FreshRemote.Work

Sign in

We're shutting down by the end of this month! Looking for coding jobs? Check out foojobs.com 👀

Claims Adjudication Remote Jobs

27 fresh jobs found

Lead Billing Strategy & Systems Analyst
US Remote

EDI Automation Healthcare Tech Integration Billing System Configuration Claims auditing Payer Portals SQL queries Healthcare Billing Payer Policy Denial Management +58

Senior Full Time

USD 134K+

Claims Examiner | Workers Compensation | Must have 4850 Experience | Hybrid - Rancho Cucamonga, CA
Telecommuter CA, United States

Claims Exposure Assessment Claims Communication Autonomy in Work Service Expectations Claims Industry Knowledge Claims Action Planning Benefit Determination Customer-Facing Solutions Claims Workflow +86

USD 71K+

Clinical Pharmacist - Remote
Home, United States

Prime Therapeutics

RxClaim Drug List Maintenance Medispan Point of Service Messaging Benefit Plan Management PBM Experience Drug Utilization Review Queries AS400 +37

Entry Full Time

USD 108K+

Project Manager, Provider Services Operations
United States

Navitus Health Solutions, LLC

Provider Payments Relations Claims System Changes Claims Performance Legal and Regulatory Knowledge Claims System Network Setup Network Pricing Service Desk Management +48

USD 77K+

Associate Director, Michigan Medicaid Provider Services
Work at Home - Michigan, United States

Claims Education Provider performance Provider communications Provider Recruitment Recruitment Strategy Driver safety Team performance Claims analysis Driver’s license +81

USD 115K+

Product Analyst
Remote, United States

Epic creation Claims corrections HIPAA X12 271 Claims editing HIPAA X12 837 HIPAA X12 270 HIPAA X12 834 Claims integration Agile ceremonies +53

Entry Mid Full Time

USD 101K+

Coordinator, Manual Claims
United States

Navitus Health Solutions, LLC

Report creation Claim adjudication Claims Adjudication HIPAA Compliance Client Services Claims processing Health Audits Pharmacy +14

Entry Mid Full Time

USD 43K+

Claims Systems, Technical Lead Analyst – eviCore – Remote
Oklahoma Work at Home, United States

The Cigna Group

Data configuration design Technical requirements writing Custom delimited Claims systems Healthcare data standards Cigna X12 User Story Development Claims Adjudication +44

Senior Mid Full Time

USD 74K+

Claims Systems, Business Solutions Lead Analyst - eviCore - Remote
Tennessee Work at Home, United States

The Cigna Group

Claims systems Cigna User Story Development Claims Adjudication Business solutions Health Services Data Validation Requirements Gathering Agile Methodology +32

Senior Mid Full Time

USD 74K+

Workers Compensation Claims Examiner | Dedicated Client | NY Jurisdictions & NY Licensing required
Syracuse, NY - Widewaters, United States

Jurisdiction knowledge Action Planning Action plans Claims Adjudication Adjudication Keyboarding Settlement Disability Workers Compensation +17

USD 62K+

Director, Claims Configuration
Remote-MO, United States

Centene Corporation

Pricing setup Claims Payment Systems Business Requirements Gathering Health care administration Claims Configuration Provider contracts Claims payment Claims Adjudication Adjudication +19

Exec Senior Full Time

USD 145K+

Associate VP, Provider Data
Remote US, United States

Provider Network Operations Budget oversight Trending Provider data management Process redesign Digital adoption Compliance Audits Analyzing Claims Adjudication +80

Senior Mid Full Time

USD 184K+

Bilingual Pharmacy Technician, Navigation (Spanish/English)
Remote

Pharmacy Claims Adjudication Benefit design PBM Pharmacy Technician Claims Adjudication Administrative Tasks Prior authorization Healthcare experience Specialty Pharmacy +8

Entry Mid Full Time

USD 42K+

Maryland Senior Consultant, Technical Client Engagement, DentaQuest
U.S. Telecommuters, United States

Technical client engagement Eligibility processing Oral health Healthcare navigation Application Architecture Claims Adjudication Absence Management User Testing Waterfall +42

Senior Mid Full Time

USD 84K+

Claims Team Lead - Auto Liability
Telecommuter AL, United States

Liability Claims Performance development Quality review Liability Motivational Interpretive Claims Adjudication Rehabilitation Adjudication +34

