Remote Claims Specialist II - Adjudication & Audit
Trillium Health Resources
- Remote job
Trillium Health Resources seeks a Claims Specialist II to analyze and audit claims per NC Medicaid guidelines. The role supports providers by phone/email and collaborates with stakeholders to resolve claims efficiently. Strong knowledge of billing and coding, plus travel availability within NC, is expected. The position offers remote work within North Carolina, standard hours, and benefits. A high school diploma with relevant experience is required; an Associate’s degree is preferred. #J-18808-Ljbffr Trillium Health Resources
- Trillium Health Resources is seeking a Claims Specialist II to perform data analysis, auditing, and adjudication finalization for pre- and post-payment reviews in NC Medicaid and Trillium policies. You will assist providers by phone or email with claims processing questions...Remote job
$17.88 - $26.73 per hour
LoanCare is seeking a Claims Specialist II to support mortgage claim processing for agencies and investors. The role... ...reconciliation, document validation, tracking payments, QA audits, and research for missing documents. This remote position offers a comprehensive benefits package...Remote jobHourly pay- ...Claims Specialist II Trillium Health Resources is a Tailored Plan and Managed Care Organization... ...II performs data analysis, auditing and finalizes adjudication results for claims designated for... ...~ Quarterly stipend for remote work supplies Required:...Remote workLocal areaImmediate startWork from homeFlexible hours
- 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 jobFlexible hours
- Medica, a nonprofit health plan, seeks a Claim Appeals & Correspondence II to manage inventory of claim appeals, VIP cases, and inquiries remotely from the United States. The role... ...researching, analyzing, and resolving post-adjudication issues with cross-functional partners...Remote job
- Blue Cross and Blue Shield of Nebraska is seeking a Claims Examiner I to adjudicate healthcare claims, review data against CMS and billing guidelines, and ensure proper benefit coverage. This remote role requires Nebraska residency and offers opportunities to develop expertise...Remote job
$55k - $60k
Posting Description 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... ...virtual training followed by a hybrid or 100% remote work schedule. Responsibilities: Review and service...Remote workFull timeTemporary workPart timeWork experience placementLocal area- Join to apply for the Medical Claims Specialist II - DOE role at Alaska Native Tribal Health Consortium... ...to fiscal intermediary; assesses adjudicated claims. Identifies liability and... ...preparation of month end reports through desk audit, pending claims reporting from fiscal...Remote jobTemporary workWork experience placementWork at officeImmediate startFlexible hours
$29.33 per hour
...hiring process For positions that work remotely or in a hybrid work-from-home... ...experiences, then our Mercury Insurance Claims team could be the place for you! We offer... ...ongoing guidance and support, the Claims Specialist II takes the lead in guiding customers through...Remote workHourly payLocal areaWork from homeMonday to Friday$62.5k - $93.5k
...encompass IA and surrounding states. Claims inspections will include... ...off and more. #LI-JJ1 #LI-Remote Job Description Summary... ...Property Contents, Field Claims Specialist, you'll assist with the investigation... ...for Field Claims Specialist II, Property Content : $62,500.00...Remote workFull timeTemporary workPart timeCasual workWork at officeLocal areaWork from homeFlexible hoursNight shift3 days per week- Naukri Mitra is seeking a Remote Health Insurance Claims Examiner to evaluate and adjudicate claims with HIPAA compliance, accuracy, and compassion. The role supports... ...members, and maintain precise documentation in audit systems. This remote position emphasizes quality,...Remote jobWork from home
- ...growth. This approach optimizes both remote and in-person interactions, enabling you... ...for focused tasks and projects. The Claims Specialist analyzes complex Personal Injury Protection... ...determines benefits owed, manages and adjudicates high‑exposure claims to meet service...Remote workWork experience placementWork at officeLocal area
$69.5k - $103.5k
...extraordinary care. #LI-KP1#LI-Remote Job Description Summary... ...problem-solve workers’ compensation claims resolution, while following... ...hear from you! As a Claims Specialist, you’ll investigate and handle... ...salary range for Claims Specialist II, Workers Compensation : $69,50...Remote workFull timeTemporary workPart timeCasual workWork at officeHome officeFlexible hoursNight shift- The University of Rochester is seeking a Claims Resolution Representative II to support the professional fee organization, performing routine follow-up to bring open accounts receivable to closure and pursuing timely resolution of claims. You will research, correct, resubmit...Remote job
