Remote Claims Examiner - Adjudication & Process Improvement
Med Point 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
- ...Wellness resources Summary The claims examiner is responsible for the adjudication of claims, in accordance with... ...issues, as needed. Suggests process improvements to management and is a resource... ...the ability to work independently This is a remote position....Remote workProcess improvement
$20 per hour
...Remote Xcelys Medical Claims Examiner NTT DATA is currently seeking remote Xcelys... ...full-cycle, medical claims processing experience and one year... ...Role Responsibilities: Adjudication & Review: Process... ...Process & System Improvement: Participate in system...Remote workProcess improvementContract workMonday to Friday$20 per hour
...DATA is currently seeking Remote XCELYS Medical Claims Examiners Minimum 3 years of... ...-cycle, medical claims processing experience 1+ year of... ...Responsibilities: # Adjudication & Review Process... ...# Process & System Improvement Participate in system...Remote workProcess improvementHourly payContract workTemporary workMonday to FridayFlexible hours- Claims Adjuster (Individual Life Insurance) We are currently... ...responsible for handling and adjudicating life insurance claims,... ...plus. Any experience with process improvement, developing procedures, special... ...office 3 days a week (hybrid) remote 2 days a week. For anyone...Remote workProcess improvementPermanent employmentFull timeWork at officeLocal areaRelocationRelocation package2 days per week3 days per week
$20 per hour
...and innovation that will improve your business outcomes. Outsourcing... ...seeks Xcelys Medical Claims Examiners to join our team remotely for a 6-12 month contract... ..., audits, and process optimizations. Role Responsibilities: # Adjudication & Review Process comprehensive...Remote workProcess improvementHourly payContract workTemporary workFlexible hours- ...St. Louis is seeking an Experienced Claims Processor to efficiently process medical claims while ensuring... ...compliance with requirements. In this fully remote role, you will leverage your 1-2... ...processing experience to review, adjudicate, and maintain accurate claims records...Remote 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
- CareOregon is hiring a Claims Examiner II in Wisconsin. This intermediate position is responsible for the timely review and adjudication of various claims including Medicaid, Medicare, and more. The ideal candidate will have at least 2 years of experience in related roles...Remote jobWork from home
$20 per hour
NTT DATA Services seeks a remote Xcelys Medical Claims Examiner for a 6-12 month contract role. The ideal... ...candidate has over 5 years of claims adjudication experience, at least 1 year of... ...HCPCS). Responsibilities include processing medical claims, engaging in quality...Remote jobHourly payContract work- ...Insight Global is seeking a fully remote Claims Management Analyst to join the team of... ...and leverages relationships to drive process improvements. In addition, the role is responsible... ...rejections, denials, payment methodologies, adjudication, and encounters—is essential to...Remote workProcess improvementWork experience placement
$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 workProcess 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
$61k - $65k
...Profile We offer remote work opportunities (AK, AR... ...citizenship and a favorably adjudicated DOD background... ...moderate to high complexity claims issues and escalations... ...system issues, and/or improvement opportunities.... ...Knowledgeable of claims processing and medical management...Remote workProcess improvementContract workTemporary workFor subcontractorLocal areaShift work- ...opportunity! The purpose of the Claims Adjudicator III position is to... ...Level III ensures claims are processed accurately according to the... ...areas for process improvement and makes recommendations to... ...and Employee Assistance Program (EAP). #LI-Remote #LI-HybridRemote workProcess improvementHourly payTemporary workWork experience placementWork at officeWork from homeMonday to FridayFlexible hours
$23 per hour
W e are seeking a Pharmacy Adjudication Specialist at our Specialty pharmacy in Scottsdale, AZ... ...will be a Full-Time position. This is a remote hybrid opportunity, after onsite... ...Adjudication Specialist will adjudicate pharmacy claims, review claim responses for accuracy....Remote workFull timeTemporary workWork experience placementFlexible hoursShift work$20 - $25 per hour
