Remote Claims Adjudication Specialist
Humana Inc
- Remote job
Humana Inc. is recruiting for a Claims Processing Representative 2 in Louisville, KY. The role involves reviewing and adjudicating complex or specialty claims, performing computations, and determining whether to return, deny, or pay claims according to policy. Training starts with in-person sessions for 6 weeks, 8:00AM-4:30PM Eastern, then transitions to a 40-hour workweek from home with same hours. The position requires analytical thinking, experience with multiple computer systems, and strong #J-18808-Ljbffr Humana Inc
- ...Automotive Group, Inc. is looking for a full-time Ancillary Specialist who will review and adjudicate claims for the GAP product while ensuring accuracy in... ...processing and customer satisfaction. This role is performed remotely. The ideal candidate will possess a High School...Remote jobFull time
- Visa Hunt is seeking an experienced claims adjudication specialist to review and process medical claims in a remote team. You will apply plan benefits, COB rules, and contractual terms to approve, pend, or deny claims while maintaining quality standards. This role supports...Remote job
$25 per hour
...We are seeking a Pharmacy Adjudication Specialist for our Specialty Oncology pharmacy. Full‑time position... ...based in the State of Missouri; remote work available. Shift times currently... ...Responsibilities Adjudicate pharmacy claims, review claim responses for accuracy and...Remote workFull timeTemporary workWork experience placementRelocation packageFlexible hoursShift work- ...Oncology Pharmacy in Columbus, OH is looking for a Pharmacy Claims Adjudication Specialist to work full-time. Candidates must have active Ohio... ...sign-on bonus and various health perks. Flexibility to work remotely is offered. #J-18808-Ljbffr Onco360 Oncology PharmacyRemote jobFull timeRelocation package
$25 per hour
Onco360 is seeking a Pharmacy Claims Adjudication Specialist based in St. Louis, MO with opportunities to work remotely. This full-time role involves adjudicating pharmacy claims, ensuring their accuracy, resolving rejections, and maintaining patient communication regarding...Remote jobFull timeRelocation package- Onco360 is seeking a Pharmacy Claims Adjudication Specialist for their Specialty Oncology pharmacy in Columbus, OH. The role involves adjudicating pharmacy claims, resolving rejections, and providing patient outreach regarding claims. Applicants must have active Ohio Pharmacy...Remote jobRelocation packageFlexible hours
$26 per hour
JobRx, Inc. is seeking a Pharmacy Adjudication Specialist for its Specialty Oncology pharmacy in Hartford, Connecticut. This full-time role offers potential remote work opportunities and involves managing pharmacy claims effectively while ensuring proper patient outreach...Remote jobHourly payFull time- Onco360 in Scottsdale, AZ is seeking a Pharmacy Claims Adjudication Specialist for a hybrid remote position after an onsite training period. You will adjudicate pharmacy claims, resolve third-party issues, and provide service to healthcare providers and patients. The ideal...Remote jobRelocation 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
$26 per hour
Onco360 is seeking a Pharmacy Claims Adjudication Specialist in Hartford, CT. This full-time position involves adjudicating pharmacy claims, ensuring accuracy, and resolving third-party rejections. Candidates must possess active Connecticut Pharmacy Technician credentials...Remote jobHourly payFull timeRelocation package$25 per hour
JobRx, Inc. is hiring a Pharmacy Adjudication Specialist based in Columbus, Ohio. The role involves adjudicating pharmacy claims, resolving third-party rejections, and ensuring accurate... ...position offers the possibility to work remotely. A starting salary of $25.00 an hour is...Remote jobFull timeRelocation package- JobRx, Inc. is seeking a Pharmacy Adjudication Specialist for their Scottsdale, AZ location. This Full-Time... ...position offers the potential for hybrid remote work after training. Successful candidates will adjudicate pharmacy claims, ensuring accuracy and compliance with...Remote jobFull time
- Evry Health is seeking a dedicated claims examiner to review and process medical claims based on contractual agreements. The... ...will have a minimum of 3 years’ experience in medical claim adjudication. This remote role requires strong attention to detail, excellent communication...Remote jobFlexible hours
$23 per hour
We are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Scottsdale, AZ . This will be a Full‑Time position and a remote hybrid opportunity after an onsite training period... ...Specialist will adjudicate pharmacy claims, review claim responses for accuracy...Remote workFull timeTemporary workWork experience placementFlexible hoursShift work- A leading health insurance provider in Seattle is seeking a Claims Processor to oversee claims adjudication for various types. Responsibilities include processing Institutional, Professional, and Dental claims, while adhering to privacy and quality standards. The ideal...Remote workFlexible hours