- Blue Cross Blue Shield of Michigan is seeking a Claim Representative II to handle intermediate-level property and casualty claims, with authority... ...settlements and establish reserves. The role involves remote work with occasional on-site visits to insured municipalities...Remote job
- AF Group in Lansing, Michigan seeks an experienced Claim Representative II to handle intermediate-level property and casualty claims. You will... ...degree, three years of experience, and the ability to work remotely with occasional on-site visits to insured municipalities in...Remote job
- Grow Therapy is seeking an experienced Specialist II, Collections, to improve financial accuracy by addressing claim denials and ensuring correct processing. You will identify root causes and craft fixes to be implemented upstream in the RCM process, including bulk corrections...Remote job
- Medica in the United States is seeking an intermediate Claims Appeals & Correspondence II specialist to manage inventory of claim appeals, VIP cases, and customer inquiries. You will research, analyze, and resolve processing issues with limited supervision, collaborating...Remote job
- ...Cross Blue Shield of Michigan is seeking an intermediate level Claim Representative II to manage a caseload of Michigan No-Fault PIP claims of... ...injury causation, and litigation management. This is a fully remote opportunity for Michigan residents. You will investigate,...Remote job
- California Dental Association is seeking a Claims Representative II, Professional Liability for a remote-first role with occasional travel. The position focuses on evaluating coverage, investigating liability, and managing litigation workflow with TDIC and outside partners...Remote job
- Medica Services Company LLC is seeking a remote Claims Appeals & Correspondence II to manage inventory of claim appeals and VIP cases, researching and... ...quality, and support process improvements in post-adjudication operations. Strong analytical skills and Excel proficiency...Remote job
- Blue Cross and Blue Shield of Nebraska is seeking a Claims Examiner II for a remote, Nebraska-based role. You will interpret claim adjudication rules, analyze complex claims, and determine benefits based on member contracts and CMS guidelines. Daily responsibilities include...Remote job
- Liberty Mutual Insurance is seeking a Claims Specialist in Illinois to analyze Personal Injury Protection... ...Fault claims, determine benefits, and adjudicate high-exposure cases. You will... ...for collaboration while enabling focused remote work on complex investigations and settlements...Remote workWork at office
- Zurich North America is seeking an accomplished Workers Compensation Claims Specialist II for the Northeast region. The role offers a hybrid schedule from Parsippany or Boston offices, or a fully remote setup based in select states across the Northeast and mid-Atlantic....Remote job
- Zurich North America is seeking a Workers Compensation Claims Specialist II for the Northeast region. The role offers a hybrid schedule from Parsippany or Boston offices, or fully remote from select U.S. states. You will handle multi-party claims, assess liability and coverage...Remote job
- ...Description The Job Description The Warranty Claims Representative II receives and processes warranty... ...with 4 days in office and day remote after training. Responsibilities Deliver... ...information for accuracy and completeness. Audit warranty claims, supporting...Remote workContract workFor contractorsWork at officeWorldwide
- Zurich North America is seeking an accomplished Workers' Compensation Claims Specialist II for our Northeast region. The role offers a hybrid schedule from Parsippany or Boston, or a fully remote setup in select states including New Hampshire. You will handle multi-party...Remote job
$59.9k - $98.2k
Zurich is looking for an accomplished Workers Compensation Claims Specialist II for our Northeast region. This position offers a hybrid work schedule from our Parsippany or Boston offices, or a fully remote setup based in one of the following states: Connecticut, Delaware...Remote workFull timeTemporary workFor contractorsApprenticeshipWork at officeLocal areaVisa sponsorship- Zurich North America is seeking a Workers Compensation Claims Specialist II for the Northeast region. This role offers a hybrid work schedule from Parsippany or Boston offices, or fully remote in eligible states. Responsible for handling multi-party WC claims of varying...Remote job
- Zurich Insurance is seeking a Workers Compensation Claims Specialist II for the Northeast region with a hybrid setup in Parsippany or Boston, or a fully remote option for eligible states. You will manage multi-party workers’ compensation claims, apply coverage and liability...Remote job
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