Remote Claims Examiner - Adjudication & Process Improvement
MedPOINT Management
- Remote job
MedPOINT Management is seeking a Claims Examiner to adjudicate claims in accordance with health plan regulations and contractual obligations. This role involves reviewing Provider claims, resolving issues, and assisting staff in claims research. The ideal candidate is a high school graduate with at least one year of experience in an automated claims system, strong organizational and mathematical skills, and knowledge of ICD-10 and CPT-4 coding. This is a remote position. #J-18808-Ljbffr MedPOINT Management
- ...insurance Wellness resources The claims examiner is responsible for the adjudication of claims, in accordance with... ...and issues, as needed. Suggests process improvements to management and is a resource... ...to work independently This is a remote position. #J-18808-Ljbffr...Remote workProcess improvement
- 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
- Primerica is seeking a Life Insurance Examiner to adjudicate individual life claims. This role requires a minimum of 4 years in adjudicating Life, Health,... ...communication and organizational skills. The position offers a remote working arrangement across the United States. Benefits...Remote work
- ...opportunity! The purpose of the Claims Adjudicator III position is to... ...Level III ensures claims are processed accurately according to the... ...Identifies areas for process improvement and makes recommendations... ...Employee Assistance Program (EAP). #LI-Remote #LI-Hybrid...Remote workProcess improvementHourly payTemporary workWork experience placementWork at officeWork from homeMonday to FridayFlexible hours
- ...Description Job Title:Medical Claims Specialist Location... ...documentation, and adjudicate critical illness... ...Analyze, investigate, and process complex Critical... ...and continuous process improvement initiatives. Collaborate... ...Work Location: Hybrid remote in Minneapolis, MN 554...Remote workProcess improvementContract work2 days per week
$21 per hour
...Claims Operations Specialist Looking to start or... ...accurate and timely claims processing. In this position,... ...Full-time, remote, in-person or hybrid work... ...information needed to adjudicate claims appropriately and... ...opportunities for process improvements, including changes...Remote workProcess improvementFull timeWork at officeWork from homeFlexible hours$57.1k - $116.1k
Fairygodboss is seeking a Claims Lead Examiner in California. This role involves assisting the Claims Manager and reviewing workers... ...monitoring claims, resolving partner complaints, and developing processes for improvement. Benefits include medical, dental, and retirement...Remote jobProcess improvement$70k - $100k
...Description Job Title ~ Claims Operations Specialist... ...days in office/2 days remote Reports to ~... ...pre- and post-payment adjudication audits on claim... ...to ensure financial, processing, and operational accuracy... ...solutions for quality improvement ~ Proficiency in financial...Remote workProcess improvementFull timeCasual workWork at officeMonday to FridayFlexible hours$47k - $67.2k
...time Pharmacy Post-Payment Claims Analyst to join its remote team across the United... ...analytical, and passionate about improving healthcare operations,... ...work with pharmacy data, adjudication systems, and client... ...and implementation of new processes and systems to enhance claims...Remote jobProcess improvementPermanent employmentFull timeContract workFlexible hours- ...commitment to accuracy in processing complex medical claims. If you are eager to make... ...to apply. Work Schedule Remote Monday through Friday, 8:... ...compliance. Critical Analysis Adjudicate claims according to... ...contribute to continuous process improvements. Audit Participation...Remote workProcess improvementFull timeFor contractorsWork at officeMonday to FridayFlexible hours
- SilverRock Automotive, Inc. is seeking an Ancillary Specialist for Claims Review & Adjudication focused on GAP products. The role requires reviewing and adjudicating claims, verifying documentation, and ensuring accurate financial transactions with customers. The ideal...Remote jobWork from home
$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... ...Specialist will adjudicate pharmacy claims, review claim responses for accuracy, ensure...Remote workFull timeTemporary workWork experience placementFlexible hoursShift work- ...Summary The Default Foreclosure Claims Specialist is responsible for... .... This is a fully remote position. We are looking to fill... ...(SME) on default claims processes and property preservation requirements... ...trends and recommend process improvements to enhance efficiency,...Remote workProcess improvement
- ...Reimbursement Compliance Project Manager of the RCM Team, the Claims Escalation Specialist/Team oversees stakeholder and... ...build internal and external relationships to deliver on process and performance improvements. Responsibilities Creates, manages, and maintains...Remote jobProcess improvementWork at officeLocal area
- ...Job Title: Technical Specialist- Expert (HB, PB, Claims Analyst) Job Location: North Carolina Job Type: Remote Duration: 1 year Responsibilities: Test system... ...the system. Investigates standardization and process improvement opportunities by rounding within revenue cycle...Remote workProcess improvementHourly payContract work
$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
- CareMed Specialty Pharmacy is hiring a Pharmacy Adjudication Specialist in Louisville, KY. This role involves adjudicating pharmacy claims, ensuring timely responses, and communicating effectively with patients and providers. Ideal candidates have a minimum of 1 year of...Remote job
$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- CareMed Specialty Pharmacy is seeking a Pharmacy Adjudication Specialist for a remote hybrid opportunity. The successful candidate will adjudicate pharmacy claims, resolve third-party rejections, and provide support to health care providers and patients. Qualifications...Remote jobHourly payRelocation package
- Pharmacy Solutions Group (PSG) is looking for a Claim Adjudication Department Specialist to manage real-time insurance claims while providing excellent customer service. This full-time remote position requires close communication with various pharmacy departments and the...Remote jobFull time
$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- JobRx, Inc. is seeking a Pharmacy Adjudication Specialist for their Scottsdale, AZ location. This Full... ...position offers the potential for hybrid remote work after training. Successful candidates will adjudicate pharmacy claims, ensuring accuracy and compliance with...Remote jobFull time
$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$91k - $152k
...Supplement Large Loss, Complex Claims Reinsurance Specialist in... ...Global Claims unit to work remotely based out of our Stamford,... ...is responsible for adjudicating high-value and complex Medicare... ...excellence through training and process improvement. Key Responsibilities Large...Remote workProcess improvementWorldwide$47k - $67.2k
...Professional Claims Analyst - Remote US Date: Mar 18, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception... ...practices, and identify opportunities to improve claims systems and operational processes. This position requires strong analytical expertise...Remote workProcess improvementFull timeWork at officeFlexible hours- Evry Health is seeking a dedicated claims examiner to review and process medical claims based on contractual agreements. The ideal candidate... ...a minimum of 3 years’ experience in medical claim adjudication. This remote role requires strong attention to detail, excellent...Remote jobFlexible hours
$58 per hour
...hours a week Monday-Friday, 2 days remote CONTRACT TERM 1 year contract with... ...extension POSITION OVERVIEW – The Property Claims Specialist supports key business... ...analysis, reporting, risk assessment, and process improvement initiatives. The role works cross-...Remote workProcess improvementContract workWork at officeMonday to Friday- ...you! What will the Liability Claims Specialist do? Coterie is evolving... ...Coterie team members on process, product, project, insurance,... ...Assurance (QA), Continuous Process Improvement (CPI), User Experience (UX/UI... ...We offer the following: 100% remote Health insurance through...Remote workProcess improvementFull timeWork experience placementWork at officeImmediate startVisa sponsorshipMonday to FridayFlexible hours
$18 per hour
...leading healthcare provider is hiring a Senior Claims Examiner to work from home, ensuring accurate adjudication of complex claims for SCCIPA contracted plans. The... ...diploma and two years of experience in claims processing. Responsibilities include adjudicating claims, resolving...Remote workHourly payFull timeWork from home
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