- Firstsource Solutions Limited is seeking a remote Claims Examiner to analyze documents and adjudicate claims in line with client specifications. You will determine pay/deny decisions and route items for any missing information, ensuring adherence to TAT and SLA while coordinating...Remote job
- Marpai Administrators LLC is looking for a Claims Processor to review claims for accuracy and manage claim inventories. The ideal candidate... ..., strong analytical skills, and the ability to work in a remote setting. Benefits include generous PTO, medical and prescription...Remote job
- MedPOINT Management is seeking a Claims Examiner to adjudicate claims in accordance with health plan regulations and contractual obligations. This... ...mathematical skills, and knowledge of ICD-10 and CPT-4 coding. This is a remote position. #J-18808-Ljbffr MedPOINT ManagementRemote job
- Cognizant is seeking a Claims Processing Executive who will leverage MS Excel to manage and process commercial healthcare claims. This fully remote position is open to Iowa residents only and offers day-shift hours, enabling you to balance work and personal commitments...Remote jobDay shift
- Primerica is seeking a Life Insurance Examiner to adjudicate individual life claims. This role requires a minimum of 4 years in adjudicating Life, Health... ...and organizational skills. The position offers a remote working arrangement across the United States. Benefits include...Remote work
- NTT DATA, Inc. seeks a claims processor to manage professional claim forms and adjudicate according to client workflows and HIPAA rules. You will review benefits,... ...Office and Excel skills, and the ability to work remotely 8:00-16:30 EST. Training is conducted on‑camera...Remote job
- ...Sedgwick is seeking a Claims Adjuster for Workers Compensation with jurisdiction coverage... ..., TX, IN, IL, and OH. The role supports remote work and requires a home state license.... ...experience. The position emphasizes adjudication accuracy, subrogation, and settlements,...Remote workWork from home
- ...Claims Examiner The Claims Examiner is responsible for reviewing, processing, and adjudicating complex employee benefit claims with accuracy, timeliness, and regulatory compliance. This role requires deep experience within Third-Party Administration (TPA) environments...Remote work
- ...Sedgwick in Ohio seeks a Claims Adjuster – Workers Compensation to analyze mid- to high-level claims, determine benefits, and guide adjudication to meet company standards. The role emphasizes subrogation negotiations, return-to-work coordination, and accurate claim documentation...Remote work
- ...Sedgwick is seeking a Liability Claims Associate to manage lower-level general liability claims from anywhere in the continental U.S... ...claims industry experience. As part of a dynamic team, you will adjudicate claims, maintain client relationships, and ensure compliance...Remote workFlexible hours
- ...who we are looking for. The role we are looking to fill: Claims Specialist If you are a passionate and detail-oriented professional... ...to be a BCBSWY Claims Specialist today. As a claims adjudicator you will be responsible for reviewing, assessing, and processing...Remote workFull timeWork at officeLocal areaWork from homeVisa sponsorshipWork visa
$55k - $60k
...Aon is looking for a Claims Specialist II Do you have experience in claims adjudication and enjoy resolving issues for clients? If you'd like to grow your experience... ...of virtual training followed by a hybrid or 100% remote work schedule. Responsibilities Review and service...Remote workFull timeTemporary workPart timeWork experience placementLocal area- ...Sedgwick is seeking a Liability Claims Associate to work remotely, analyzing lower-level general liability claims and ensuring accurate adjudication within company standards. The ideal candidate will possess a high school diploma, have at least one year of general...Remote workWork at office
$41.1k - $59.52k
...Data Analyst Working Title: Senior Claims Specialist FLSA Status: Exempt... ...41,102 - $59,518 Office Location: Remote within North Carolina POSTING DETAILS... ...data analysis, auditing and finalizes adjudication results for claims designated for pre-...Remote workWork at officeLocal areaImmediate startWork from homeFlexible hours- ...Claims Specialist As a Claims Specialist, you will combine veterinary medical knowledge, critical... ...in a flexible workplace! This is a remote position for candidates in Germany or... ...records, supporting patient care, claims adjudication, or insurance operations is considered...Remote workFull timeCasual workWork at officeFlexible hours
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