Remote Claims Adjudication Operations Lead
Navitus Health Solutions
Navitus Health Solutions, LLC is seeking a Supervisor for Claim Adjudication Operations who will oversee department roles to ensure alignment with team efforts. This position requires strong collaboration and communication skills while providing superior customer service to partners and clients. Qualified candidates will have a Bachelor's degree, 4 years of experience, and preferably knowledge in the PBM industry. The role offers comprehensive benefits including health insurance and paid time off. #J-18808-Ljbffr
- ...JobRx, Inc. is seeking a Claim Adjudication Department Specialist to manage real-time insurance claims while providing customer service. The... ...approving claims, and communicating discrepancies. This full-time remote position prefers candidates with a Pharmacy Technician...Remote workClaimsFull time
- ...Pharmacy Solutions Group (PSG) is looking for a Claim Adjudication Department Specialist to manage real-time insurance claims while providing excellent customer service. This full-time remote position requires close communication with various pharmacy departments and the...Remote workClaimsFull time
- ...Regal Medical Group is seeking a Claims Processor to evaluate and assist in the processing of all claims. You will maintain workflow... .... The ideal candidate will have experience in claims adjudication and knowledge of medical coding. This full-time position offers...ClaimsFull time
- ...CommuniCare Health is seeking a Pharmacy Adjudication Specialist based in Broadview Heights, OH. In this full-time remote role, you will be responsible for managing real-time insurance claims while providing exceptional customer service. The ideal candidate will have...Remote workClaimsFull time
- ...Claim Adjudication Department Specialist Reports to: Adjudication Specialist Supervisor Job Type: Full-Time Remote Pharmacies located in: West Virginia, Ohio, Indiana, and Maryland Position Overview: As the Adjudication Specialist, you will manage real time insurance...Remote workClaimsFull time
- ...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 workClaimsWork from home
$24 per hour
...Caremed-Specialty-Pharmacy in Woodridge, IL, is seeking a Pharmacy Adjudication Specialist to adjudicate pharmacy claims based on coordination of benefits. This is a Full-Time position with a remote hybrid opportunity after an onsite training period. Successful candidates...Remote workClaimsFull timeRelocation package$5,000 per month
...Pharmacy in Scottsdale, AZ is looking for a full-time Pharmacy Adjudication Specialist. This hybrid position allows remote work after an onsite training period. The role involves managing pharmacy claims, ensuring accuracy, and communicating with patients and insurance...Remote workClaimsHourly payFull time- ...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 workClaimsHourly payRelocation package
- ...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 workClaimsFull time
- ...Evry Health is seeking a dedicated claims examiner to review and process medical claims based on contractual agreements. The... ...will have a minimum of 3 years’ experience in medical claim adjudication. This remote role requires strong attention to detail, excellent communication...Remote workClaimsFlexible hours
$20.36 - $24.97 per hour
...UNITE HERE HEALTH is looking for a Claims Adjudicator II in Oak Brook, IL, to efficiently manage medical claim processing. You will handle various... ...medical coding. The salary range is $20.36 to $24.97 hourly, with remote work options after initial training. #J-18808-Ljbffr...Remote workClaimsHourly pay- ...The State of Washington is looking for a Workers’ Compensation Adjudicator 4 (WCA 4) in Tumwater. This role involves developing and delivering training for support staff and adjudicators in Claims Administration. The successful candidate will have strong analytical and...Remote workClaimsApprenticeshipFlexible hours
$21 per hour
...Position: Pharmacy Adjudication Specialist Location: Louisville, KY (remote hybrid after onsite training). Shift time: 9... ...Responsibilities Adjudicate pharmacy claims and review claim responses for... ...to requests from pharmacy operations, providers and/or patients regarding...Remote workClaimsHourly payTemporary workWork experience placementRelocation packageFlexible hoursShift work$24 per hour
...again later. Position: Pharmacy Adjudication Specialist Location:... ...Full-Time position. This is a remote hybrid opportunity, after onsite... ...Specialist will adjudicate pharmacy claims, review claim responses for... ...to requests from pharmacy operations, providers and/or patients regarding...Remote workClaimsFull timeTemporary workWork experience placementRelocation packageFlexible hoursShift work$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 workClaimsHourly pay- ...is looking for a Product Manager specializing in Claim Adjudication focused on Medicaid/Medicare. This remote position requires strong expertise in claims processing... .... Responsibilities include overseeing audits, leading root cause analysis projects, and maintaining training...Remote workClaims
- ...MedPOINT Management is seeking a Claims Examiner to adjudicate claims in accordance with health plan regulations and contractual obligations. This... ...organizational and mathematical skills, and knowledge of ICD-10 and CPT-4 coding. This is a remote position. #J-18808-Ljbffr...Remote workClaims
- ...Imagenetllc is seeking a remote Claims Adjudication Manager to lead offshore claims adjudication operations. This role requires deep expertise in both hospital and professional claims, along with proven leadership abilities. The ideal candidate will work with a Philippines...Remote workClaims
- ...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 workClaims
- ...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 workClaimsFull timeRelocation package
- CareMed Specialty Pharmacy is hiring a Pharmacy Adjudication Specialist in Louisville, KY. This role involves adjudicating pharmacy claims, ensuring timely responses, and... ...also offers a comprehensive training program leading to hybrid work opportunities after onboarding...Remote jobClaims
- 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 workClaimsFlexible hours
- ...Primerica is seeking a Life Insurance Examiner to adjudicate individual life claims. This role requires a minimum of 4 years in adjudicating Life,... ...communication and organizational skills. The position offers a remote working arrangement across the United States. Benefits...Remote workClaims
- CareMed Specialty Pharmacy is hiring a Pharmacy Adjudication Specialist in Woodridge, IL. This full-time role involves adjudicating pharmacy claims and ensuring accurate responses to insurance issues. The position includes a hybrid work model after onsite training and offers...Remote jobClaimsFull timeRelocation package
$63.93k - $76.9k
...Supervisor, Claim Adjudication Operations Location US- ID 2026-6024 Category Administration Position Type Full-Time Remote Yes Company Navitus About Us Navitus - Putting People First in Pharmacy -...Remote workClaimsFull timeWork experience placementWork at officeFlexible hours$60k - $65k
...Lemieux & Associates in San Diego is seeking a Surveillance Operations Manager to lead a focused investigative team, ensuring top-quality services for clients. This full-time, remote role requires leadership, exceptional communication, and strong organizational skills...Remote workClaimsFull time$60k - $65k
...Lemieux & Associates in Las Vegas is seeking a dynamic and experienced Surveillance Operations Manager to join our fully remote team. This full-time position plays a crucial role in delivering high-quality investigative products to clients while supervising and directing...Remote workClaimsFull time$60k - $65k
...Lemieux & Associates is seeking a Surveillance Operations Manager based in Phoenix, Arizona. This full-time, remote position involves overseeing investigative teams and ensuring high-quality deliverables for clients. Required skills include strong communications, team...Remote workClaimsFull time- ...Silva-Lining HR is looking for a Fractional Customer Service (Claims) Manager to optimize the claims process while ensuring exceptional customer experience. The role is fully remote, requiring around 10 hours per week aligned with EST business hours. The ideal candidate...Remote workClaims10 hours per week
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