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Claims Adjudication Remote Jobs

46 fresh jobs found

Workers' Compensation Claims Examiner | Dedicated | IL Jurisdiction | Open to Remote
Telecommuter IL, United States

Action Planning Jurisdiction knowledge Action plans Claims Adjudication Adjudication Keyboarding Workers Compensation Disability Claims management +15

USD 61K+

Team Lead
Recruiting Only - Telecommuter, United States

Performance development Liability Claims Quality review Motivational Liability Rehabilitation Interpretive Performance competencies Claims Adjudication +33

Senior Mid Full Time

USD 90K+

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+

Claims Processor -Dental and Vision
Work From Home - AZ, United States

Productivity standards Third Party Administration Vision Claims Dental coding Diagnosis coding Hcpcs coding Ethical Standards Claims Adjudication Adjudication +25

USD 30K+

Claims Processor, Dental & Vision
Work From Home - AZ, United States

Productivity standards Third Party Administration Vision Claims Dental coding Diagnosis coding Hcpcs coding Ethical Standards Claims Adjudication Adjudication +25

USD 30K+

Administrator, Pharmacy Reimbursement
United States

Navitus Health Solutions, LLC

Electronic funds transfer Network auditing Network Pricing Pharmacy reimbursement Ncrx Claims Adjudication Provider Relations Health Pharmacy +13

Senior Mid Full Time

USD 47K+

Contract Negotiator II
Remote-NC, United States

Centene Corporation

Provider experience Contract Analysis Contract Compliance Guidelines Claims Adjudication Adjudication Provider Relations Health Plan Healthcare administration +22

USD 55K+

Escalation Response Specialist III
Remote-FL, United States

Centene Corporation

Provider experience Claims payment Escalation management Claims Adjudication Adjudication Contact center Customer Care Issue Resolution Claims processing +18

Senior Mid Full Time

USD 68K+

Clinical Consultant I
Remote, United States

Appeals management Coding validation Medical payment policy Payment policy MicroStrategy CMS guidelines Payment Claims Adjudication Clinical services +43

USD 75K+

Claims Intake Coordination of Benefits Specialist
Remote USA, United States

Enterprise System Navigation Form Submission Processing EOB interpretation Training material creation Documentation Development Billing codes Insurance coverage Claims Adjudication Client Communication +8

USD 42K+

Manager - Medical Staff Services & Provider Enrollment
Remote-CA, United States

Stanford Health Care

Medical Staff Services Privileging Medi-cal C-i-care Staff management Claims Adjudication Credentialing Staffing EPIC +15

Senior Mid Full Time

USD 114K+

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 III
Remote-CA, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Claims Adjudication Contract Compliance Adjudication Provider Relations Healthcare administration Health Plan +20

Senior Mid Full Time

USD 68K+

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+

Contract Negotiator I
Remote-MO, United States

Centene Corporation

Guidelines Provider experience Contract Analysis Contract Compliance Claims Adjudication Adjudication Provider Relations Healthcare administration Health Plan +20

Entry Mid Full Time

USD 55K+

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+

Contract Negotiator I
Remote-IA, United States

Centene Corporation

Healthcare Programs Guidelines Provider experience Contract Analysis Contract Compliance Claims Adjudication Adjudication Provider Relations Healthcare administration +20

Entry Mid Full Time

USD 55K+

Senior Quality Auditor
Remote-CA, United States

Centene Corporation

Health insurance regulations Claims research Provider data management Researching Medical Review Claims Adjudication Adjudication Business solutions Training Programs +26

Senior Mid Full Time

USD 44K+

Specialist II, Medical Billing
USA - FL - Remote (EST), United States

Telehealth billing Denial resolution Billing regulations Insurance Regulations Claim processing Data privacy laws Insurance Verification Denials Claims Adjudication +31

USD 54K+

Medical Director - Implementation & Sales
Remote, United States

Medical payment policy Payment policy Client relationship Health Plan Operations Clinical Medicine Payment Integrity Policy Management Payment Medical policy +27

Exec Senior Full Time

USD 190K+

Medical Director
Remote, United States

Medical payment policy Health Plan Operations Coding expertise Payment Integrity Payment Medical policy Claims Adjudication Adjudication Exchange +27

Exec Senior Full Time

USD 190K+

Operations Analyst
Seattle, Washington, United States

Community Health Plan of Washington

Electronic data interface Stakeholder consultation Encounter data reporting Benefits configuration Data assessment Health Plan Operations Claims coding Claims Adjudication Quality improvement +7

Entry Mid Full Time

USD 71K+

Claims Processor, Dental & Vision
Work From Home - AZ, United States

Dental coding Third Party Administration Vision Claims Diagnosis coding Productivity standards Hcpcs coding Ethical Standards Claims Adjudication Adjudication +26

Entry Mid Full Time

USD 30K+

Bilingual Disability Claims Adjudicator
CAN, Quebec - Full Time Remote, Canada

Insurance Legislation Underwriting Process Financial Documentation Claims Adjudication Bilingual French French Counseling Investigations Financial +21

USD 58K+

Pharmacy Claims Representative
Remote US, United States

Drug knowledge Dispensing systems Pbm systems Electronic claims submissions Pharmacy Claims PBM Prescription Pharmacy Technician Claims Adjudication +37

Entry Mid Full Time

USD 40K+

Field Reimbursement Manager - Neurology - Ohio - IN, WV, KY, VA
Remote, US, United States

Financial assistance Medical policy Patient Support Services Claims Adjudication Payer Environment Patient Support Rare diseases Neurology Issue Resolution +32

