Remote Claims Examiner - Adjudication & Process Improvement
Med Point Management
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
- ...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
$65k - $85k
...is seeking a detail-oriented Claims Examiner I to support a federal claims... ...Experience in insurance, claims processing, legal support, or quality assurance... ...requirements, and process improvement initiatives. Support claims adjudication activities under the direct...Remote workProcess improvementContract workWork at office- ...MVP Health Care in New York is looking for a dedicated Claims Examiner to enhance healthcare delivery. The position entails using PC-based systems to adjudicate health care claims while ensuring accuracy and compliance with company protocols. Qualified candidates should...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
- ...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
$20 per hour
...and innovation that will improve your business outcomes. Outsourcing... ...seeks Xcelys Medical Claims Examinersto join our team remotely for a 6-18 month contract... ..., audits, and process optimizations. Role Responsibilities: # Adjudication & Review Process...Remote workProcess improvementHourly payContract workTemporary workFlexible 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 workProcess improvement$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- ...better. Summary The Claims Resolution Specialist... ...Claims Review, Adjudication & Resolution Review... ...duplicate claims, and processing errors; calculate allowable... ..., Quality & Process Improvement Document claim decisions... ...Maintain a secure remote work environment. Perform...Remote workProcess improvementFull timeWork at officeFlexible 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 workWork from home
- ...Claims Quality Analyst | Remote Job Type: Full time Work Setup: Remote Reports to... ...effectiveness of claims processing and provider dispute resolution... ...to drive continuous improvement and operational excellence... ...or in a claims processing/adjudication environment Hands‑on...Remote workProcess improvementFull time
- ...Claims Adjudication Manager U.S.-Based Operational Leader... ...Adjudication Work Setup: Remote Reports To: SVP... ...adjudication team (examiners, auditors, team leads... ...performance, quality, and improvement actions. Manage... ...knowledge-management process for client directives...Remote workProcess improvementAfternoon shift
$105k - $115k
...Claims Team Lead - Workers Compensation | Brea,... ...knowledge and experience to adjudicate complex customer... ...days in office, 3 days remote)**PRIMARY PURPOSE OF... ...multiple teams of examiners and technical staff handling... ...opportunities for process improvement; advises management...Remote workProcess improvementWork at officeFlexible hours- ...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
- ...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
$72k - $76k
...We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA... ...The Supervisor, Claims Administration is responsible... ..., respond to inquiries, and improve processes. Education & Experience... ...receive a favorable Interim and adjudicated final Department of Defense...Remote workProcess improvementTemporary workFor subcontractorInterim roleLocal area$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$105k - $118k
...Claims Team Lead (Supervisor) - Workers Compensation... ...days in office, 2 days remote). Oversees multiple teams of examiners and technical staff handling... ...guidance on claims adjudication and maintains regular diaries... ...and opportunities for process improvement; advises management and...Remote workProcess improvementWork at officeFlexible hours$103.45k - $191.97k
...spouses. USAA roles may offer remote or hybrid flexibility for active... ...seeking dedicated Manager(s), Claims Operations to lead a team of Injury Examiners. This team will cover the the Tampa... ...business results. Executes process improvements, provides feedback on the process...Remote workProcess improvementH1bRelocation package$105k - $115k
Workers Compensation Claims Team Lead | Roseville... ...days in office, 2 days remote) Are you looking for... ...and experience to adjudicate complex customer claims... ...multiple teams of examiners and technical staff handling... ...opportunities for process improvement; advises management...Remote workProcess improvementWork at officeFlexible hours$63.93k - $76.9k
...Supervisor, Claim Adjudication Operations Location US- ID 2026-6024... ...Position Type Full-Time Remote Yes Company Navitus... ...CAO team to leverage technology and process improvement for the purpose of meeting the business...Remote workProcess improvementFull timeWork experience placementWork at officeFlexible hours$28 - $30 per hour
...path and to assist in the expedited processing of all claims, special projects and escalated reconsiderations... ...by unit Supervisor regarding claims adjudication issues discovered in audit or... ...special projects. Recommend process improvements based on appeal tracking and...Process improvementHourly payFull timeContract workCasual workWork at officeRelocation packageFlexible hours$70k - $100k
...Job Title ~ Claims Operations Specialist Location... ...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$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- ...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 workHourly payRelocation package
$70k
...French Bilingual, Claims Quality Assurance Analyst... ...of pet medical claims adjudication across Claims teams and... ...excellence and continuous improvement. At Trupanion, we... ...everywhere. This is a remote position open to candidates... ...and opportunities for process improvement across...Remote workProcess improvementFull timeCasual workWork at officeImmediate startFlexible hours- ...JobRx, Inc. is seeking a Pharmacy Adjudication Specialist for their Scottsdale, AZ location. This... ...Time position offers the potential for hybrid remote work after training. Successful candidates will adjudicate pharmacy claims, ensuring accuracy and compliance with...Remote workFull time
- ...technical advisor to the Veterans Claims Examiners (VCEs) and Senior Veterans... ...an online onboarding process. Acceptable form(s) of identification... ...feedback to examiners to improve claim processing quality (4)... ..., after notification of the adjudication of your request, you will...Remote workProcess improvementFull timePart timeSecond jobWork at officeLocal areaRelocation packageMonday to FridayFlexible hours
$28 - $32 per hour
...Hill Physicians Medical Group is seeking an experienced Full Risk Claims Analyst to process claims accurately and timely in Stockton, California. This role involves adjudicating claims for various healthcare services and ensuring compliance with regulations. The ideal...Remote workHourly pay- ...Caremed-Specialty-Pharmacy in Houston, TX is seeking a Pharmacy Adjudication Specialist. The role involves adjudicating pharmacy claims and managing communications with patients and insurers to ensure timely medication delivery. This is a Full-Time position offering a...Remote workFull timeRelocation package
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