Claims Adjudication Specialist (Hybrid/Remote)
Blue Shield Of California
Blue Shield of California is seeking a Claims Processor, Intermediate to review and adjudicate claims and adjustments for services in and outside California. The role reports to the Operations Supervisor and focuses on meeting operational, financial, and service requirements while supporting a high-performing team. The position offers hybrid virtual work with in-office requirements based on business needs; candidates should have strong back-end processing experience and advanced Excel/Office #J-18808-Ljbffr
$23 per hour
Onco360 is seeking a Pharmacy Adjudication Specialist in Scottsdale, AZ. This full-time role offers a remote hybrid model after an initial onsite training period, with shift times between 8am and 8pm. Starting salary is $23.00 per hour, plus a $5,000 sign-on bonus for those...Remote jobHourly payFull timeRelocation packageShift work- ...Sedgwick Claims Management Services Ltd is seeking a dedicated professional to process... ...liability claims from the East Coast. You will adjudicate within guidelines, determine benefits,... ...a Bachelor's degree. The role offers hybrid work and a comprehensive benefits...Remote work
$23 per hour
...Onco360 Pharmacy is seeking a Pharmacy Claims Adjudication Specialist in Salt Lake City, UT. This full-time, remote/hybrid role requires active Utah Pharmacy Technician credentials. Starting salary is $23.00 per hour with a $5,000 sign-on bonus for hires before Dec...Remote workHourly payFull timeRelocation package$5,000 per month
...Onco360 is seeking a Pharmacy Claims Adjudication Specialist to adjudicate pharmacy claims and manage COB-related processes in a remote/hybrid Denver-based role. The position requires active Colorado Pharmacy Technician credentials and offers a starting wage of $24/hour...Remote workRelocation package- ...Mutual Insurance is seeking a Claims Specialist in Illinois to analyze... ...claims, determine benefits, and adjudicate high-exposure cases. You will... ..., with the option of a hybrid in-office schedule for collaboration... ...while enabling focused remote work on complex investigations...Remote workWork at office
$23 per hour
...Oncology Pharmacy in Scottsdale, AZ is seeking a Pharmacy Adjudication Specialist for a full-time, hybrid role with initial onsite training. The position... ...company-paid coverage. The specialist will adjudicate claims, ensure COB accuracy, engage with insurers, manage #J...Remote workHourly payFull timeRelocation package- Pacific Medical Centers is seeking a Senior Claims Specialist for the USFHP program in Renton, WA. The role is Full Time with a Hybrid schedule. You will adjudicate external claims for capitated populations and handle complex adjustments, supporting workflow and acting...Full time
- ...Qualfon is seeking detail-oriented Medi-Cal Claims Processing Specialists to review and resolve suspended claims accurately and efficiently in... ...reviewing records, correcting errors, and applying Medi-Cal guidelines to adjudicate claims within deadlines. #J-18808-LjbffrRemote workWork from home
$23 per hour
Position: Pharmacy Claims Adjudication Specialist Location: Salt Lake City, UT Job Id: 5447 # of Openings: 1 We are seeking a Pharmacy Adjudication... ...Time Zone.This will be a Full-Time position. This is a remote/hybrid opportunity, Full-Time position may work remotely but...Remote workFull timeTemporary workWork experience placementRelocation packageFlexible hours$45k - $55k
...applications and next steps. Our partner is looking for a Claims Adjudication Specialist based in the United States. Join a fast-growing technology... ...fraud investigation, and technology-enabled service delivery. Remote work: A remote position for eligible candidates based...Remote workFlexible hours$24 per hour
Onco360 is seeking a Pharmacy Claims Adjudication Specialist for our Woodridge, IL location. This full-time role requires hybrid work, with shift times between 8am and 8pm. Starting pay is $24.00 per hour and up, plus a $5,000 sign-on bonus for eligible hires. You will...Hourly payFull timeRelocation packageShift work- ...As a critical member of the Operations Department, the remote Claims Adjudication Specialist will evaluate and service claims related to Product and Shipping Protection plans, managing complex claim submissions and collaborating with internal teams to ensure timely and...Remote workContract work
- ...The Hartford in the United States seeks a Claim Consultant for the EPL Claims Group to manage a portfolio of EPL claims from inception... ...communication and negotiation skills. The role supports hybrid or remote work, with office options in select locations. #J-18808-...Remote workWork at office
- ...Zurich North America is seeking a Workers’ Compensation Claims Specialist I for the Northeast region. The role offers hybrid schedules from Parsippany or Boston offices, or fully remote work based in eligible US states. You will handle multi-party Workman’s Compensation...Remote workWork at office
