Remote Healthcare Claims Specialist - Adjudication & QA
Visa Hunt
- Remote job
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 coordination with multiple departments to ensure accurate adjudication. The ideal candidate has 3+ years in health insurance claims, CPT/ICD-10/HCPCS knowledge, strong communication, and experience with CRM systems and claim #J-18808-Ljbffr Visa Hunt
- 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
$24 per hour
...The Claims Quality Assurance Analyst is responsible... ...ideal candidate has prior healthcare claims auditing... ...; DME preferred. Other QA/production experience a... ...through it. Including how to adjudicate an audit appeal Subject... ...opportunities Remote Opportunities We are...Remote workHourly payFull timeTemporary workLocal areaFlexible hours$55k - $60k
...the review and processing of claims within the claims transactional... ...procedures related to claim adjudication. Audit auto-adjudicated and/... ...Grievance. Certified Coding Specialist (CCS) or Certified Coding Professional... ...Requirements This is a remote position. Our whole company...Remote workLive inWork at officeFlexible hoursWeekday work$15 - $15.5 per hour
...Claims Specialist – Remote Healthcare Administrative Agent Join LEC as a remote Healthcare Administrative Support Representative, helping healthcare... ..., delayed, and paid claims. Inquire about claim adjudication and payment timelines. Request missing...Remote workTemporary workFor contractorsWork from homeHome officeMonday to Friday- NTT DATA is seeking a Remote Claims Processing Associate to work for our end client. In this role you will process professional claim forms... ...HIPAA and PHI confidentiality. You will prioritize work, adjudicate claims per client workflows, maintain quality scores above 98...Remote job
$17.71 - $25.28 per hour
...exciting place to be within the healthcare industry. As a member of... ...much more. The D‑SNP Claims Review Specialist reviews and processes... ...manual intervention when auto‑adjudication is not achieved. The... ...Working Condition This is a remote role that can be done from...Remote workHourly payFull timeWork at officeFlexible hoursShift work$40 per hour
Claims Specialist / Contract - Remote to Office-Based Setting - Jericho, NY (#25322A) Location: Remote to... ...on-site position. About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing... ...managing appeal and dispute adjudication programs. Why Join Us? Competitive...Remote jobHourly payFull timeContract workPrivate practiceWork at officeFlexible hours- Providence Health & Services is seeking a Claims Specialist to review, process, and adjudicate TRICARE medical claims with accuracy and compliance. The role involves investigating discrepancies, responding to provider and beneficiary inquiries, and maintaining quality...
- Sutherland is hiring a full-time permanent healthcare claims adjudicator. You will process medical claims via data entry, adjudicate to policy and regulatory guidelines, and maintain privacy according to HIPAA. The role emphasizes independence with support from knowledge...Permanent employmentFull time
$16.5 - $22.2 per hour
A healthcare provider in the United States is seeking a Claims Processor responsible for evaluating and adjudicating claims. This role requires strong communication skills and the ability to navigate multiple systems. Candidates should have a high school diploma and at...Hourly payWork at office- ...Phoenix. This role involves reviewing and adjudicating medical claims, ensuring compliance with industry... ..., and working collaboratively with healthcare providers. The ideal candidate will possess... ...the flexibility of a primarily remote work environment. If you are passionate...Remote job
- ...NTT DATA North America is seeking a Remote Claims Processing Associate to support our end client. You will process professional claim forms... ...scores while meeting SLAs. A high school diploma and 1–3 years of healthcare claims processing are required. #J-18808-Ljbffr...Remote workWork from home
- ...Seeking motivated individuals, the full-time Remote Healthcare Claims Specialist will manage and coordinate patient cases, assist with healthcare-related inquiries, and serve as a liaison between patients and insurance carriers while working from home. Key Responsibilities...Remote workFull timeWork from home
$17 - $18 per hour
...Job Title : Medial Claims Processor Industry : Healthcare FSLA status : Non-Exempt Department... ...claims • Prioritize work and adjudicate claims as per turnaround time/SLAs... ...The starting hourly range for this remote role is $17.00-18.00. This range...Remote workHourly payTemporary workWork at officeWork from homeFlexible hours- ...Remote Jobs Solutions is seeking a detail-oriented individual to manage the entry of medical claim forms and maintain adherence to privacy standards. The ideal candidate will possess... ...have over 2 years of experience in the healthcare industry. Proficiency in MS Office and...Remote work