A leading claims management company located in South Carolina is seeking a Claims Evaluator to evaluate incoming claims and conduct... ...initiatives. The role ensures compliance and aims for process improvement within the claims department. Competitive pay rate of $20-$2...Process improvement$20 - $25 per hour
A leading software provider in Rhode Island is seeking a Claims Evaluator to assess incoming claims for eligibility and validity... ...communicate effectively with stakeholders and contribute to process improvement initiatives. A pay rate of $20-$25 per hour is offered,...Process improvementHourly pay$105k - $118k
...Claims Team Lead (Supervisor) - Workers Compensation... ...and experience to adjudicate complex customer claims... ...in office, 2 days remote) Primary Purpose of... ...Oversees multiple teams of examiners and technical staff... ...opportunities for process improvement; advises management...Remote workProcess improvementWork at officeFlexible hours$105k - $115k
## Claims Team Lead - Workers Compensation | Roseville... ...and experience to adjudicate complex customer... ...days in office, 2 days remote)**PRIMARY PURPOSE OF... ...Oversees multiple teams of examiners and technical staff... ...opportunities for process improvement; advises management and...Remote workProcess improvementWork at officeFlexible hours$98k - $107k
...end-to-end platform to improve clinical outcomes,... ...The Senior Associate, Claims and Benefits Analyst owns... ...calculations, claims processing, eligibility inputs, and... ...of claims adjudication, cost-share structures... ...Metropolitan area, NY, and remotely via San Francisco/Bay...Remote workProcess improvementFull timeContract workWork at officeImmediate startFlexible hours3 days per week- ...serve. Position Summary The Claims Examiner, Team Lead will be a... ...resolving issues related to claims processing, configuration, and appeals... ...well as potential process improvements. Create agendas using the... ...) Experience working in a remote environment with laptop...Remote workProcess improvementWork at officeLocal area
$50k - $65k
...Hydrogeologist 2 to join the Adjudications team! Hydrogeologist 2... ...may offer the ability to work remotely, within Arizona, based upon... ...Stream Adjudications. Legal process to determine water rights.... ...level recorders, etc. Process improvement and lean practices. Ability...Remote workProcess improvementFull timeTemporary workPart timeWork at officeWork from home$22.9 - $29.19 per hour
The Claims Research Analyst reviews and monitors adjudicated claims for file submission and upstream processing and communicates with provider agencies on... ...trainings, and process improvement efforts. The position requires... ...including hybrid/remote options Paid time off...Remote workProcess improvementHourly payFull timeWork at officeFlexible hours- ...United StatesAbout the job Data Entry Claims Intake ProcessorJob Type: Part-timeOnly... ...am - 4:30pm CST. Position can be fully remote.If selected for further consideration,... ...discrepancies.Provide recommendations on process improvements to increase efficiencies as appropriate...Remote workProcess improvementFlexible hours
$42.51k - $50.6k
...am To 5pm) M-F 8am to 5pm CT Remote Work Notification ATTENTION:... ...Due to growth, we are adding a Claims Quality Analyst to our team.... ...Medicaid, and Exchange claims are adjudicating per State/CMS regulations as... ...manage changes to existing processes, including defining...Remote workWork experience placementFlexible hours- ...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
- ...Claims Resolution Specialist The Claims Resolution Specialist is responsible for managing Accounts Receivable and resolving... ...upstream issues impacting claim quality Root Cause Analysis & Process Improvement Identify patterns in denials and rejections and...Remote workProcess improvement
- 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
- ...Claims Resolution Specialist At the Innovative Hematology (IHI), we offer a future... ...opportunity to contribute to enterprise-wide improvements in claims performance while... ...systemic trends and opportunities for upstream process improvement. The ideal candidates will...Remote workProcess improvement
- ...OEMs). While this is a remote position, the candidate needs... ...to effectively resolve cargo claims submissions and disputes.... ...identify and implement quality improvement initiatives Evaluates... ...Investigates, negotiates, and processes cargo claims in accordance with...Remote workProcess improvement
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