- ...Guarantee Trust Life Insurance Company is seeking a Life Claims Adjuster (Adjuster IV) to adjudicate claims and Return of Premium (ROP) claims. The role... ...position is on-site in Glenview, IL with three flexible remote days per month and half-day Fridays. Prior life claim...Remote workFlexible hours
- ...The Hartford is seeking an experienced Claims Consultant for its Cyber and Technology team in a hybrid or remote capacity. You will manage a caseload of first party and third party cyber and technology claims from inception to disposition, including litigation matters...Remote work
- ...Hamilton Group seeks a Senior Claims Adjuster for Casualty/ specialty claims, with remote or Richmond, VA based work and hybrid possibilities. You will handle primary and excess placements, mentor future adjusters, and collaborate with underwriting and management across...Remote work
- ...Pacific Life in the Workforce Benefits Division seeks a Sr. Life Claims Specialist to manage group life claims from notice to adjudication, with 4 days in office in Omaha, NE or remote in Tennessee. You will apply policy provisions, review beneficiary designations and...Remote workWork at office
- ...Liberty Mutual Insurance is seeking a Senior Claims Specialist for our Personal Lines Casualty Team.... ...with prompt, quality service. Hybrid work is offered; site presence within 5... ...requires two days on-site monthly, while remote work is available beyond 50 miles. Start...Remote work
- ...Controls and QA Analyst - Claims Adjudication Specialist - Remote Role and Responsibilities The Controls and QA Analyst is responsible for developing, monitoring, assessing, reviewing, and recommending changes to Livinitis quality and control procedures to ensure...Remote workFull timeLocal areaImmediate startMonday to FridayWeekend work
- ...Jobgether, acting on behalf of a partner, seeks a Claims Adjudication Specialist in the United States. You will evaluate complex claims, investigate... ...plus experience with claims systems and Google Workspace. Remote work is available for qualified US-based candidates. #J-18...Remote work
- ...Tampa General Hospital is seeking a Claims Resolution Specialist I to ensure timely submission, follow-up, and resolution of third-party insurance... ...and regulations. The position is part-time with hybrid remote eligibility in the Tampa area. Qualified candidates will...Remote workPart time
- ...The Hartford is seeking an experienced EPL Claims Consultant to manage litigated EPL claims from inception to disposition. The role... ...experience, and strong negotiation and communication skills. Hybrid or remote work options are available, with some office presence...Remote workWork at office
- ...Sedgwick is seeking an experienced Workers’ Compensation Claims Representative to adjudicate complex claims for clients across various industries. This role involves analyzing lost-time claims, determining benefits due, and ensuring adherence to service expectations and...Remote work
- Sedgwick Claims Management Services Ltd is seeking an experienced Liability Claims Adjuster... ...the Marlton, NJ area. The role supports a hybrid work schedule with potential remote options depending on commute. You will adjudicate general liability claims, determine benefits...Remote work
- ...Zurich Insurance is seeking a Workers Compensation Claims Specialist II for the Northeast region. The role offers a hybrid work schedule from Parsippany or Boston offices, or a fully remote setup based in one of several states. You will handle multi-party WC claims...Remote work
- ...Liberty Mutual Insurance is seeking a Technical Claims Specialist I/II, Workers' Compensation, to handle complex, high... ...cases under limited supervision. This role supports hybrid work with in-person collaboration and remote tasks in the Northeast region. You will...Remote work
$91.08k - $122.82k
...Republic Indemnity Company of America in Southern California seeks a Workers' Compensation Claims Specialist. Hybrid schedule for local Woodland Hills candidates; remote consideration possible for non-locals. The role requires examining coverage and liability, managing...Remote workLocal area$93.1k - $139.7k
...and handling new and existing litigation claims. Ensure timely and effective application... ...new Program Business.Conduct in-person or remote claim file reviews and audits on multiple... ...technology and other tools that will make hybrid working normal rather than an exception,...Remote workFlexible hours- ...Zurich North America is seeking a Workers Compensation Claims Specialist I for the Northeast region. The role supports a hybrid schedule from Parsippany or Boston offices or fully remote within specified states, handling complex, multi-party Workman’s Compensation claims...Remote work
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