing matters.... ...support timely and accurate resolution in accordance with... ...outstanding accounts. Research and resolve claim denials...Remote workClaimsWork at officeLocal areaWork from home$17.69 - $23.56 per hour
...requests and customer inquiries, researches account information and... ...analyze and resolve Home Warranty claims in a timely manner while... ...investigation of the claim through resolution Make decisions and... ...Spanish a plus Pay Range: $17.69 - $23.56 Hourly, Remote...Remote workClaimsHourly payContract workFor contractorsWork at office- ...our past-due portfolio. As our Account Resolution Specialist, you'll be the dedicated point person for... ...or account information to our proof-of-claim vendor when needed. Prepare and send... ...highly collaborative team environment Work from home stipend #J-18808-Ljbffr Remote JobsRemote workClaimsWork from homeFlexible hours
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