- ...To support a growing healthcare initiative, the remote Claims Processor will manage the timely and accurate processing of insurance claims and appeals... ...issue resolution. Key responsibilities Ensure timely adjudication and payment of medical claims, maintaining accurate...Remote work
- ...To support healthcare clients in managing insurance claims, the contracted Remote Claims Specialist will make outbound calls to insurance companies, navigate payer IVR systems, and accurately document results in the client's platform. Key Responsibilities Follow up on...Remote work
$22 - $28 per hour
...Remote setup sorted. Get fiber internet for $55/month, work distraction... ...Sana’s vision is to make healthcare easy. All of us can agree... ...We’re currently seeking a Claims Processor who will be responsible... ...the timely and accurate adjudication and payment of medical claims...Remote workHourly pay$28 - $35 per hour
...Claims Resolution SpecialistThe Claims Resolution Specialist is responsible for the day-to-day investigation and resolution... ...a multi-site, multi-specialty healthcare organization specializing in pain... ...and efficiently.*This is a remote role. We are only hiring in the...Remote work$22 - $25 per hour
...Temporary, Full-Time Medical Claims Processor. Become an integral... ...Analysis: Analyze claims and adjudicate them according to program... ...Understanding of medical terminology, healthcare services, and insurance... ...the program. PM18 #remote Salary Description...Remote workFull timeTemporary workWork at officeFlexible hours$14 per hour
A healthcare service company is seeking a Customer Service Representative for a remote role in Dallas. This position involves handling outbound calls and documenting customer... ...experience, and six months in healthcare claims. The job offers a base pay of $14/hour and opportunities...Remote work- Arthur J. Gallagher & Co. (AJG) is seeking a Senior Claims Specialist for Healthcare Professional Liability - Long Term Care. This role manages moderately complex claims through the full life cycle, conducts coverage analysis, and negotiates settlements with clients and...Remote job
- HealthEdge Software, Inc. is seeking a Claims Examiner II to adjudicate healthcare claims remotely in the United States. You will review data in the claims processing system to determine service appropriateness and whether benefits meet coverage criteria, reporting to the...Remote job
- Gallagher Bassett is seeking a Senior Claims Specialist for Healthcare Professional Liability - Long Term Care. The role focuses on managing moderately... ...complex claims from coverage analysis to resolution, remotely across jurisdictions. Strong analytical and negotiation skills...Remote job
- 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
- Firstsource Healthcare is seeking a detail-oriented Claims & Appeals & Grievances (A&G) Specialist to join our Healthcare Operations team. The candidate should have at least two years of experience in US healthcare back-office operations with expertise in claims processing...Remote job
$14 per hour
A leading business process management provider is seeking a Customer Service Representative with remote work flexibility. The role involves conducting outbound calls, documenting customer transactions, and ensuring compliance with regulatory guidelines. Candidates should...Remote workHourly payFull time- A healthcare startup is seeking a Claims Specialist to manage healthcare claims processing, including investigating and resolving claim issues. This entry-level role requires a background in medical billing and strong attention to detail. Responsibilities include making...Remote job
$67k - $75k
...Healthcare Claims Resolution Specialist Fully Remote $67,000-$75,000 annually Monday-Friday | Full-Time Temp-to-Hire Position Overview We're seeking a detail-oriented Claims Resolution Specialist to support payer audits, appeals, contracting activities...Remote workFull timeContract workTemporary workLocal areaMonday to Friday$17 - $20 per hour
...Job Description: Claims & Appeals & Grievances (A&G) Specialist – Back Office Operations Job... ...Specialist Department: Healthcare Operations Location: United States (Remote) Employment Type: Full... ...documentation prior to claim adjudication or escalation. ~...Remote workFull timeWork at office
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