Top 205 Blue cross blue shield Jobs

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Claims Adjuster I (Remote)
CareFirst BlueCross BlueShield —Washington, DC
- $36,576 - $67,056 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- 401(k)
Quick Apply
12d
Claims Recovery Specialist II (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $42,624 - $78,144 a year
- Full-time
- Remote
- Basic math
- Mid-level
- High school diploma or GED
- 401(k)
Quick Apply
13d
Clinical Appeals Nurse (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $67,320 - $133,705 a year
- Full-time
- Remote
- Nursing
- Addiction Medicine
- RN License
- 401(k)
Quick Apply
11d
Functional Analyst I (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $47,448 - $94,237 a year
- Full-time
- Remote
- Research
- Mid-level
- Analysis skills
- 401(k)
Quick Apply
7d
Payment Policy Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $58,320 - $115,830 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- Mid-level
- 401(k)
Quick Apply
14d
Regulatory Compliance Analyst (Remote) - Privacy
CareFirst BlueCross BlueShield —Baltimore, MD
- $54,864 - $108,966 a year
- Online Application
- Remote
- Research
- Mid-level
- Bachelor's degree
- 401(k)
Quick Apply
Payment and Medical Policy Coordinator (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $51,264 - $101,816 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Finance
- 401(k)
Quick Apply
14d
Claims Customer Service Advocate II
BlueCross BlueShield of South Carolina —Nashville, TN
- Full-time
- Hybrid work
- Basic math
- Research
- Mid-level
- Health insurance
- Dental insurance
Reimbursement Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $53,928 - $107,107 a year
- Full-time
- Remote
- Microsoft Word
- Microsoft Access
- Mid-level
Quick Apply
Clinical Medical Review Nurse (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $67,320 - $133,705 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- 401(k)
Quick Apply
5d
Technical Analyst (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $64,944 - $128,986 a year
- Full-time
- Remote
- Computer Science
- Mid-level
- Analysis skills
- 401(k)
Quick Apply
Broker Support Representative II (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $49,320 - $90,420 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- 401(k)
Quick Apply
General Clerk II (Hybrid)
CareFirst BlueCross BlueShield —Baltimore, MD
- $33,480 - $61,380 a year
- Online Application
- Mid-level
- Administrative experience
- High school diploma or GED
Quick Apply
Digital Case Manager
BlueCross BlueShield of Tennessee —Chattanooga, TN
- Full-time
- Remote
- RN License
- Computer literacy
- Mid-level
7d
Auditor (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $50,904 - $101,101 a year
- Online Application
- Remote
- CPA
- Mid-level
- Finance
Quick Apply
Claims Processor I
BlueCross BlueShield of South Carolina —Columbia, SC
- Full-time
- Customer service
- Word processing
- Basic math
- Health insurance
- Dental insurance
Operations Supervisor - Government Programs Mail Room (In Office)
CareFirst BlueCross BlueShield —Baltimore, MD
- $63,648 - $131,274 a year
- Full-time
- Mid-level
- Office
- 3 years
Quick Apply
Business Consultant (Remote)
CareFirst BlueCross BlueShield —Reston, VA
- $88,848 - $176,462 a year
- Online Application
- Remote
- Mid-level
- Bachelor's degree
- Continuous improvement
- 401(k)
Quick Apply
Processor, Claims I-2
BlueCross BlueShield of South Carolina —Florence, SC
- Full-time
- Customer service
- Word processing
- Basic math
- Health insurance
- Dental insurance
6d
Account Advisor I - Call Center
BlueCross BlueShield of Louisiana —Louisiana
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Medical office experience

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Claims Adjuster I (Remote)

CareFirst BlueCross BlueShield -
Washington, DC

Quick Apply

Job Details

Full-time
$36,576 - $67,056 a year
12 days ago

Benefits

401(k)

Qualifications

Customer communication
High school diploma or GED
Investigative data analysis
Internal employee customer service

Full Job Description

Resp & Qualifications

PURPOSE:
Investigate and perform adjustment of claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines. Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records.

ESSENTIAL FUNCTIONS:

Proactively investigate and perform adjustments of claims. Ensure claims are handled within authority limits, and in line with standard procedures and guidelines.
Updates claims audit records by entering, verifying, and securing data.
Settle standard/complex claims through payment or denial.
Provides claims audit information and reports by collecting, analyzing, and summarizing data and trends.
Improves claims adjustment job knowledge by attending training sessions.

QUALIFICATIONS:

Education Level: High School Diploma or GED.

Experience: 3 years claims experience and complete understanding of all systems, policies and procedures.

Preferred Qualifications:

Above Target performance rating preferable.

Knowledge, Skills and Abilities (KSAs)

Ability to analyze information gathered from investigation.
Excellent communication skills both written and verbal.
Ability to recognize, analyze, and solve a variety of problems.
Skill in completing assignments accurately with attention to detail.

Salary Range: $36,576 - $67,056

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

#LI-LY1

Quick Apply

Refine Your Search

blue cross blue shield jobs

Claims Adjuster I (Remote)

Claims Recovery Specialist II (Remote)

Clinical Appeals Nurse (Remote)

Functional Analyst I (Remote)

Payment Policy Analyst (Remote)

Regulatory Compliance Analyst (Remote) - Privacy

Payment and Medical Policy Coordinator (Remote)

Claims Customer Service Advocate II

Reimbursement Analyst (Remote)

Clinical Medical Review Nurse (Remote)

Technical Analyst (Remote)

Broker Support Representative II (Remote)

General Clerk II (Hybrid)

Digital Case Manager

Auditor (Remote)

Claims Processor I

Operations Supervisor - Government Programs Mail Room (In Office)

Business Consultant (Remote)

Processor, Claims I-2

Account Advisor I - Call Center

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