Top 13 Claims examiner remote Jobs in Kaiser Ca

Xcelys Medical Claims Examiner-REMOTE
NTT DATA —Ontario, CA
- $20 an hour
- Contract
- Remote
- High school diploma or GED
- Analysis skills
- Continuous improvement
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Xcelys Medical Claims Examiner (Remote)
NTT DATA —Ontario, CA
- $20 an hour
- Contract
- Remote
- Mid-level
- High school diploma or GED
- Analysis skills
- Health savings account
- AD&D insurance
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7d
Claims Examiner - Workers Compensation (On-Site Ontario, California)
Sedgwick —Ontario, CA
- Full-time
- Hybrid work
- Mid-level
- 3 years
- High school diploma or GED
- Health savings account
- Disability insurance
Workers' Compensation Claims Examiner
JT2 Integrated Resources —California
- From $90,000 a year
- Full-time
- Mid-level
- 3 years
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
Workers Compensation Claims Examiner | Ontario, California
Sedgwick —Ontario, CA
- Full-time
- Hybrid work
- Customer service
- 5 years
- Office
- Health savings account
- Disability insurance
Workers Compensation - Claims Examiner | HYBRID | Riverside, CA
Sedgwick —Riverside, CA
- Full-time
- Hybrid work
- Background check
- Customer service
- 5 years
- Health savings account
- Disability insurance
Quick Apply
Senior Claims Examiner, Workers' Compensation
Gallagher —Corona, CA
- $71,500 - $102,000 a year
- Remote
- 5 years
- High school diploma or GED
- Bachelor's degree
Claims Supervisor, Workers' Compensation
Gallagher —Corona, CA
- $70,500 - $137,500 a year
- Remote
- Management
- High school diploma or GED
- Analysis skills

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Property & Casualty Claims Advocate - Remote - California
Insurance Relief —California
Analyze complex claims and coverage issues and implement strategies for resolution with producers and service teams. Generous paid time off and paid holidays.
$90,000 - $125,000 a year
Quick Apply
Senior Customer Service Representative
Optum —Los Angeles, CA
Ability to interpret provider and health plan contracts to ensure accurate responses to calls. Maintain minimum standards for the department for quality and…
$18 - $32 an hour
3d

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Xcelys Medical Claims Examiner-REMOTE

NTT DATA -
Ontario, CA

Quick Apply

Job Details

Contract
$20 an hour

Qualifications

Pricing
Regulatory compliance in claims processing
Medical claims processing software
ICD-10
HCPCS
Legal compliance

Full Job Description

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company’s growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

NTT DATA Services currently seeks Xcelys Medical Claims Examiners to join our team remotely for a 6-12 month contract role.

MUST HAVE XCELYS EXPERIENCE

To serve as a Medical Claims Processor within the Xcelys environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations.

Role Responsibilities:

Adjudication & Review

Process comprehensive medical claims using Xcelys and associated subsystems
Resolve complex pends, coding issues, and contract exceptions
Author overpayment/underpayment determinations and coordinate appeals

Quality & Compliance

Engage in quality reviews, audits, root cause analyses
Monitor accuracy, variance, and rework metrics
Ensure alignment with regulatory and internal compliance guidelines

Support

Act as escalation point and subject matter expert

Process & System Improvement

Participate in system testing, UAT, and workflow enhancements
Recommend improvements, document system and process changes

Reporting & Analytics

Prepare production, pending, and quality reports
Identify trends and recommend corrective actions

Cross-Functional Collaboration

Liaise with provider relations, legal, IT, compliance teams
Support internal initiatives related to claims systems / operational improvements

Required Skills/Experience

5+ years claims adjudication experience
Minimum of 1 year experience in Xcelys
2+ years in coding (CPT, ICD-10, HCPCS)
2+ years provider contracts, pricing, regulatory guidelines experience

Preferences

Excellent analytical and communication skills
Experience training staff or acting as a mentor
Familiarity with system testing and documentation
Ability to manage high-volume workload and meet performance metrics

Education: Verifiable high school diploma or GED

About NTT DATA Services:

NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is ($20/hourly ). This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

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Refine Your Search

claims examiner remote jobs in kaiser ca

Xcelys Medical Claims Examiner-REMOTE

Xcelys Medical Claims Examiner (Remote)

Claims Examiner - Workers Compensation (On-Site Ontario, California)

Workers' Compensation Claims Examiner

Workers Compensation Claims Examiner | Ontario, California

Workers Compensation - Claims Examiner | HYBRID | Riverside, CA

Senior Claims Examiner, Workers' Compensation

Claims Supervisor, Workers' Compensation

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