Top 30 Adjudicator Jobs

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
Adjudicator, Provider Claims - Remote Ohio on the phone-closing shift
Molina Healthcare —Ohio
- $16.40 - $31.97 an hour
- Full-time
- Remote
- Research
- Mid-level
- Organizational skills
- Health insurance
13d
Adjudicator
Protection Strategies Inc —Washington, DC
- $90,000 - $100,000 a year
- Full-time
- 5 years
- Writing skills
- Pass drug screening
- Commuter assistance
- Health savings account
Quick Apply
Disability Claims Adjudicator
State of Indiana —Indianapolis, IN
- From $47,320 a year
- Background check
- Physical & Rehabilitation Medicine
- Research
- Free parking
- Paid parental leave
5d
Warranty Claims Adjudicator
Infosys —Peoria, IL
- Management
- Office
- Microsoft Office
Quick Apply
Associate Disability Adjudicator
State of New Mexico, DVR Disability Determination Services —Albuquerque, NM
- $21.96 - $32.94 an hour
- Online Application
- Customer service
- No background check
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Senior Security Adjudicator
One Federal Solution —Washington, DC
- Full-time
- 5 years
- Analysis skills
- Psychology
Quick Apply
Student and Exchange Visitor Program (SEVP) Adjudicator
US Immigration and Customs Enforcement —Vienna, VA
- $85,447 - $158,322 a year
- Online Application
- Background check
- Psychiatry
- Pass drug screening
- Paid holidays
- Loan repayment program
14d
Accounts Payable Claims Adjudicator
Gulfside Healthcare Services, Inc. —Land O' Lakes, FL
- Background check
- Mid-level
- High school diploma or GED
Quick Apply
Claims Adjudicator
BEST DOCTORS INSURANCE SERVICES LLC —Miami, FL
- Spanish
- Microsoft Excel
- English
Quick Apply
14d
Adjudicator - TS/SCI w/Poly
General Dynamics Information Technology —Chantilly, VA
- $80,750 - $109,250 a year
- Mid-level
- No travel
- 2 years
- 401(k) matching
7d
Claims Adjudicator
National Healthcare Solutions, Inc. —Miami, FL
- Full-time
- Spanish
- Customer service
- Data analysis skills
Quick Apply
Temporary Ballot Tabulation Center (BTC) Adjudicator
Maricopa County —Phoenix, AZ
- $18 an hour
- Overtime
- Background check
- Spanish
- Customer service
Adjudicator
The State of Oklahoma —Oklahoma County, OK
- $20.83 an hour
- Full-time
- Spanish
- Microsoft Excel
- Microsoft Outlook
UI Adjudicator
State of Nebraska —Lincoln, NE
- $21.33 an hour
- Full-time
- Word processing
- Computer literacy
- Basic math
- Paid holidays
- Health insurance
6d
Claims Adjudicator III
UNITE HERE HEALTH —Oak Brook, IL
- $23.79 - $29.13 an hour
- Full-time
- Hybrid work
- Microsoft Outlook
- HIPAA
- Research
- Commuter assistance
- AD&D insurance
Quick Apply
Temporary Ballot Tabulation Center (BTC) Adjudicator
Maricopa County, AZ —Phoenix, AZ
- $18 an hour
- Overtime
- Background check
- Spanish
- Customer service
26-033 - Medical Billing Adjudicator
Chesapeake Employers Insurance Company —Towson, MD
- $21.14 - $31.70 an hour
- Full-time
- Hybrid work
- Bilingual
- Mid-level
- Office
- Disability insurance
- Health insurance
Quick Apply
3d
Claims Adjudicator II
UNITE HERE HEALTH —Oak Brook, IL
- $20.36 - $24.97 an hour
- Full-time
- Mid-level
- 3 years
- Experience equivalent to degree accepted
- Commuter assistance
- AD&D insurance
Quick Apply
UI CLAIMS ADJUDICATOR
State of Idaho —Boise, ID
- $23.91 an hour
- Full-time
- Background check
- Spanish
- English
- Paid parental leave
- Paid holidays
3d

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Claims Adjudicator

WellSense Health Plan -
Remote

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Job Details

Full-time
$18.27 - $25.72 an hour

Benefits

Health insurance
Dental insurance
Flexible spending account
Paid time off
Vision insurance
403(b)
Opportunities for advancement

Qualifications

High school diploma or GED

Full Job Description

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

Responsible for the accurate and timely processing of claims. Must meet published quality and productivity standards. Also, responsible for simple adjustments to previously processed claims.

Our Investment in You:

Full-time remote work

Competitive salaries

Excellent benefits

Key Functions/Responsibilities:

Evaluates and processes claims in accordance with company policies and procedures according to productivity and quality standards.

Interprets and processes routine and less complex claims including CMS 1500 and UB04.

Reviews and analyzes data from system-generated reports for in-process claims in order to identify and resolve errors prior to final adjudication.

Alerts claims management to claims aging issues as well as provider billing problems.

Maintains current knowledge of company members' benefits, policies/procedures, provider network development and contract issues, processing system issues, Massachusetts Medicaid regulations, as well as industry standards for claims adjudication.

Consistently maintains production standards based on transactions/units per hour

Consistently meets quality standards

Qualifications:

Education:

High School degree or equivalent required.

Associate degree or some college coursework preferred.

Experience:

Two years or more years experience in managed care claims processing preferred.

Competencies, Skills, and Attributes:

Working knowledge of medical terminology as well as CPT4, HCPCS and ICD9 coding sets and HIPAA regulations.

Familiarity with UB04's and CMS 1500's

Knowledge of Microsoft Office and FACETS preferred.

Ability to maintain production level and quality goals.

Follow through on commitments and meets deadlines

Work is thorough, accurate, and effective.

Demonstrates ability to complete assigned work in a timely fashion.

Working Conditions and Physical Effort:

Ability to work OT during peak periods.

Compensation Range

$18.27- $25.72

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Note: This range is based on Boston-area data, and is subject to modification based on geographic location.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

Apply Now

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