Top 224 disability adjudication services Jobs in remote

Assistant Medical Director
Medical Mutual of Ohio —Ohio
- Remote
- Medicine
- 5 years
- Word processing
- Health savings account
- Disability insurance
Patient Advocate Representative
Claritev —Remote
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- Full-time
- Bilingual
- Computer literacy
- Bachelor of Science
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Claims - Claims Examiner
Wellcove —Remote
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- Microsoft Excel
- Microsoft Outlook
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Payment Accuracy Specialist 2
Cotiviti —Remote
- $29 - $33 an hour
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
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- Disability insurance
Pharmacy Operations Specialist (TEMP)
WellSense Health Plan —Remote
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- Temporary
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11d
Human Resources Representative
Ross Stores —Remote
- $23.08 - $31.73 an hour
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- Microsoft Word
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2d
Associate Director, Patient Recruitment Partnerships
Care Access —Remote
- $115,000 - $145,000 a year
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- 6 years
- Marketing
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Revenue Cycle Specialist
Cotiviti —Remote
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- Full-time
- Remote
- Computer literacy
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- Mid-level
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- Disability insurance
3d
IT Support Technician
IronEdge Group, LTD —Remote
- $38,000 - $42,999 a year
- Full-time
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- Background check
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Quick Apply
2d
Senior Coordinator, Human Resources
Ross Stores —Remote
- $23.08 - $31.73 an hour
- Remote
- Microsoft Word
- Background check
- Microsoft Excel
2d
Claims Processor
Zenith-American —Remote
- Full-time
- Computer literacy
- Writing skills
- Basic math
- AD&D insurance
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IT Support Technician
IronEdge Group —Remote
- $38,000 - $42,999 a year
- Full-time
- Remote
- Background check
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- Health savings account
- AD&D insurance
Quick Apply
3d
Insurance Claims Specialist HB
SYSTEM West Virginia University Health System —Remote
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Intake Specialist - Revenue Cycle Management
Vital Care Infusion Services —Remote
- $18.92 - $23.46 an hour
- Full-time
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- Writing skills
- English
- Mid-level
- Health savings account
- Paid holidays
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Senior Property Claim Specialist - Homeowners and Dwelling Fire
Kingstone Insurance Company —Remote
- $80,000 - $95,000 a year
- Full-time
- Remote
- Computer literacy
- Writing skills
- Data analysis skills
- Paid parental leave
- Paid holidays
Quick Apply
Auditor
Contact Government Services, LLC —Remote
- $50,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Appeals and Grievances Coordinator
Avesis, Incorporated —Remote
- $18.33 - $35.84 an hour
- Email
- Writing skills
- HIPAA
- Mid-level
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- Disability insurance
Manager of Member and Provider Service
WellSense Health Plan —Remote
- $69,500 - $101,000 a year
- Full-time
- Background check
- 5 years
- Bachelor's degree
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Training Instructor
EnableComp —Remote
- Full-time
- Classroom
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Claims Adjudicator
WellSense Health Plan —Remote
- $18.27 - $25.72 an hour
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
4d

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disability adjudication services jobs near remote

Assistant Medical Director

Medical Mutual of Ohio -
Ohio

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Job Details

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Parental leave
Employee assistance program
Vision insurance
401(k) matching
Gym membership

Qualifications

BC/BE
Patient care

Full Job Description

**Medical Mutual employees must submit their applications through MySource.

**This is a remote-based role, and we are currently seeking candidates located in Ohio.

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Job Summary:

Provides clinical expertise to promote the delivery of high quality, cost effective, (member centric) medical care. Contributes to the achievement of clinical excellence; quality ratings improvement, appropriate inpatient and outpatient utilization, affordability, compliance, growth and focused improvement, and that initiatives are consistently implemented and successfully executed to achieve goals.

Responsibilities:

Provides clinical expertise to the utilization review process and determinations.
Provides pre-determination reviews and reviews of claims determinations, providing clinical, coding and reimbursement expertise.
Ensures compliance with clinical goals through monitoring of care management performance.
Ensures the appropriate and most cost-effective medical care is received.
Recommends changes and enhancements to current managed care, review guidelines, and clinical criteria based on clinical knowledge of health care delivery systems, utilization methods, reimbursement methods and treatment protocols.
Assists in development and interpretation of medical policy, including medical necessity criteria, clinical practice guidelines, and new technology assessments.
Provides guidance to case management team in the coordination of quality care.
Performs other duties as assigned.

Qualifications:

Education and Experience:

Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited medical school.
Minimum of 5 years of established (clinical) care practice experience required.
Physician reviewer experience in the insurance industry preferred.

Professional Certification(s):

Board Certification, in nationally recognized specialty (ABMS or AOA) is required.
Active unrestricted license to practice medicine in U.S state of residency.

Technical Skills and Knowledge:

Foundational windows-based computer skills, including typing, word processing, presentation, and internet research skills.
Strong understanding of integration of evidence-based medicine and managed care principles.
Knowledge of health plan claims adjudication and utilization review processes preferred.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
Discounts at many places in and around town, just for being a Medical Mutual team member.
The opportunity to earn cash rewards for shopping with our customers.
Business casual attire, including jeans.

Excellent Benefits and Compensation:

Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

Career development programs and classes.
Mentoring and coaching to help you advance in your career.
Tuition reimbursement up to $5,250 per year, the IRS maximum.
Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual’s status as a mutual company means we are owned by our policyholders, not stockholders, so we don’t answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There’s a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We’re not just one of the largest health insurance companies based in Ohio, we’re also the longest running. Founded in 1934, we’re proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

#LI-CS1 #LI-REMOTE

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

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Refine Your Search

disability adjudication services jobs in remote

Assistant Medical Director

Patient Advocate Representative

Claims - Claims Examiner

Payment Accuracy Specialist 2

Pharmacy Operations Specialist (TEMP)

Human Resources Representative

Associate Director, Patient Recruitment Partnerships

Revenue Cycle Specialist

IT Support Technician

Senior Coordinator, Human Resources

Claims Processor

IT Support Technician

Insurance Claims Specialist HB

Intake Specialist - Revenue Cycle Management

Senior Property Claim Specialist - Homeowners and Dwelling Fire

Auditor

Appeals and Grievances Coordinator

Manager of Member and Provider Service

Training Instructor

Claims Adjudicator

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