Senior Mid Full Time

USD 90K+

Patient Account Lead Representative - Remote
United States

Tenet Healthcare

UB-04 knowledge EOB interpretation ICD-9 codes UB-04 Insurance follow-up Insurance terminology Billing compliance Insurance Billing EOB +27

Senior Mid Full Time

USD 56K+

Senior Management Liability Technical Claims Specialist-Contractor
Remote

Management liability claims Management Liability Litigation management Claims Adjudication Insurance Knowledge Report Writing Customer focus Technical Guidance Client Communication +4

Senior Contract

USD 100K+

Medical Director
Remote, United States

Medical payment policy Payment policy Client relationship Clinical Medicine Health Plan Operations Medical policy Payment Integrity Payment Adjudication +30

Exec Senior Full Time

USD 190K+

Clinical Consultant I
Remote, United States

Coding validation Appeals management Medical payment policy Payment policy Payment CMS guidelines MicroStrategy Adjudication Claims Adjudication +45

USD 75K+

Senior Management & Professional Liability Technical Claims Specialist
Remote

Professional liability Claims Adjudication Customer focus Investigation Team Collaboration Insurance Time Management Analysis Negotiation +4

Senior Full Time

USD 100K+

Client Policy Manager I
Remote, United States

Medical payment policy Payment policy Healthcare Claims Clinical coding Reimbursement methodologies Medical policy ICD CMS guidelines Payment +32

USD 75K+

Trainer, Benefit Configuration
United States

Navitus Health Solutions, LLC

Adjudication Systems NCPDP Benefit configuration Claim adjudication Formulary management Claims Adjudication Issue Resolution Workflow Management Health +15

USD 52K+

Patient Account Lead Representative - Remote
United States

Tenet Healthcare

Billing compliance EOB interpretation ICD-9 codes Insurance follow-up Insurance terminology UB-04 Insurance Billing CPT codes EOB +26

Senior Mid Full Time

USD 56K+

Specialty Pharmacy Network Contracting Manager (PBM)
United States

Navitus Health Solutions, LLC

Pharmacy Contracting Reimbursement Management Network strategy Medicare part d Claims Adjudication Specialty Pharmacy Health Pharmacy Health care +12

USD 98K+

Terms & Conditions Analyst - Remote
United States

Tenet Healthcare

UB-04 Healthcare reimbursement Query writing Contract Interpretation Hospital billing Government Contracts Contract Analysis Healthcare industry expertise ICD-9 +30

Entry Mid Full Time

USD 67K+

Contract Negotiator II
Remote-CA, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Claims Adjudication Contract Compliance Adjudication Provider Relations Healthcare administration Health Plan +21

USD 52K+

Tester, Benefit Configuration
United States

Navitus Health Solutions, LLC

Benefit configuration NCPDP Claim adjudication Pharmacy Claims Claims Adjudication Workflow Management Issue Resolution Claims processing Health +15

Entry Mid Full Time

USD 42K+

Remote Jobs in North America Remote Jobs in Europe Remote Jobs in Asia/Pacific Remote Jobs in South America Remote Jobs in Africa Remote Jobs in Middle East Full Time Remote Jobs Part Time Remote Jobs Contract Remote Jobs Internship Remote Jobs Temporary Remote Jobs Freelance Remote Jobs Mid-Level Remote Jobs Senior-Level Remote Jobs Entry-Level Remote Jobs Exec-Level Remote Jobs Lead-Level Remote Jobs

Remote Jobs with CAD > 60K in Salary Remote Jobs with CAD > 80K in Salary Remote Jobs with EUR > 80K in Salary Remote Jobs with GBP > 100K in Salary Remote Jobs with CAD > 100K in Salary Remote Jobs with PHP > 40K in Salary Remote Jobs with PHP > 60K in Salary Remote Jobs with PHP > 80K in Salary Remote Jobs with CAD > 120K in Salary Remote Jobs with PHP > 100K in Salary Remote Jobs with PHP > 120K in Salary Remote Jobs with PHP > 180K in Salary Remote Jobs with PHP > 160K in Salary Remote Jobs with PHP > 200K in Salary Remote Jobs with PHP > 220K in Salary Remote Jobs with PHP > 140K in Salary Remote Jobs with PHP > 240K in Salary Remote Jobs with PHP > 280K in Salary Remote Jobs with PHP > 300K in Salary Remote Jobs with PHP > 260K in Salary