Senior Mid Full Time

USD 122K+

Field Reimbursement Manager - Neurology - West Texas - CO, NM, TX
Remote, US, United States

Financial assistance Medical policy Patient Support Services Claims Adjudication Payer Environment Patient Support Rare diseases Neurology Issue Resolution +32

Senior Mid Full Time

USD 122K+

Liability Claims Team Lead | Frisco, TX (open to telecommuters)
Frisco, TX - Frisco, United States

Performance development Quality review Liability Claims Rehabilitation Motivational Claims Adjudication Liability Interpretive Adjudication +33

Senior Full Time

USD 61K+

Field Reimbursement Manager - Neurology - Carolinas - GA, NC, SC, TN
Remote, US, United States

Financial assistance Medical policy Patient Support Services Claims Adjudication Payer Environment Patient Support Rare diseases Neurology Issue Resolution +32

Senior Mid Full Time

USD 147K+

Experienced QNXT Developer
Any city, TX, US, 99999

Gainwell Technologies

Web Forms Platform Configurations Payer Systems Qnxt .NET framework Posting Claims Adjudication ASP.NET Healthcare IT +31

Senior Full Time

USD 77K+

Field Reimbursement Manager - Neurology - North West, WA, OR, CA, NV, UT, ID, MT, WY
Remote, US, United States

Financial assistance Medical policy Patient Support Services Billing and Coding Claims Adjudication Payer Environment Patient Support Rare diseases Neurology +33

Senior Mid Full Time

USD 122K+

Field Reimbursement Manager - Neurology - South West - CA AZ NV UT AZ
Remote, US, United States

Financial assistance Medical policy Patient Support Services Billing and Coding Claims Adjudication Payer Environment Patient Support Rare diseases Neurology +33

Senior Mid Full Time

USD 122K+

Field Reimbursement Manager - Neurology - Mid West - ND, SD, NE, IA, MN, WI
Remote, US, United States

Financial assistance Medical policy Patient Support Services Billing and Coding Claims Adjudication Payer Environment Patient Support Rare diseases Neurology +33

Senior Mid Full Time

USD 122K+

Field Reimbursement Manager - Neurology - East Texas - TX, OK, AR, LA, TN, MS
Remote, US, United States

Financial assistance Medical policy Patient Support Services Billing and Coding Claims Adjudication Payer Environment Patient Support Rare diseases Neurology +33

Senior Mid Full Time

USD 122K+

Field Reimbursement Manager - Neurology - East Central - NJ, VA, DE, MD, Washington, DC
Remote, US, United States

Reimbursement processes Healthcare provider education Financial assistance Medical policy Patient Support Services Billing and Coding Claims Adjudication Payer Environment Patient Support +35

Senior Mid Full Time

USD 122K+

Field Reimbursement Manager - Neurology - Great Lakes - MI, IN, OH
Remote, US, United States

Financial assistance Medical policy Patient Support Services Claims Adjudication Payer Environment Patient Support Rare diseases Neurology Issue Resolution +32

Senior Mid Full Time

USD 147K+

Client Services Representative | Must Reside in CA
Telecommuter CA, United States

Claims Adjudication Interpretive Liability Performance competencies PC literate Microsoft Office products Project Coordination Cross-selling Disability +32

USD 71K+

QNXT Developer
Any city, TX, US, 99999

Gainwell Technologies

Web Forms Payer Systems Platform Configurations Qnxt Design and development .NET framework Posting Claims Adjudication Processes +36

Entry Mid Full Time

USD 61K+

Senior QNXT Developer
Any city, TX, US, 99999

Gainwell Technologies

Platform Configurations Web Forms Payer Systems Qnxt Design and development .NET framework Posting Claims Adjudication Processes +36

Senior Full Time

USD 61K+

Director, Technical Operations
United States

Navitus Health Solutions, LLC

Eligibility administration Vendor contract management Operational expertise Compliance oversight Regulatory Interpretation Financial controls Data reconciliation Claims Adjudication RDS +13

Exec Senior Full Time

USD 120K+

Supervisor - Claims Quality Assurance (Accountable Care)
Remote - USA, United States

Stanford Health Care

Staff Supervision C-i-care Operational reporting Claims Adjudication Audit Management Claims processing Medical terminology Training Development Performance Management +8

USD 121K+

Senior Management & Professional Liability Technical Claims Specialist
Remote

Claims Adjudication Professional liability Report Preparation Policy analysis Customer focus Claims management Investigation Time Management Negotiation +4

Senior Full Time

USD 100K+

Claims Systems Senior Analyst - eviCore - Remote
Tennessee Work at Home, United States

The Cigna Group

MPPR OPPS FFS MC400 MCNET Configuration design RC3 HCPC RBRVS +32

Senior Full Time

USD 53K+

Associate Director, Claims-Stop Loss
Sun Life Wellesley, United States

Claims-related software Stop loss claims Claims Adjudication Client Experience Internal Audit Claims processing Client service Audit Equity +17

Senior Mid Full Time

USD 99K+

Project Manager, Provider Services Operations
United States

Navitus Health Solutions, LLC

Pharmacy benefit services Client implementation Medicare part d Claims Adjudication Network Design Operational processes Credentialing Claims processing Health +13

USD 77K+

Claims Team Lead - Workers Compensation
Recruiting Only - Telecommuter, United States

Performance development Quality review Claims Adjudication Motivational Rehabilitation Interpretive Adjudication Performance competencies Keyboarding +33

Senior Mid Full Time

USD 65K+

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